Perinatal bereavement: grieving pregnancy loss in miscarriage and stillbirth

Abstract

Many couples have experienced the death of a baby. It could happen during pregnancy, during delivery, shortly after birth, or during infancy. Some are unexpected: in spite of medical advances, more than one-fifth of all expectant parents will at some time experience miscarriage, stillbirth or infant death. For some other couples, early termination, whether of unwanted pregnancies due to personal choice or of wanted pregnancies due to medical reasons, is carried out at their own decision. A couple’s experience of loss in miscarriage and stillbirth is not easily shared by others – “but it wasn’t even a baby yet.” The lack of clarity of the loss (in the absence of a touchable, separate infant’s body) is the reason for many who find it difficult to appreciate the full extent of grief in pregnancy loss. Couples who have miscarriage and stillbirth are also confused about their bereavement experience and sometimes not sure about how to react. As a result, many of them choose not to seek help and support from their family and friends; the couple does not know how to name the grief, neither do those who are close to them know how to respond. In Chinese societies, expectant mothers do not disclose their pregnancy during the first trimester for the traditional fear that it would jinx or ‘upset’ the baby, who would then ‘refuse to be born’. Pregnancy loss during this early stage, while not uncommon, will be a secret within a secret, further complicating the grief process. In essence, pregnancy loss due to miscarriage or stillbirth is always considered as disenfranchised grief over an ambiguous loss. Cultural considerations are important in helping the Chinese couples who are facing the losses.