Many times people who have experienced perinatal loss don’t talk about it. Well, today we are changing that!
Losing a baby through miscarriage or stillbirth can have devastating effects on your mental health—but you’re not alone. This week, we explore the way perinatal loss impacts your mental health and ways you can cope.
Savvy Psychologist is hosted by Dr. Monica Johnson. A transcript is available at Simplecast.
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Based on listener requests, today we are going to talk about perinatal loss—that is, the loss of a baby before birth. It’s such a devastating experience when it happens to you, especially because it can feel very isolating. But it’s more common than you think—many times people who have experienced perinatal loss don’t talk about it. Well, today we are changing that!
Welcome back to Savvy Psychologist. I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
When we talk about perinatal loss, we usually use two different words to describe it: miscarriage and stillbirth. Both miscarriage and stillbirth describe pregnancy loss, but they differ according to when the loss occurs. In the United States, a miscarriage is usually defined as the loss of a baby before the 20th week of pregnancy, and a stillbirth is the loss of a baby at 20 weeks of pregnancy and later.
Both miscarriage and stillbirth are more common than you might think. Each year about 24,000 babies are stillborn in the United States—approximately 1 pregnancy out of 100 that make it to 20 weeks or later will end in stillbirth. For women who know they’re pregnant, about 10 to 20 percent end in miscarriage, and many women miscarry without even realizing they were pregnant. 80 percent of miscarriages happen in the first trimester before the 12th week of pregnancy. A study from the CDC found that Black mothers were more than twice as likely to experience stillbirth compared to Hispanic and white mothers. While they didn’t have a full explanation for these racial disparities, they noted that improvements in women’s health, with regular access to quality prenatal care, can potentially reduce the risk of stillbirth for women and families.
Perinatal loss can have a lasting impact on women's mental health: 55% of women who experienced a loss presented symptoms of depression, 27% presented perinatal grief, and more than 18% reported moderate anxiety. If you experience repeated pregnancy loss then the effects can be even greater in some cases, and can lead to feelings of discouragement and emotional pain as well as an increased risk of anxiety, depression, grief, guilt, and anger. Symptoms of moderate or severe depression are present in about 10% of affected couples, and high stress levels are reported in more than 40% of patients with recurrent pregnancy loss.
When compared to women with one previous miscarriage, those with repeated pregnancy loss display symptoms of both depression and stress, for a longer time, and experience a greater negative impact on their mental health during subsequent pregnancies.
Recurrent miscarriage affects not only the woman who miscarried but also, in cishet relationships, her male partner. If we compare the effects of recurrent miscarriage, nearly 73% of the affected women and 66% of their male partners revealed a risk of anxiety; and 51% of women and 19% of their male partners presented a risk of depression. This is important to make note of because men and women are typically socialized to convey grief and other mental health concerns differently. If you know a couple that has experienced perinatal loss, check in with all members of the relationship. If you’re in the relationship yourself, please recognize that both you and your partner are suffering even if it doesn’t always seem that way from your perspective.
Other symptoms that you may see in yourself, your partner, or other loved one include: a loss of interest in daily activities, strain in your personal relationships, social isolation, difficulty thinking about anything other than your loss, difficulty focusing or completing tasks, changes in appetite/weight, increased use of drugs and alcohol, feelings of anger/guilt/pessimistic outlook/worthlessness/bitterness, sleep disturbances, and thoughts of suicide.
One of the reasons why coping with perinatal loss is so difficult is that our reproductive story has been altered. Our reproductive stories are our narratives of parenthood. They involve all our hopes, dreams, and the imagined future we’ve created when it comes to parenthood and having children. When we lose a baby during pregnancy or the delivery, that imagined future feels snatched, those dreams are crushed, and we wonder if we can regain what we have lost. The wonderful thing is that the reproductive story can be rewritten. In therapy, you can work through your grief and loss, accept that your story can be edited, and leave with a positive new ending that acknowledges and validates your experiences and leaves space for a hopeful new beginning.
In terms of your relationship, be curious about your partner's experience. Allow space for both of you to express yourselves fully. This is a process, so having patience and compassion for yourself and your partner is paramount. You may also want to acknowledge that your experience may be different from theirs or that you may be experiencing similar feelings internally, but how they are shown externally might be different.
It’s also helpful to have rituals that allow you all to move through the grief process. This can include things like journaling, eating meals together, going for walks, and attending a support group for those who have experienced perinatal loss. Having a community is one of the best ways you can support yourself. While it may feel overwhelming at times and counterproductive, talking about your experience and allowing others to provide support aids you in moving forward. The March of Dimes, International Stillbirth Alliance, Compassionate Friends, and RTZHope are all examples of organizations you can explore for additional resources on this topic.
As always, I’m wishing you well as you begin to write the next chapter of your story.
What is a resource that helped you cope with perinatal loss? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191.