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Caring for Pregnancy Loss

Understanding, Supporting, and Navigating Through Grief

Written by Evelyn Gama, LCSW

Perinatal Therapist at The Motherhood Center of New York

Pregnancy loss is a profoundly emotional experience that affects not only the birthing person but also the entire family system. Pregnancy loss is marked by grief, trauma, and complex emotions that often go unrecognized by the family’s larger community. In this blog post, we will explore the basics of pregnancy loss, recognizing its symptoms and understanding its mental health implications. We will discuss appropriate supports, including the importance of rituals and anniversaries in grief integration and navigating pregnancy after loss.

Understanding Pregnancy Loss

While we often think of pregnancy loss as monolithic, the term encompasses many different experiences. This includes loss of embryos in fertility treatments, miscarriages, ectopic pregnancies, medically necessitated and other abortions, stillbirths, and neonatal deaths. Pregnancy loss occurs in 10-25% of all pregnancies. Rates vary depending on gestational age, with disparities observed across racial and socioeconomic lines. It’s crucial to recognize that women of color, particularly non-Hispanic Black women, face higher rates of pregnancy loss, highlighting the importance of culturally competent care and support.

Recognizing Symptoms and Effects of Grief

Pregnancy loss represents the loss of not only a pregnancy but also the person’s associated hopes, dreams, and expectations for this baby. The associated grief manifests differently for everyone. In pregnancy loss, the birthing person experiences physical symptoms such as fatigue, bleeding, physical healing, and hormonal shifts alongside emotions such as shock, sadness, guilt, anger, and isolation.

Grief symptoms are the mind’s usual way of integrating the loss and should not be pathologized. Instead, the birthing person and family should be supported and cared for on the timeline and in ways they find comforting. This might include physical support—making meals, helping with other children, spending time together—or being present by text, phone, or in person as the family heals and recognizes any milestones or anniversaries, such as planned ultrasounds or due dates.

Supporting Mental Health Needs

While grief is normal, some individuals who experience pregnancy loss develop symptoms of depression, anxiety, or PTSD. There is no timeline for grief in which a person or family should have “moved on.” However, a referral for support can be made if a birthing person or those caring for them identify symptoms of mental health complications. Effective treatment involves addressing both the symptoms and the underlying grief, utilizing therapeutic interventions, peer support groups, and culturally sensitive approaches to care.

Navigating Pregnancy After Loss

Pregnancy after loss is fraught with conflicting emotions, ranging from hope and anticipation to fear and anxiety. As providers, we can acknowledge and validate these feelings, providing personalized support that respects the individual’s unique journey and coping mechanisms. Partnering with clients, understanding their beliefs, and allowing them to lead the conversation fosters a supportive environment. Examples include asking open-ended questions: “Tell me about your loss,” “Tell me about your feelings associated with this new pregnancy,” and mirroring the individual’s language. Use the previous baby’s name if they do. Listen for important dates for them.

Importance of Rituals and Anniversaries

Rituals and anniversaries play a crucial role in grieving, providing opportunities for remembrance, reflection, and healing. Recognizing significant dates and supporting clients in planning meaningful rituals or self-care activities fosters a sense of validation and empowerment, enabling them to navigate grief on their own terms.

Cultural Considerations and Barriers to Support

Cultural beliefs and practices shape individuals’ experiences of pregnancy loss, influencing perceptions of grief, rituals, and support-seeking behaviors. As providers, we must approach care with cultural humility, respect diverse perspectives, and understand the unique challenges and stigmas different communities face. This includes not imposing our own religious or cultural beliefs or projecting our own meaning onto the loss with statements such as “It was God’s will” or “It wasn’t your time.”

Caring for pregnancy loss requires a holistic approach that encompasses medical, emotional, and cultural considerations. Remember that many of these families lost not just a pregnancy but a baby that was very real to them. Others lost the expectation and hope of an uncomplicated pregnancy journey. We serve families best when we seek to meet them where they are and hold space for their unique experiences. By recognizing the diverse experiences of individuals and families affected by pregnancy loss and providing compassionate, culturally competent support, we can help navigate the journey of grief and healing with empathy and understanding.

The Motherhood Center of New York: Your partner in perinatal mental health care.
Whether your patient is experiencing mild, moderate, or severe symptoms of a perinatal mood and anxiety disorder (PMAD), you need a trusted partner you can refer them to.

The Motherhood Center is the only New York State Office of Mental Health Article 31 Perinatal Partial Hospitalization Program (Day Program). Our multidisciplinary team of perinatal mental health experts provides a range of treatment options based on empirically proven best practices and the unique needs of each new or expecting mother.

Refer your patients to The Motherhood Center using our online referral form or by calling/faxing your referral today. P: (212) 335-0034 F: (212) 202-4369

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