Navigating Psychosocial Aspects of Pregnancy Care After Baby Loss: A Roadmap for Professionals

Ana Todorović, Aoife O'Higgins, Shona Johnston, Nathalie Hilton, Guinevere Webster, Brenda Kelly
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Abstract

The death of a baby during pregnancy, birth or in infancy is an intensely traumatic event for the mother and her family. Many women who suffer such loss go on to conceive another baby during this psychologically fragile time when grief and trauma dominate. Although pregnancy after loss may bring hope, it can come with exceptionally high anxiety and distress. Unfortunately, pregnancy after loss, especially if progressed to beyond the gestation of the previous loss, is not always recognised by health professionals as an acutely vulnerable time for parents. Whilst many caregivers receive training in how to break bad news and support bereaved parents around the time of loss, few receive guidance on optimal psychosocial care for parents during a subsequent pregnancy. There can also be hesitance on the part of health professionals to mention the baby who died, which means that many families are left to cope with this distress in their own time. However, if the psychosocial aspects of the new pregnancy are negotiated with skill and the right support, this period can restore some psychological balance for parents and support bonding with the baby who died as well as attachment to the growing baby. This article, written by parents who have experienced pregnancy after loss and caregivers, offers suggestions for psychosocial care based on how trauma and grief impact women and partners in subsequent pregnancies. We propose a set of communication strategies that involve gently acknowledging the loss and anticipating its effects on how the new pregnancy is experienced, as well as organisational strategies that offer an additional emotional safety net. Together, these suggestions have the potential of creating a pregnancy experience that allows for better communication between expectant parents and health professionals.
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