Sharing about loss during pregnancy
Pregnancy can be a life-changing experience, bringing in excitement as well as many challenges that those who are expecting might not be entirely prepared for. They can experience a multitude of feelings from excitement, joy, happiness, worry, fear, disappointment. No one feeling is more acceptable than the other. No one ALWAYS feels positive throughout this journey.
For the expectant looking after their emotional health becomes as important as taking care of their physical health during and after they give birth. Mental health is a state of wellbeing where we feel satisfied, connected, and alive. Many things can impact how the individual feels, acts, behaves ranging from their physical health, support systems, stressful life events/circumstances like socio-economic status, violence and abuse, HIV/Aids, adolescent pregnancy, unplanned pregnancy, substance use, divorce/separation. 1 in 3 to 1 in 5 persons in developing countries, and about 1 in 10 in developed countries, have a significant mental health problem during and after childbirth (1), making it even more important to be vigilant if their discomfort is increasing
There may be many pressing questions running through their minds – Will everything turn out to be, okay? Will they become good parents? What if something they do harms the baby? Will they be able to provide for their needs? Are they capable enough to handle this? Feeling doubtful/anxious/sad is valid.
The body goes under numerous changes during and after pregnancy, and pregnancy hormones such as estrogen and progesterone can contribute to a mix of emotional highs and lows. Women ‘s changing body shapes can also impact how they feel internally. Some women may feel comfortable and happy about changes in body weight while others may really feel anxious about not fitting into the portrayal of “perfect pregnant women body contours.” It is important for them to accept and embrace their body.
Relationship dynamics between partners changes from being a couple to preparing for parenthood. Some partners can become overprotective, both can become anxious about being a parent, or worry about losing our appeal to our partner. There can also be changes in your sex drive during this period. It is always a good idea to talk about their feelings with each other rather than holding back these conversations, which can bring in distress.
Keep a close check on what is happening for you during this time- How have you been feeling? What are these feelings trying to tell you? What are they asking for you to do? Do you feel the need for some more support? Are you finding it difficult to manage yourself? Do you feel the impact of your worries and anxieties growing? Are you feeling guilty and shameful for experiencing these unpleasant feelings often enough when you are expected to stay happy? Rather than hesitating to ask for more help, support, and care, they should start taking active action to take care of their mental health
Pregnancy and Loss:
It doesn’t matter at which stage of pregnancy this occurs or why, miscarriages, still birth, intrauterine death, leaves a grave impact on parents, family, and friends.
Becoming pregnant starts changing a woman’s relationship with her body. They may begin eating healthy, get enough sleep, and start caring for this new life. Miscarriage leads to a breach of this self-trust and self-compassion, experiencing a range of emotions (guilt/shame/anger) towards themselves and their body for not being able to sustain the pregnancy and save the child. One may feel empty inside. The term ‘Miscarriage’ can itself be stigmatizing as it places the fault on the expecting women failing to carry something. Most miscarriages happen because the fetus is not developing healthy – not because of anything the woman did or did not (Mayo Clinic). Women tend to start bonding with the child at an early stage, but their partners may take longer. This can also lead to differences in the levels of loss in both the partner’s experience. Sometimes they may care more about the women’s health leading the women to wonder why they don’t seem to experience the loss of this child making them feel isolated in this loss.
Losing a baby to stillbirth can be incredibly painful. After dealing with the initial shock of losing a baby, a person might experience conflicting emotions as they adjust to the unexpected reality of life without the baby they were waiting for so eagerly. Not only do they require time to physically adjust back to their bodies but also requires time for them to heal emotionally. It may not only feel as a loss of a baby but for the expecting it can also signify the loss of a part of themselves. Nearly 2 million babies are still born (WHO), yet the grief associated with this loss is not recognized enough.
The experience of grief after the loss is different for every couple. Some of the ways that grief might look like are shock and denial, anger, depression, despair, and acceptance. We need to acknowledge the grief, understand and empathize with the loss to create an ecosystem of care and support for the bereaved.
Working toward recovery might look like
1. Allowing yourself to feel: Try not to push away your feelings. Try not to force yourself to feel happy or rush yourself in anyway.
2. Expressing yourself: Both the partners might be grieving differently. It is helpful to find ways to express how you have been feeling with your closed ones.
3. Letting others help you: Many friends and family members can be supportive during this process. Allow yourself to get this invaluable support.
4. Honoring the pregnancy/baby: Acknowledge that the pregnancy existed. Many find it healing to memorialize their pregnancy in some way- by having a goodbye ceremony, writing a farewell letter, planting a tree, making a scrapbook from the items during pregnancy, naming the baby. Find your way
5. Taking care of your body: Sleep well, eat healthy meals, do something engaging during the day, find time to relax, limit caffeine intake.
6. Finding a support group: The journey can become more comfortable if we are able to take it along with others who are in the same boat and in the process of grieving. Giving us the possible hope of us coming through this.
7. Seeking Information: Knowing about what happened and the potential future implications can give us more clarity. For eg knowing: When can you try again? Will you be able to get pregnant?
8. Seeking Professional Support: Even after giving yourself time and patience, but still find this grief to be looming around for an extended period, it can become concerning. If there is persistent sadness/crying, feeling worthless and hopeless, loss of interest in activities, lack and energy/tiredness, disturbed sleep, difficulty managing your day-to-day work, thinking about suicide/self-harm consider visiting a counselor or a mental health professional, as experiencing mental health concerns is not uncommon.
Grieving about the loss is not a linear process. One day you might feel better, other days may seem very difficult. So be patient and kind to yourself.
- Maternal mental health and child health and development in low and middle-income countries. Report of the WHO meeting. Geneva, World Health Organization, 2008. (https://www.who.int/mental_health/prevention/suicide/Perinatal_depression_mmh_final.pdf)