Grief and loss in the perinatal period
Grief and loss is a normal aspect of the transition to parenthood yet it is not often talked about. Holding a sense of grief and loss alongside the joy and anticipation of becoming a parent can feel confusing, incongruent and complicated. Often new mothers and fathers feel shocked, guilty and ashamed by their feelings of grief and loss and subsequently disallow them. Their grief has no name; it is not acknowledged or socially recognised, is often hidden, feels invalidated or not seen as legitimate or real. This disenfranchised grief can be associated with a sense of stigma and shame and if left unacknowledged can impact a parent’s mental health and wellbeing.
Anticipating the birth of your baby is a time of excitement and anxiety for many families. It is also a time where many women are exposed to the myth that motherhood is nothing but joyful, that you will bond with your baby immediately. With this myth comes a sense of pressure to feel nothing but pleasant emotions about meeting and caring for your baby. To disallow the less pleasant feelings common to parenthood such as loneliness, boredom and low confidence denies the richness of what it means to be a parent and pushes the sense of loss further underground.
Often the losses endured on the road to parenthood can be linked to the journey of conception. Complex losses can include a traumatic birth, a past miscarriage, stillbirth, IVF, relationship breakdowns. These losses are often minimised upon the birth of a baby; women are told to focus on the healthy baby they hold in their arms and all the losses incurred along the journey to conception are invalidated. Subsequently, new parents will often not connect with their hidden grief until long after their baby has been born. A new parent experiencing grief and loss can oscillate between a preoccupation with their loss and a refocusing on accepting their life changes. It is important that new parents are given permission to grieve their losses and be reassured that this grief does not negate the feelings they have for their new baby.
Grief is confronting for most people and this often means that loved ones and professionals may experience a strong urge to side step the emotional distress that comes with listening to a parent’s grief. Loss is not intended to elicit an intellectual response but rather an emotional response. Loss is both physically and emotionally painful and should be addressed in this context. When a parent’s grief is not given time and space to be heard and validated their grief may become protracted and complex and can lead to perinatal mental health issues such as depression of anxiety.
Losses associated with parenthood
The losses associated with parenthood can be multi layered and loosely fall into the below categories:
• Material: Loss of income, loss of a home that becomes too small for a growing family, loss of clothing that fits comfortably and expresses individual style. These losses may sound minor but they can hold major meaning.
• Relational: Loss of time spent with a partner, loss of workmates for mothers that take a break from paid employment, loss of time spent solely with the eldest child, loss of time with friends in adult only environments.
• Functional: Birth trauma, incontinence, changing body shape, sleep deprivation, breastfeeding difficulties.
• Role: Loss of one’s sense of place and belonging in a social context, loss of friendships. Losses of professional identify loss of ‘stay at home mum’ role.
• Systemic: A new parent’s lost sense of self can affect each member of the family system. The family dynamic can be shifted and roles and needs impacted.
• Intrapsychic: The loss of feeling familiar to oneself. The loss of a sense of possibility, a letting go of future plans, hopes and dreams. A loss of a sense of self-worth.
Myths vs realities of parenthood
It is important for new parents to understand their own definition of what a ‘good enough’ parent looks like, to challenge expectations of perfection. Many new parents experience disappointment and frustration when the realities of parenthood do not meet the expectations they had of themselves and their experience. The greater the gap between the expectation and the reality of parenthood, the more vulnerable a new parent is to sitting with feelings of grief and loss.
Common myths of parenthood:
• Mothers should be calm, grateful and confident
• Mothering is intuitive, romantic and natural
• Childbirth is to be embraced and celebrated in its entirety
• Mothers bond with their baby immediately
• A mother is selfish if she expresses her own needs
• A good mother is always available to her child
• Couples always agree on parenting approaches
• Birthing a healthy baby brings closure to all prior pregnancy related losses
Realities of parenthood:
• Being a parent is a challenging and rewarding job that involves long hours and little respite
• It can take many weeks for a new mother or father to bond with their baby
• Motherhood is not simply instinctive; a woman learns how to parent over time
• It is okay to make mistakes and reach out for help
• A mother or father must express their own needs and learn to nurture themselves in order to nurture their family
• Couples often experience unexpected differences in core parenting values and approaches, this can sometimes cause conflict and tension
• The birth of a new baby can often reactivate past trauma and feelings of grief and loss
The experience of grief
New parents experiencing grief and loss often talk of stepping through phases of numbness, a yearning and experiencing of the loss both cognitively and emotionally, despair and disorganisation marked by anxiety, ambivalence and hopelessness and finally a reorganisation or acceptance of what is, a surrendering that brings some relief and connection to here and now.
Loss calls for external, internal and spiritual adjustments. New parents will often experience this adjustment as a gradual process of letting go of how their life looked before their baby and settling into a new version of ‘normal’; the good and less good bit.
This adjustment can include:
• developing a new day to day rhythm
• a new sense of role
• a new way of relating to a partner
• an emerging confidence as a parent
• an impact on our core values, beliefs and assumptions about oneself, family and the world.
What do parents need (and what does PANDA provide)
• Space to tell their story in a way that honours the unique meaning of their individual grief and loss
• Opportunity to bring grief and loss into the light, allowing it space and time to be validated
• Education on grief/loss as a normal part of the parenthood journey
• A space to ‘speak the unspeakable’ often for the very first time
• Identification and validation of emotions and exploration of how disenfranchised they have become
• Acknowledgement of the complexity of holding grief alongside celebrating new life
• Allowance of individual differences and personal meaning making around grief and avoidance of assumptions
• Respect for the cultural context and family norms around grief
• Support in exploration of personal defences and coping styles
• Assessment for perinatal mental health and risk issues that can be associated with grief and loss
PANDA National Perinatal Anxiety & Depression Helpline 1300 726 306