Perinatal Bereavement

Perinatal bereavement is the deeply distressing experience of losing a baby, typically through miscarriage, stillbirth, or neonatal death. This type of grief has a profound emotional impact on the parents, families, and their support networks, as they navigate the devastating loss of a child during the perinatal period (which includes pregnancy and the immediate postpartum period).

Sensitive, compassionate care that addresses both the immediate and long-term effects of such a profound loss can help parents and families through the bereavement process.

What is grief?

Grief is a natural reaction to loss, which can affect emotional, social, physical, spiritual/religious and mental wellbeing. Grief is not a set of finite stages, instead it comes and goes over a lifetime, reducing in intensity over several months or years, often re-emerging around anniversaries or milestones. It is an individual experience which involves varied, complex and sometimes conflicting emotions that may come up suddenly and unexpectedly.

Everyone copes with and expresses their feelings of grief differently. Each parent within a couple will have their own unique way of dealing with loss, and some conflict is inevitable, and many couples will benefit from attending grief counselling together. For single parents who have suffered a loss, reaching out trusted friends and family for support will be particularly important.

Talking about grief can be challenging, and friends and family members may not always know what to say to grieving parents. Although their intentions may be well-meaning, grief is hard, and some comments can impact grieving parents in a negative way. Having some planned responses ready can help parents navigate uncomfortable conversations when they bump into people unexpectedly in the community, or once they return to work.

For anyone struggling with loss, are feeling unsupported, or are unable to cope, they are encouraged to seek support from a trusted health professional, or a counsellor who works with perinatal loss, so they can work through and move forward in their bereavement journey.

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Symptoms of grief

No two people will experience or cope with perinatal grief in exactly the same way. Personal circumstances, cultural background, spiritual and religious beliefs and previous life experiences are some of the factors that can impact how grief is experienced. However, identifying some common responses to grief and loss can help parents understand their experiences, and know when further support might be needed.

Physical symptoms of perinatal grief

Disrupted sleep and appetite
Headaches, body tension or aches and pains
Stomach pain, nausea and digestive issues
Flare-ups of pre-existing chronic health issues
Still feeling pregnant
Feeling empty
The distress of lactation issues
Physical trauma related to the pregnancy and loss

Emotional symptoms of perinatal grief

Shock, disbelief or numbness after learning that their baby has died
A sense of detachment from reality, or thoughts of death in the hope of joining their baby
Feeling guilty that they didn’t prevent the loss, that they should have done something differently or that their body has let them down
Parents may blame themselves or others. They may be angry that life isn’t fair, or they may feel confused about spiritual or religious beliefs.
Anger at the possibility of medical negligence contributing to the loss
Worry they may struggle to get pregnant again, and significant anxiety during subsequent pregnancies
Deep sadness about the baby’s absence and grieving a future that no longer exists
Fears or anxiety about their own or loved ones’ future, health or safety
Jealousy about other people’s pregnancies
Feeling overwhelmed with daily life

Cognitive symptoms of perinatal grief

Thoughts about dying or wanting to die
Poor concentration, inability to think clearly
Avoiding thoughts and reminders of the loss
Intrusive thoughts or images about the safety or wellbeing of themselves or other loved ones
Negative thoughts about self-including thoughts of failure, hopelessness
Repetitive thoughts of "what if", or "if only"
Feeling alone in that no one can understand what they are going through

Social symptoms of perinatal grief

Feeling distant, isolated from other family and friends or feeling abandoned
Experiencing other people as insensitive, unsupportive, or feeling let down or disappointed by others’ difficulty in dealing with grief
Changes in family dynamics or relationships.
Behavioural changes in their other children or tensions with other family members
Losing interest in social activities or finding small talk difficult
Stress about returning to work, financial issues, or disinterest in work
Lacking the motivation to leave the house or see other people
Concern about how to explain what has happened to family, friends or colleagues

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Ongoing triggers of perinatal grief

In the months and years after their loss, parents may experience painful reminders from expected and unexpected sources including:

Pregnancies and births among family or friends
Deciding what to do with the contents of their baby’s room
Birth dates or the anniversary of the death
Significant occasions such as Mother’s Day, Father’s Day, or holidays
Any major life change such as moving house or the loss of another loved one
Childhood milestones, such as when the child would have started walking or started school
Dealing with questions such as ‘how many children do you have?'
Feeling excessively vigilant or protective of their other children
Feeling anxiety and fear during subsequent pregnancies or when subsequent babies are asleep or sick
Having to visit a hospital or other locations associated with the loss
Subsequent pregnancies

Suggestions to help grieving parents

Find ways to create an ongoing bond or connection with the pregnancy, or the baby who died. This may include regular rituals and acknowledging birthdays, anniversaries, and other milestones
Sharing photos and saying their name
Try to have as many parenting experiences as possible: stay with them, bath them, dress them and take photos
Talk to a doctor or other healthcare professionals to gain further understanding of the possible medical causes for the pregnancy loss or baby’s death
Take care of the relationship with the other parent, or seek counselling together.
Provide feedback to the medical team if there are unresolved issues
Seek support from family and friends or others who have been through a perinatal loss
Seek counselling, peer support, support groups or online groups
Remember that grief is an individual experience and different people grieve in diverse ways
Speak to a Manager or workplace about bereavement leave
Don’t feel rushed, as there is no time limit for perinatal grief or when to get pregnant again

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