Perinatal loss: loss occurred at any time during pregnancy until the first month of the baby’s life, which includes: spontaneous or induced abortions, ectopic pregnancy, selective reduction (induced abortion of one or more fetuses in a multiple pregnant woman), death of a twin in pregnancy, dead fetus in utero or during childbirth, death of premature or newborn. As well as the transfer of a child for adoption.
Perinatal grief: Natural response of parents and family members to a perinatal loss. It implies the loss of other aspects, eg, truncated expectations, loss of the projected child, loss of a stage of life and identity as a parent, grieving for infertility, loss of sharing the experience with the environment that does have or expect children…
It is considered that 22 percent of mothers who have had a perinatal loss suffer from a psychological disorder such as depression or anxiety, and 15-20 percent of couples have problems overcoming grief.
Although there is no agreement about when the perinatal grieving process ends, there are authors who claim that it can last from two to four years, although after six months-a year of the event it is no longer the center of the emotional life of parents.
- Emotional: Sadness, hope, guilt, rage, self-criticism, hopelessness, intense fear/panic, loneliness, internal emptiness, relief, in cases of unwanted pregnancies or risk pregnancies, feeling of socially unauthorized grieving.
- Physics: Pain. Sleep and eating disorders. Tiredness, fatigue, weakness. Gastric discomfort. Chest tightness. Nose in the throat. Difficulty swallowing or speaking. Air shortage. Hypersensitivity to noise.
- Cognitive: Search for the meaning of the loss. Ambivalence before the idea of a new pregnancy. Mental block. Disbelief. Confusion. Disorganization. Difficulties of attention, concentration and memory. Recurring thoughts and images.
- Perceptive: Pseudo-visual hallucinations, auditory or phantom fetal movements. Dreams related to the baby and perception of slowing down time.
- Behavioral: Detachment and social avoidance, especially of pregnant women and babies. Hyperactivity or hypoactivity. Maintaining the connection with the lost baby.
Grief process in perinatal loss
- Stunning and shock: Anxiety, crying, despair, aggressiveness, lightheadedness and disbelief appear as frequent symptoms.
- Avoidance and denial: Minimization of the importance of the loss may occur, maintenance of the activity to handle the symptoms, guilt with ruminant thinking, replacement of the loss by deciding to have another child immediately, social isolation, trying to clarify the loss looking for the causes and possible culprits, etc.
- Connection and integration: At this stage parents may not resist so much resistance to openly expressing their feelings. They feel the need to talk about what happened, about their relationship with the baby and what they miss. They no longer blame or hold anyone responsible. The sadness and the rituals of connection with the baby appear: visit or walk around the place where your body is, plan a small family ceremony on the day of your anniversary…
- Growth and transformation: Integration and changes appear, continuously extracting the fruits of the lost relationship and its application in the present and future life.
What can be done if we are close to a person who is going through a perinatal duel?
- Allow the emotional expression of the loss and normalize the reactions. Listen without judging your feelings, or interpret them. Listen, rather than talk. Facilitate communication with questions about your mood. Ask how they can be helped, not try to guess their needs.
- Support both partners equally. It is often considered that parents do not suffer, nor should they cry or show their pain. Likewise, mothers are often ignored in administrative procedures. Both attitudes involve an exclusion in matters related to their babies and can constitute risk factors for the development of a complicated duel.
- Favor the company of close relatives if parents wish, since for grandparents and other relatives it is also a loss. Like ensuring the privacy of parents and relatives to facilitate farewell and grief.
- Parents sometimes have not thought if they want have memories or if they want to name their baby. The decisions they make should be supported, since the possibility of obtaining and conserving objects related to the newborn may be important; However, you also have to respect that some parents do not want to interact with their baby, take pictures, keep memories or hold a funeral.
- Avoid phrases made: “Do not worry, you will have another baby”; “Look on the bright side, I would have been born with serious problems…”; “You must be strong for your other child/family…”; “It is the will of God”; “time heals everything” and blaming phrases: “I should have come to the hospital before…”; “I shouldn’t have taken the medication…”
- Do not must be recommend a new pregnancy until there has been a physical and psychological recovery. Pregnancy after perinatal loss is associated with an increase in maternal anxiety and emotional vulnerability, especially when the interval between pregnancies is short. The waiting period after a loss is variable, therefore, dogmatic recommendations cannot be established in this regard and the waiting period will depend on different individual factors.
California University Hospital