Chains of Grief: The Impact of Perinatal Loss on Subsequent Pregnancy

Article excerpt

ABSTRACT: This paper identifies women who are at greater potential for medical complications in their pregnancies due to post traumatic stress resulting from previous perinatal loss. The loss may have been suffered by the woman herself during a past pregnancy or she may have inherited heightened anxiety from perinatal loss experienced by her mother. In the latter case, the unresolved grief is transmitted from mother to daughter, affecting physiological, emotional and behavioral patterns in the next generation. Pregnancy presents an opportunity for healing. Given effective prenatal counseling by a trained clinician, perinatal loss issues can be addressed through body-centered hypnosis so that history does not repeat itself. Left untreated, post traumatic stress can produce crippling anxiety for the pregnant woman, contributing to complications of pregnancy, childbirth and even parenting.

The family who loses a newborn infant (or fetus through miscarriage or stillbirth) endures a deep tragedy. When asked, many families who have experienced perinatal death have said that the death of a newborn hurts as much as the death of an older child, spouse or parent. The loss is different: one mourns unfulfilled life. However, the love and expectations that go into anticipating a life that will not be fulfilled are usually greatly underestimated by those who have not experienced such a loss.

Richard Marshall

Medical research has documented the impact of emotional stress on the outcome of pregnancy and childbirth (Lederman, et al., 1978; Levenson and Shnider, 1979; Gotsuch and Key, 1974, Peterson et al., 1988) as well as substantiating a critical period for bonding. (Klaus et al., 1972; Kennel, et al., 1975). The impact of emotional support on the length of labor and facilitation of maternal-infant interaction immediately following birth has also verified the importance of the emotional and psychological aspects of medical care during the perinatal period (Sosa, et al., 1980). However, little research has been done on the impact of perinatal loss on subsequent pregnancy and prenatal bonding, despite the fact that it is one of the most emotionally charged issues that a woman may have to deal with during the course of a subsequent pregnancy.

Although some authors have attempted to identify the needs of bereft parents (Benreid and Nichols, 1981; Marshall, 1981) there has been little research done to explore the impact on a subsequent pregnancy, or information about what can be done to help women resolve grief prenatally. The purpose of this paper is to share the importance of addressing these needs during pregnancy, and the use of body-centered hypnosis in the context of a preventive prenatal counseling program as a method of choice to reduce anxiety and resolve loss, making way for the potential birth of another child.

Women who have endured previous perinatal loss have greater emotional adjustments to a new pregnancy, including fear of another loss, which has impact not only on attachment to the unborn fetus but also may precipitate heightened fear and panic states throughout the pregnancy and into the labor process. Little had been done in standard prenatal care to help this special needs population. In my clinical experiences, it is evident that women who have endured loss in the perinatal period are at greater risk for future miscarriage, prematurity and complications of childbirth. As these women approach a subsequent pregnancy, attachment and loyalty to the previous child resurfaces, often making it difficult for the mother to form an attachment to the next pregnancy. When loss remains unresolved, disruption in bonding and attachment can affect not only the immediate maternal-infant relationship, but can have substantial impact on successive generations.

Women who have absorbed the impact of their mother's unresolved prenatal loss during their own childhood are particularly vulnerable to high levels of anxiety and fear during pregnancy, childbirth and the ongoing maternal-child relationship. …