Pregnancy Loss, Infant Death, and Maternal Mental Health

Mental Distress   

  • Perinatal loss is an unexpected, traumatic, and life-changing event (Caccitore, 2013; Gold, Leon, Boggs, & Sen, 2016; Kersting & Wagner, 2012)
  • It can cause severe distress (Gold, Leon, Boggs, & Sen, 2016) presenting as depression, anxiety, obsessive compulsive disorder, social phobia, post-traumatic stress, and suicidal ideations (Caccitore, 2013; Caccitore, Schnebly, & Froen, 2008; Gold, Boggs, Muzik, & Sen, 2014; Gold & Johnson, 2014; Hutti, 2004).
  • Bereaved mothers have 4 times greater odds of depressive symptomatology and 7 times increased odds of post-traumatic stress disorder than non-bereaved mothers (Gold, 2016).
  • The existence of mental health problems is also an added risk factor for poor fetal outcomes during a subsequent pregnancy (Gold, Leon, Boggs, & Sen, 2016) and can negatively affect the attachment to this child (Gaudet, Sejourne, Camborieux, Rogers, & Chabrol, 2010; Hutti, 2004).

Existential Dilemma   

  • After this type of loss, a mother’s values, beliefs, and spirituality can be challenged.
  • The experience of death at birth is an existential dilemma (Uren & Wastell, 2002).
  • The mother’s assumptive world is jeopardized (Uren & Wastell, 2002) and things that once had meaning to her no longer do.

Loss Affects Everyday Life   

  • The death of an infant impairs a mother’s day-to-day functioning (Kersting & Wagner, 2012; Jaffe, 2014).
  • Mothers report changed appetite and sleep patterns, decreased social participation, decreased marital satisfaction, and increased isolation (Caccitore, Froen, &  Killian, 2013; Caccitore, Schnebly, & Froen, 2008; Kersting & Wagner, 2012).
  • This type of loss frequently affects her professional career and relationships with workplace colleagues (Caccitore, 2013; Jaffe, 2014).

Cultural Reactions to the Death of a Baby   

  • Perinatal loss leads to the deconstruction of motherhood and role confusion (Caccitore, 2013).
  • Society does not recognize this type of death, and without a live baby in her arms, the mother has lost her maternal identity (Caccitore, 2013). This is also known as disenfranchised grief.
  • There is social pressure to forget the baby who died, move on, and try to have other children (Caccitore, 2013).
  • Perinatal loss also carries a stigma with it, leaving these mothers to feel shame and guilt (Caccitore, 2013; Kersting & Wagner, 2012).
  • Women report a discrepancy between the intensity of their grief and the extent to which they are allowed to express it (Uren & Wastell, 2002).

Improving Mental Health   

Finding meaning and connection with your baby

  • Women who find meaning in their loss report decreased mental distress, increased marital satisfaction, ongoing bonds with their deceased child, and better physical health (Caccitore, 2013; Jaffe, 2014).
  • It is not uncommon for mothers to remain connected to their baby and continue the relationship through ritual for many years after the death of their baby (Caccitore, 2013; Cote_Arsenault & Mahlangu, 1999; Jaffe, 2014; Uren & Wastell, 2002).
  • Parents feel empowered when they create their own rituals to maintain this connection (Brin, 2004).
  • It may take many years to come to a sense of meaning and experience healing (Caccitore & Bushfield, 2007).

Social Support

  • Social support plays a role in buffering the effects of trauma and in mediating stress after bereavement (Caccitore, 2013; Caccitore, Schnebly, & Froen, 2008; Kersting & Wagner, 2012).
  • Women are searching for an environment where they have permission to talk about their child’s death and meet other mothers in a similar situation (Caccitore, Schnebly, & Froen, 2008; Jaffe, 2014).
  • An intervention that allows mothers to express their emotions and retell their stories helps to decrease depression, self-blame, and trauma (Caccitore, 2013).
  • Women find bereavement support groups and talking with other parents helpful because they validate their experience, provide comfort and connection, and reverse isolation (Caccitore & Bushfield, 2007). 
  • Resilience is a character trait that has been observed to be a counterweight to mitigate mental distress. Support networks are a major ingredient of resilience and are significantly associated with decreases in both depression and PTSD (Caccitore, Schnebly, & Froen, 2008; Gold, Leon, Boggs, & Sen, 2016), as well as with improvements in health outcomes and prevention of disease (Hutti, 2004).



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