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Midwifery for Pregnancy after Perinatal Loss

Question:

Describe about the Midwifery for Pregnancy after Perinatal Loss.

Answer:

Grief and grieving process

Elisabeth Kubler- Ross, a Swiss-American psychiatrist, explained in her book “On Death and Dying (1969), ‘Five stages of grief’ that every human being has to deal. Grief is seen as a natural response to the loss of anything. According to Shear & Gorscak, et al,. (2011), it may arise from a sense of one's own approaching death. Loss of familiar environment, loss of independence or privacy and loss of natural body functions. As found in Mercer & Evans, et al,. (2006), the grieving process is a systematic method explains how one deals with grief. The five stages are Denial, Anger, Bargaining, Depression, and Acceptance. 

Timeframe and patterns of healing from Perinatal loss

As according to Moore & Black et al., (2011), Perinatal loss is the loss of a child during birth. Parents go through a tough time dealing with it as the grief resulting from the loss affects both physical and mental well-being. The loss is even more pertinent because it is coupled with many other losses. As found in Gaudet, et al., (2010), Parents loose confident, future expectations and realize the hardships that life can offer. It is not a personal loss rather it affects the whole family set up, and even the relationship between the husband and wife gets strained. They, therefore, need a systematic timeframe and process to overcome this grief.

A nurse or a doctor should give emotional support and plan the future pregnancy for the couple. However, the grief can be overcome with the birth of a child and during this interconception period the nurse can help the couple to differentiate between uncomplicated and complicated grief, and depression to cope with the loss. Healing process also includes expressing the grief, encouraging future pregnancy if there is no big health issue, and mobilizing support to each other.

References

Gaudet, C., Séjourné, N., Camborieux, L., Rogers, R., & Chabrol, H. (2010). Pregnancy after perinatal loss: Association of grief, anxiety and attachment.Journal of reproductive and infant psychology, 28(3), 240-251.

Mercer, D. L., & Evans, J. M. (2006). The impact of multiple losses on the grieving process: An exploratory study. Journal of Loss and Trauma, 11(3), 219-227.

Moore, T., Parrish, H., & Black, B. P. (2011). Interconception care for couples after perinatal loss: a comprehensive review of the literature. The Journal of perinatal & neonatal nursing, 25(1), 44-51.

Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., ... & Gorscak, B. (2011). Complicated grief and related bereavement issues for DSM‐5. Depression and anxiety, 28(2), 103-117.

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