"The nurse crouched next to us, her arm around my shoulders, physically holding me together."
Emotional Response to Perinatal Loss
Grief
Defined in Taber's as: The emotional reaction that follows the loss of a loved object.
Can be complicated or uncomplicated. In the past has been defined with five stages from the Kubler-Ross model with denial, anger, bargaining, depression, and acceptance. Current grief models are no longer set in stages rather is a complex process individualized for each person. Mothers and fathers grieve differently. Mothers can experience extreme sadness, guilt, suicidal ideation, feelings of emptiness, isolation, irritability and anger. Some mothers struggle to be around other pregnant women or infants. Fathers also experience a wide range of feelings, but added to that of mothers, powerlessness, and often they are concerned for the emotional well-being of the mother.
Signs and Symptoms of uncomplicated grief can include:
Uncomplicated grief is normal when faced with the loss. The feelings are often temporary, and day to day function can be compromised for a period of time. However, complicated grief can stem from uncomplicated grief when the symptoms become more disruptive, pervasive and long lasting.
Risk for complicated grief comes when the loss is sudden, unplanned, traumatic or violent. Perinatal loss fits into this category. Parents are at a higher risk of developing complicated grief, especially those without partners, close family support, lack of church or religious groups, or women that have a personality that is more neurotic in nature.
Signs and symptoms of complicated grief:
Can be complicated or uncomplicated. In the past has been defined with five stages from the Kubler-Ross model with denial, anger, bargaining, depression, and acceptance. Current grief models are no longer set in stages rather is a complex process individualized for each person. Mothers and fathers grieve differently. Mothers can experience extreme sadness, guilt, suicidal ideation, feelings of emptiness, isolation, irritability and anger. Some mothers struggle to be around other pregnant women or infants. Fathers also experience a wide range of feelings, but added to that of mothers, powerlessness, and often they are concerned for the emotional well-being of the mother.
Signs and Symptoms of uncomplicated grief can include:
- fatigue
- hollow empty feeling in chest or abdomen
- hyperventilation
- insomnia
- feeling of a lump in the throat
- feelings of shock or disbelief
- sorrow
- regret
- all feelings may be followed by tears, sobbing, and cries of pain
- can be complicated or uncomplicated.
Uncomplicated grief is normal when faced with the loss. The feelings are often temporary, and day to day function can be compromised for a period of time. However, complicated grief can stem from uncomplicated grief when the symptoms become more disruptive, pervasive and long lasting.
Risk for complicated grief comes when the loss is sudden, unplanned, traumatic or violent. Perinatal loss fits into this category. Parents are at a higher risk of developing complicated grief, especially those without partners, close family support, lack of church or religious groups, or women that have a personality that is more neurotic in nature.
Signs and symptoms of complicated grief:
- self-blame
- inability to make or keep friendships
- "child envy"
- continued avoidance form people with children
- isolation of self
How to support parents
Understand the rights of a parent and infant
Elicit, listen and respect parents needs and wishes
BE PRESENT
Help them create memories
Guide them in decision making about autopsy, organ donation or burial
Make sure to stress the importance of follow up outside the hospital
Elicit, listen and respect parents needs and wishes
BE PRESENT
Help them create memories
Guide them in decision making about autopsy, organ donation or burial
Make sure to stress the importance of follow up outside the hospital
Kavanaugh, K., Moro, T. (2006). Supporting parents after stillbirth or newborn death. American Journal of Nursing, 106 (9), 74-79
Loss and Grief retrieved from www.marchofdimes.com
Loss and Grief retrieved from www.marchofdimes.com