Pregnancy Loss, Infant Death, and Maternal Mental Health
Virtual Support Group for Bereaved Parents
Kiley Krekorian Hanish, OTD, PMH-C
Founder, Return to Zero: HOPE
Return to Zero: HOPE
Dates: Thursdays, 4:00 - 5:30 pm PT (July 9, 16, 23, 30; August 6, 13)
Cost: $150 (Couples can join for the price of one)
Learning Modules
Week 1: Share Your Story
Week 2: Normalizing grief and awareness of mental health
Week 3: Relationships with spouse
Week 4: Relationships with others
Week 5: Connecting with child
Week 6: Creating a self-care plan
This support program is limited to 10 people and the deadline to register is Monday, July 6, 2020.
Learn more about the group and how to register here.
If you have any questions, contact Kiley Krekorian Hanish, OTD, PMH-C, Founder of Return to Zero: HOPE at Kiley@rtzhope.org
Mental Distress
Perinatal loss is an unexpected, traumatic, and life-changing event (Caccitore, 2013; Gold, Leon, Boggs, & Sen, 2016; Kersting & Wagner, 2012)
It can cause severe distress (Gold, Leon, Boggs, & Sen, 2016) presenting as depression, anxiety, obsessive compulsive disorder, social phobia, post-traumatic stress, and suicidal ideations (Caccitore, 2013; Caccitore, Schnebly, & Froen, 2008; Gold, Boggs, Muzik, & Sen, 2014; Gold & Johnson, 2014; Hutti, 2004).
Bereaved mothers have 4 times greater odds of depressive symptomatology and 7 times increased odds of post-traumatic stress disorder than non-bereaved mothers (Gold, 2016).
The existence of mental health problems is also an added risk factor for poor fetal outcomes during a subsequent pregnancy (Gold, Leon, Boggs, & Sen, 2016) and can negatively affect the attachment to this child (Gaudet, Sejourne, Camborieux, Rogers, & Chabrol, 2010; Hutti, 2004).
Existential Dilemma
After this type of loss, a mother’s values, beliefs, and spirituality can be challenged.
The experience of death at birth is an existential dilemma (Uren & Wastell, 2002).
The mother’s assumptive world is jeopardized (Uren & Wastell, 2002) and things that once had meaning to her no longer do.
Loss Affects Everyday Life
The death of an infant impairs a mother’s day-to-day functioning (Kersting & Wagner, 2012; Jaffe, 2014).
Mothers report changed appetite and sleep patterns, decreased social participation, decreased marital satisfaction, and increased isolation (Caccitore, Froen, & Killian, 2013; Caccitore, Schnebly, & Froen, 2008; Kersting & Wagner, 2012).
This type of loss frequently affects her professional career and relationships with workplace colleagues (Caccitore, 2013; Jaffe, 2014).
Cultural Reactions to the Death of a Baby
Perinatal loss leads to the deconstruction of motherhood and role confusion (Caccitore, 2013).
Society does not recognize this type of death, and without a live baby in her arms, the mother has lost her maternal identity (Caccitore, 2013). This is also known as disenfranchised grief.
There is social pressure to forget the baby who died, move on, and try to have other children (Caccitore, 2013).
Perinatal loss also carries a stigma with it, leaving these mothers to feel shame and guilt (Caccitore, 2013; Kersting & Wagner, 2012).
Women report a discrepancy between the intensity of their grief and the extent to which they are allowed to express it (Uren & Wastell, 2002).
Improving Mental Health
Finding meaning and connection with your baby
Women who find meaning in their loss report decreased mental distress, increased marital satisfaction, ongoing bonds with their deceased child, and better physical health (Caccitore, 2013; Jaffe, 2014).
It is not uncommon for mothers to remain connected to their baby and continue the relationship through ritual for many years after the death of their baby (Caccitore, 2013; Cote_Arsenault & Mahlangu, 1999; Jaffe, 2014; Uren & Wastell, 2002).
Parents feel empowered when they create their own rituals to maintain this connection (Brin, 2004).
It may take many years to come to a sense of meaning and experience healing (Caccitore & Bushfield, 2007).
Social Support
Social support plays a role in buffering the effects of trauma and in mediating stress after bereavement (Caccitore, 2013; Caccitore, Schnebly, & Froen, 2008; Kersting & Wagner, 2012).
Women are searching for an environment where they have permission to talk about their child’s death and meet other mothers in a similar situation (Caccitore, Schnebly, & Froen, 2008; Jaffe, 2014).
An intervention that allows mothers to express their emotions and retell their stories helps to decrease depression, self-blame, and trauma (Caccitore, 2013).
Women find bereavement support groups and talking with other parents helpful because they validate their experience, provide comfort and connection, and reverse isolation (Caccitore & Bushfield, 2007).
Resilience is a character trait that has been observed to be a counterweight to mitigate mental distress. Support networks are a major ingredient of resilience and are significantly associated with decreases in both depression and PTSD (Caccitore, Schnebly, & Froen, 2008; Gold, Leon, Boggs, & Sen, 2016), as well as with improvements in health outcomes and prevention of disease (Hutti, 2004).
References
Altounji, D., Morgan, H., Grover, M., Daldumyan, S., & Secola, R. (2012). A self-care retreat for pediatric hematology oncology nurses. Journal of Pediatric Oncology Nursing, 30(1), 18-23.
Azri, S. & Ilse, S. (2015). The Prenatal Bombshell. Lanham, Maryland: The Rowman & Littlefield Publishing Group.
Boyle, F. M., Vance, J. C., Najman, J. M., & Thearle, M. J. (1996). The mental health impact of stillbirth, neonatal death or SIDS: Prevalence and patterns of distress among mothers. Social Science and Medicine, 43(8), 1273-1282.
Brin, D. J. (2004). The use of rituals in grieving for a miscarriage or stillbirth. Women & Therapy, 27(3/4), 123-132.
Centers for Disease Control and Prevention (2016). Infant Mortality. Retrieved from http://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
Centers for Disease Control and Prevention (2017). Facts about Stillbirth. Retrieved from https://www.cdc.gov/ncbddd/stillbirth/facts.html.
Cacciatore, J. (2007). Effects of support groups on post traumatic stress responses in women experiencing stillbirth. Omega, 55(1), 71-90.
Caccitore, J. (2013). Psychological effects of stillbirth. Seminars in Fetal & Neonatal Medicine, 18(2), 76-82. doi: 10.1016/j.siny.2012.09.001
Caccitore, J. & Bushfield, S. (2007). Stillbirth: The mother’s experience and implications for improving care. Journal of Social Work in End-of-Life & Palliative Care, 3(3), 59-79.
Caccitore, J., Froen, J. F., & Killian, M. (2013). Condemning self, condemning other: Blame and mental health in women suffering stillbirth. Journal of Mental Health Counseling, 35(4), 342-359.
Caccitore, J., Schnebly, S., & Froen, J. F. (2008). The effects of social support on maternal anxiety and depression after stillbirth. Health and Social Care in the Community. doi : 10.1111/j.1365-2524.2008.00814.x
Cote-Arsenault, D. & Mahlangu, N. (1999). Impact of perinatal loss on the subsequent pregnancy self: Women’s experiences. Journal of Obstetric, Gynecologic & Neonatal Nursing, 28(3), 274-282.
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health. (2015). Stillbirth Collaborative Research Network. Retrieved from https://www.nichd.nih.gov/research/supported/Pages/scrn.aspx
Gaudet, C., Sejourne, N., Camborieux, L., Rogers, R., & Chabrol, H. (2010). Pregnancy after perinatal loss: association of grief, anxiety and attachment. Journal of Reproductive and Infant Psychology, 28(3), 240-251.
Gold, K. J., Leon, I., Boggs, M. E., & Sen. A. (2016). Depression and posttraumatic stress symptoms after perinatal loss in a population-based sample. Journal of Women’s Health, 25(3), 263-269.
Gold, K. J., Boggs, M. E., Muzik M. & Sen, A. (2014). Anxiety disorders and obsessive compulsive disorder 9 months after perinatal loss. General Hospital Psychiatry, 36, 650-654.
Gold, K. J. & Johnson, T. R. B. (2014). Maternal mental health outcomes after perinatal death. Obstetrics & Gynecology (abstract).
Hutti, M.H. (2005). Social and professional support needs of families after perinatal loss. Journal of Obstetric Gynecologic, and Neonatal Nursing, 34(5), 630-638.
Jaffe, J. (2014). The reproductive story: Dealing with miscarriage, stillbirth, or other perinatal demise. In D.L. Barnes (ed.), Women’s reproductive mental health across the lifespan (pp. 159-176). New York: Springer.
Jaffe, J. & Diamond, M.O. (2011). Reproductive trauma: Psychotherapy with infertility and pregnancy loss clients. Washington, D.C.: American Psychological Association.
Kersting, A. & Wagner. B. (2012). Complicated grief after perinatal loss. Dialogues in Clinical Neuroscience, 14(2), 197-194.
MacDorman, M. F. & Gregory, E. C. W. (2015). Fetal and perinatal mortality: United States, 2013. National Vital Statistics Report, 64(8).
Uren, T. H. & Wastell, C. A. (2002). Attachment and meaning-making in perinatal bereavement. Death Studies, 26(4), 279-308.