The Emotional Trauma of Perinatal Loss

The experience of family planning, preservation, and treatment comes with a whirlwind of losses on so many levels. The attachment to a future child isn't just a physical thing; it’s emotional, too—long before a pregnancy even begins (Covington, 2006; Jaffe et al., 2011).

Jaffe and Diamond (2011) and Jaffe et al. (2005) reference the “reproductive story”—the idea of having a “mental blueprint” of being a parent before the journey actually happens. These stories encompass picturing all the joys, challenges, and special moments prospective parents may dream of, like reading bedtime stories or pushing a stroller down the street. Jaffe and Diamond (2014) explain that the reproductive story is so deeply woven into the very fabric of a person’s identity that it might only be recognized when it unravels, whether due to infertility, miscarriage, stillbirth, termination, or other perinatal trauma (Jaffe & Diamond, 2011; Jaffe et al., 2005).

Perinatal losses are profound and often misunderstood. These losses include miscarriages and ectopic pregnancies (before 20 weeks), stillbirths (after 20 weeks), and the death of a newborn up to 28 days after birth (Moore et al., 2011). Some experts (Covington, 2006; Jaffe & Diamond, 2011) argue that the definition of perinatal losses needs to be expanded to include Infertility and its treatment, chemical pregnancies, or very early miscarriages, as well as multi-fetal pregnancy reduction. These are all forms of reproductive loss and can trigger grief just as intense as any other perinatal loss.

Perinatal loss causes emotional trauma. The pain of a miscarriage or any other perinatal loss is often minimized, dismissed as just a medical event. But women bear the brunt of it in silence, wrestling with feelings of guilt, self-blame, anger, grief, depression, and anxiety (Adolfsson 2011). To make matters worse, in many cases, no one outside of the woman and her partner may have known about the pregnancy or the attempt to conceive, leaving the woman or couple without rituals to grieve or much-needed support when they need it the most.

The grief that comes with losing a child is anything but simple. It’s not just about mourning a longed-for child but also all the hopes and dreams that came with them. A person might be grieving the loss of their self-worth, the life they’d thought they’d have by now, the pain of watching friends and coworkers expand their families, the loss of hope, identity, feeling healthy and normal, and even the loss of perceived control (Cousineau and Domar, 2006). Many women feel that their bodies have betrayed them, leaving them overwhelmed with grief. Yet, they often can’t properly mourn because society tends to downplay their loss, and the right support isn’t there. When men and women can’t acknowledge or discuss the loss, it can amplify feelings of shame and personal failure, leaving them feeling even more isolated and alienated. (Covington, 2006).

For women who have experienced a miscarriage, the hope of a future pregnancy often becomes the light at the end of the tunnel, even though the fear of loss may linger in subsequent pregnancies (Cote-Arsenault & Morrison-Beedy, 2001; Cuisinier, Janssen, deGraauw, Bakker, & Hoogduin, 1996; Turner et al., 1998). Bereavement is often complicated, and feelings of loss may be triggered by a subsequent pregnancy or the anniversary of the due date or miscarriage. Though, with the right support system in place, people can learn to live with and balance grief, feeling it when needed and finding ways to honor it while still embracing the hope and joy that life can offer. In time, grief becomes a part of one’s story, not the end of it.