How To Decrease Shame After A Pregnancy Loss

What's your experience like, is it hard to find community? It takes courage and vulnerability to foster connections that support our growth and healing, especially when we're struggling.

As we welcome November, I'm reflecting on October and the advocacy and awareness highlighted through the Pregnancy and Infant Loss Awareness month campaigns on social media. I was reminded by Sara*, a member of my infertility group, how much work there still is to do. Sara's experienced multiple pregnancy losses over recent years and yet never heard of this awareness campaign. How about you?

Sara joined the group feeling emotionally isolated from her large and loving family. As the parent of a toddler, there were a lot of questions about baby number 2’s arrival. She shared little with family about her recurrent miscarriages and secondary infertility and came to loathe family events. The barrage of questions that would inevitably come, and the feelings of shame were too much. Isolation was easier.  
 
Thankfully, someone pointed Sara to my group. She loved hearing from other group members who faced similar dilemmas, and similar grief. She perked up when I shared about the Pregnancy and Infant Loss Awareness campaign early in the month. We discussed the different hashtags to explore, and the Wave of Light ceremony on October 15th, where people light candles in honor of their babies who have died.

Earlier this week we met for our final group session. Sara beamed as she shared about her disclosure on social media. Inspired by the online community around #pregnancyandinfantlossawarenessmonth and the connections she made in group, Sara shared publicly for the first time about her journey.  

She was blown away by the thoughtful comments, love, and compassion she received from her community. When she attended a family event over the weekend, no one asked her about baby number 2. Was it a coincidence? She wasn’t sure, but she felt inspired by the response to her vulnerability and encouraged to keep talking with those she loved. 

I share Sara’s experience for a few reasons. To highlight:

1- Campaigns like Pregnancy and Infant Loss Awareness Month are so important!

They help create community for people who are feeling isolated. They decrease shame and inspire people, like Sara, to break their silence and gain needed support to weather difficult times. Campaigns like this also help to educate our community so we can be more empathetic towards one another.

2- Your voice matters.

Letting people in takes courage and vulnerability.  Letting people know your pain means they can offer you support. Does sharing on social media feel like too much? Consider what it would be like to open up to someone you trust. What might you gain in return?

3- Therapy groups are healing.

Not only do groups decrease isolation, but connecting with others experiencing similar struggles has the power to reduce shame. After all, empathy is the antidote to shame. 

I know it can feel scary to step out of your comfort zone. While social media can be a tough place, when you look in the right places there are many supportive communities waiting. To join a group, to speak up, to ask for help— it takes courage. And yet, taking risks, like Sara, is what brings us out of isolation and closer to one another. 

If you're interested in joining a group here in San Diego, or virtually throughout California, or would like to explore individual support along your reproductive journey, don’t hesitate to reach out.

Pregnancy and Infant Loss Awareness Month: Resources for Connection and Healing

Photo by Jeremy Bishop on Unsplash

In the United States, one in four women experience a miscarriage, and one in 160 experience a stillbirth each year. These number are high, though despite being such a common occurrence the pain is no less. 

Perhaps you have experienced a loss yourself. If not, you surely know someone who has, even if you're not aware of it. Losing a baby can be a lonely and isolating time. Unfortunately, death and loss continue to be very private topics in most circles. For some well-meaning family and friends, they're not sure what to say and how to help (this article might be helpful for them to read). And for others, they're unaware just how long these wounds remain. Time marches on, yet for those who have experienced such a loss, time also stands still.

October is Pregnancy and Infant Loss Awareness Month and this Sunday, October 15th is Pregnancy and Infant Loss Remebrence Day. In solidarity with all the families who know this pain, I offer no advice but resources to help you connect with others on your healing journey, and to honor your lost child(ren) throughout the month. You are not alone. 

San Diego Events and Resources for Pregnancy and Infant Loss Awareness Month

Walk to Remember 2017 Empty Cradle"s annual  Walk to Remember will be held on Sunday, October 15, 2017 at Town Center Community Park East in Santee, CA.Side By Side 5K  A 5K benefitting Life Perspectives, a non-profit organization that provides healing resources for men and women worldwide who are experiencing loss through miscarriage or abortion. 

Empty Cradle  A San Diego Based peer support group for parents who have experienced the loss of their baby due to miscarriage, stillbirth, TFMR, infant death, SIDS or SUID. Our goal is to offer bereaved families support via a resource parent network, through monthly meetings, written materials and partnership with the health care community.

Postpartum Health Alliance Lists many more resources, both locally here in San Diego and nationally for families experiencing a loss. 

National Events for Pregnancy and Infant Loss Awareness Month

Remembering Our Babies The official site of Pregnancy and Infant Loss Remembrance Day-- October 15th. Please consult for local to you walks and activities. 

Wave of Light  October 15th is the wave of light event. The idea is at 7pm no matter what your time zone is you light a candle in remembrance for our angels, if you keep it burning for at least an hour there will be a continual wave of light across the world all day.

Capture Your Grief  A 31 day photograph challenge. If you have experienced the death of your baby/ies/child/ren, this project is designed just for you! It doesn’t matter whether you are only a week into this walk or you have been walking this road for 20 years, all are welcome to join in.

Pregnancy Loss Journey  A podcast where you can hear from professionals, authors, and organizations in the field, along with personal loss stories. 

If you are in San Diego and could benefit from additional support along your journey, please reach out for help. It would be an honor to walk beside you. And if you are somewhere else in the world and looking for counseling around the loss of a pregnancy or infant, please refer to the Pregnancy and Infant Loss Directory. 

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Please feel free to add any additional local or national events in the comments. If you're mourning the loss of a child and would like to connect with a therapist in the San Diego area, I’m happy to help. Feel free to reach out by phone or email and we can talk about ways you might benefit from counseling. 

Birth Trauma: Is THAT What I've Been Experiencing?

I met Sara and her 4-year-old daughter, Claire, at our local playground earlier this week. Claire instantly gravitated to my 5-year-old son and within moments they were chasing balls together, holding hands and laughing. Having just moved to San Diego from Boston, she was excited to meet us.

Like many mom-conversations go, Sara asked about the age difference between my two kids and how I felt about it. She told me that although her daughter was begging for a sibling and her husband was also ready, she wasn’t prepared to get pregnant again just yet. She was conflicted about her timing tho, noting her age and the pressure she was feeling to have another baby.

I empathized with her situation and shared some of my own personal experience, as well as my professional experience as a psychotherapist supporting women on their journey through motherhood. I offered myself as a local resource given my knowledge of San Diego’s network of reproductive health providers.  

A few days later we met again by the swings. Sara jumped right into the conversation, saying, "you know, I think I could probably use some help from someone like you. I'm pretty sure I suffered from some postpartum stuff and that's what's holding me back from having another baby." She went on to tell me about her difficult pregnancy, challenging labor and unplanned cesarean birth that left both her and Claire in the hospital for several days. The experience was distressing and she was anxious about becoming pregnant again. She had wanted an unmedicated, natural birth and was understandably afraid of having a repeat similar experience with her next child.

I spent some time talking with Sara about how her traumatic birth might be impacting her. As I spoke her face softened and her head nodded. She appeared to feel validated by my explanation: that trauma after birth is REAL.

While many around her would like Sara to move on and be grateful for a happy and healthy child, Sara is still reacting to her birth experience with Claire. Although Claire had suffered no long-term effects, Sara did. And her daughter’s health does not negate Sara’s experience and the anxiety and fear left in the wake of her birth experience. As we talked more, I stressed that it’s not the specifics of the birth that is traumatic, but one’s perception of these events. This is such a key aspect of trauma.
 

What Are The Symptoms of Birth Trauma?

Post traumatic stress disorder (PTSD) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a car accident, a natural disaster, or sexual assault. However, a traumatic experience can be any experience that involves the threat of death or serious injury to you or someone close to you, like your baby (birth trauma or postpartum PTSD). Again, it's your perception of your childbirth that matters most.  It is less important whether the hospital staff were in communication about recommended procedures than your interpretation of what happened.

Common symptoms of women who’ve experienced birth trauma may include:

• Feeling socially isolated
• Difficulty bonding with their baby
• Lonely
• Angry
• Depressed
• Irritable
• Difficulty sleeping
• Anxiety or panic attacks
• Worry excessively about the health of their babies
• Worry that their child might die
• Flashbacks or memories that repeat over and over about medical procedures or the behavior of medical staff.
• Nightmares

Why Some People Experience PTSD Postpartum

It’s not always the dramatic events that trigger childbirth trauma but other factors such as a loss of control, the intimidating, aggressive or difficult attitudes of people around you, not feeling heard, or a lack of informed consent to medical procedures.

Risk factors for Postpartum PTSD include a complex mix of objective factors, such as the type of delivery, ability to feed as planned, etc, and subjective factors like those mentioned above. Additional risk factors include:

• Induction
• Length of labor
• Feelings of loss of control
• Unwanted medical intervention
• Traumatic or emergency deliveries/cesarean
• Lack of support from partner or medical staff
• Impersonal treatment
• Not feeling listened to
• Lack of information or explanation
• Lack of privacy and dignity
• Fear for baby's safety
• Stillbirth or loss soon after birth
• Birth of a disabled baby
• Baby’s stay in NICU
• Poor postnatal care
• Previous trauma (childhood, with a previous birth, domestic violence)
• History of anxiety or extreme fear of childbirth
• History of abortion or infertility
   

How common is Birth Trauma?

It’s estimated that approximately 9% of new mothers in Western societies experience full blown post traumatic stress disorder. However, research shows that 25-34% experience subsyndromal symptoms (symptoms that don't meet the diagnostic criteria for PTSD)! So while not meeting diagnostic criteria for PTSD, up to a third of mothers experience symptoms like intrusive thoughts and memories that may stimulate feelings of fear, anxiety or helplessness that interfere with daily life. That's a huge number! 

It's important to remember that while mothers most commonly receive treatment for postpartum post traumatic stress, their partners and even their medical providers may also suffer. 
 

Why You Should Seek Help

There are numerous potential consequences for women who experience a traumatic birth. They may avoid routine follow-up medical care because it reminds them of their childbirth experience. Like Sara, they may fear subsequent pregnancies and are statistically shown to be less likely to have subsequent births.

Those who do have another child are more likely to have an epidural or a scheduled cesarean; they are less likely to breastfeed and more likely to experience challenges bonding and attaching with their newborns. They’re also more likely to experience difficulties in their relationships and sexual dysfunction. Moms who suffer from Postpartum PTSD are more likely to suffer from depression, which also impacts bonding and attachment with their baby.

In part 2, we’ll look at ways to avoid the effects of birth trauma and ways to support healing. If you’re not sure you can wait to read part 2, please don’t hesitate to give me a call. I’m a licensed clinical social worker in the Banker’s Hill neighborhood of San Diego, California. I’m passionate about helping families cope with trauma and other challenges after bringing home their baby. You can reach me at 619.780.3277 for your free in-person 30 minute consultation. 

Pregnancy loss: How to help your daughter/sister/BFF cope

Someone you love has lost a pregnancy, her baby. You don’t know what to do. Or say. Or how to act. You’re wondering how to show your love for your daughter. Your sister, or your friend you adore so much she’s like your sister. You never had a miscarriage or lost a baby and have no idea what’s the “right” thing to do or say.  

As a psychotherapist and Licensed Clinical Social Worker specializing in Reproductive Mental Health, I see clients struggling with miscarriage, pregnancy loss, and infant loss in my private practice in San Diego, CA. My professional and personal experience has taught me that there is no one “right” way to console a grieving loved one. That being said, I do have some suggestions to share that seem to be universally appropriate. There are always exceptions of course.
 

How to help

1- Be Present

Even if you can’t be present physically, don’t shy away. Make your care and love known in some way. If you are local or want to jump on a plane to be with her—do it! When you get there, to her house, to her couch where she sits with tears in her eyes, her heart torn wide open. Just sit. Just be there right next to her. Hold her hand. Hug her. Let her cry. Or let her be mad and curse the world. You don’t have to say much. Being emotionally present will let her know just how much you care.
 

2- Show acts of love

Bring food, send flowers. It doesn’t really matter what it is. The act of giving shows her that you’re thinking about her. If you don’t have money to spend, come and cook the food in her fridge, clean her home, send a card. The point is to let her know you feel her pain and you are there for her.
 

3- Honor important dates

Mother’s Day, the baby’s birthday or due date, the day she found out the pregnancy wouldn’t last or the baby died. These are important dates for grieving mothers. Even months after, when the calls have ceased, and the flowers have wilted, these dates will come and bring a torrent of emotions with them. Acknowledge these significant moments; she is thinking about them more than you will likely know.
 

4- Verbally acknowledge the loss

Many many women have shared with me that the worst thing someone can do is say nothing. Ignore the loss. You might feel this is unthinkable, that someone could move on with life without a single word of love, empathy or care, but it happens. And it’s devastating. If you’re not sure what to say, check out my guide below. 
 

5- Listen

Listening seems so obvious, but I can't stress how important it is to truly truly hear her out. It's normal to think about your own losses when you sense her pain, but avoid sharing the details of your own experience during this sensitive time. Let her know you're there for her. Listen to her and nod your head, acknowledge her pain.
 

6- Remember: tone trumps content

A few words on tone before jumping into the what to/not to say guide below. HOW we speak often has more impact on the way our message is received. If you stumble and say something you "shouldn't" have, it will blow over if you've said it with empathy and love. If you're callous and try to be funny and say the wrong thing-- it might not go as well. This is a time for honesty, for being vulnerable and being real. 

I’m hoping you noticed that the answer to each of the above scenarios comes back to expressing your empathy and care for her. Why? Because that’s the bottom line. You’re sorry someone you love is dealing with this. You can combine any of the recommended "what to say instead" statements. Make it feel natural. Find your own way to express your empathy. But that's the key— empathy. It’s important to squash your own burning desire to know what her next steps are, or to inquire about what went “wrong”. Let her guide you. Pay attention to her, check in with her and she will let you know when she’s ready to share more.

These tips and guide are intended to support and strengthen relationships. What has been helpful for you? Please share your experience in the comments below. And please, let me know what I’ve missed!