Perinatal grief: experiencing and dealing with loss
The specialist of the Women's Unit Elena Iracheta explains what the perinatal grief and how its treatment should be approached from a professional point of view.
According to OMS, World Health Organization, the perinatal period extends from the 22nd week of gestation to the first week of the newborn's life.
From an obstetric point of view:
Fetal death
It is the death of the product of conception before expulsion or its complete removal from the mother's body, regardless of the length of the pregnancy. It is divided into:
Early fetal death
All deaths from conception to the 22nd week of gestation. We would be talking about abortions here.
Intermediate fetal death
Fetal deaths that occur between the 22nd and 28th week of gestation.
Late fetal death
From the 28th week of gestation.
Neonatal death
It is the death of the newborn in the first 4 weeks of life (28 days):
Early neonatal death
Of the newborn in the first 7 days of life.
Late neonatal death:
Of the newborn from 7 complete days to 28 complete days of life.
Perinatal grief
The causes of perinatal loss can be multiple and complex, and in many cases it is not possible to identify the cause.
Perinatal losses experience the same reactions as other grief situations, but with special features, some of them are:
- The first loss is the actual loss of the baby.
- Another is the loss of the stage of life the parents are currently immersed in, which is the loss of the 'future of that couple.' The loss of hope.
- Loss of the 'creation of the baby.' The baby represents life, and its death is much harder to bear than other losses in life.
- In some cases, parents face "accumulated losses." For example, if they have already faced previous losses (miscarriages) or if the pregnancy is the result of fertility treatment... In these cases, resolving this conflict leads to greater complications for the parents' psychological recovery.
Symptoms associated with perinatal grief
La symptomatology most common in the face of losses is (Moscarello, 1989):
Level…
- physical: empty stomach, oppression, fatigue, weakness…
- behavioral: Social isolation, avoidance of pregnant women, babies, and children, insomnia, lack of appetite…
- cognitive: Difficulty concentrating and making decisions, intrusive thoughts about the subject, perceptual phenomena such as hearing babies cry or continuing to feel their movements.
- emotional: anger, failure, confusion, guilt, disbelief…
During grief, it's normal to experience feelings of depression, and these two processes can become confused. During grief, it's common for women to experience sadness over the loss of a child. It's normal for their feelings of avoidance of pregnant women and babies to increase. All these feelings will evolve correctly, which is not the case with depression.
El psychological treatment In this very special type of mourning, it must begin at the same moment that perinatal death occurs. The closer in time, the better the results. will be obtained.
Support must be constant in the first few days after the incident, but also allowing space for the parents to express their feelings in solitude. know how to adapt to the situation and the partner, be there respecting the times.
Professionals must be trained to be able to handle these types of situations.
Psychological intervention should be based on:
- help the expression of feelings by the couple jointly. Also by each individual individually to the extent needed.
- Accompany in doubts, fears, uncertainties…
- Linking past losses and traumas with present grief.
- Teach strategies for managing family and work situations.
- Being able to listen to others and listen in addition.
- Express feelings linked to memory.
- Help express emotional pain throughout the family.
Ultimately, it's about letting go. About creating the necessary relationship with patients. Teaching them how to manage pain, navigate the grieving process in a healthy way... For all of this, the role of the physician and the clinical psychologist are fundamental.
Article written by the clinical psychologist Elena Iracheta.
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