Grief and Loss During Pregnancy & Postpartum: What to Expect & How to Cope
Written by Sarah Stanger, PhD
Clinical Psychologist & Co-Founder at Prospera
What is grief?
Grief is our emotional response to an important loss – often we think of grief in terms of the death of a loved one, but it can also occur in response to the loss of an experience, a relationship, a career, or even our sense of self.
For those embarking on motherhood, grief is often an unexpected and yet common experience. Some of the ways we might encounter grief during this journey include:
Pregnancy & Infant Loss
- Miscarrying (losing a pregnancy before 20 weeks)
- Giving birth to a stillborn baby (loss after 20 weeks) or losing the baby shortly after birth
- Making the difficult choice to abort a wanted or unwanted pregnancy
Birth Trauma & Medical Complications Loss
- Missing part of the birth experience due to being unconscious during a c-section
- Missing early moments and/or days with your new baby (either because of maternal complications or NICU stays)
- Having a baby with a developmental condition that changes aspects of what life will look like for you and your family
Identity & Experience Loss
- Experiencing a birth that did not go as planned, and therefore losing the imagined or expected experience
- Feeling the loss of your life, or freedom/flexibility, or identity before motherhood
- Feeling the loss of what you thought support from family, friends, or your partner was going to look like during pregnancy or postpartum
All of these situations can cause deep sadness, anxiety, anger, and many other emotions associated with grief.
Does grief follow a set pattern?
You may have heard people reference the “stages of grief,” where you are expected to move through different phases in a certain order - denial, anger, bargaining, depression, and finally on to acceptance. These stages were first defined by psychiatrist Elizabeth Kübler-Ross in her book On Death and Dying after she interviewed terminally ill patients going through their own grief process.
Her ideas were really helpful in the beginning to describe what grief can be like, but they’ve since been referenced as a rule of thumb for all grieving people in all circumstances. We now know there is no evidence to support the theory that these stages will always be present for everyone who experiences grief – let alone that they would occur in this specific order.
Grief is highly individualized. Almost everyone will experience some symptoms of depression and anxiety, but not everyone will experience the same symptoms or cope in the same way. In some cases, grief can cause a sense of detachment or unreality, even feeling outside of your body; this is usually a result of the difficulty we experience accepting the loss. Grief can also lead to difficulty with sleep, appetite, lack of energy, and concentration (including brain fog and trouble making decisions). For some people, there are moments when grief manifests as a numb lack of emotion, which can then cause guilt, or even fear that something is wrong with you.
For many people, especially as they move on from the immediate aftermath of the loss, it’s common to feel pretty normal for stretches of time, only to be interrupted by a reminder of the loss and experience a return of those intense waves of emotion such as sadness, anger, or anxiety - the process of grieving is not a straight path.
Get Support for the Motherhood Journey
Personalized 1-on-1 sessions and coping tools designed for infertility, pregnancy and postpartum
Are there different types of grief? How does grief relate to trauma?
There can be many facets to grief, and the presence of different facets can depend on the type of loss you experienced. One common facet of grief is related to separation - a yearning or longing to be reunited, or to gain back an experience that was lost. Another facet of grief is often related to your sense of self and your identity - feeling lost, without purpose, or struggling to understand who you are now or make meaning of the loss and life in the present. Finally, grief can also relate to the circumstances around which the loss occurred, and this is where trauma comes in. Many losses can be experienced as traumatic or are accompanied by events that were traumatic. When this happens, an important component of your grieving process can be to work through the traumatic memories. We have another article on birth trauma that provides more information on trauma, the variety of responses to trauma, and why processing traumatic memories is so important.
How long will I feel this way?
Grief is a process, and it takes a different amount of time for each individual to work through. In most cases, the acute symptoms of grief and intense distress will ease within a year, but for some people it goes beyond that time - grief does not work on a schedule. There is often no clear end point of grief because our goal isn’t to cure the grief, instead we’re hoping to work through it to learn how to live with the loss as a part of who we are.
You have probably heard that ‘time heals all wounds,’ and while time is an important part of the equation, it’s also important to think about what is happening during that time.
What can make grief worse?
- Relying on avoidance: Avoidance can trick you - avoidance can be a natural and adaptive response to grief in small doses, and it often feels like it’s working in the moment because it gets rid of your immediate distress. However, we know that relying on trying to avoid thinking about your loss or reminders of your loss as your main coping strategy is actually more likely to lead to increased anxiety and depression over time.
- Lack of support: Talking about your grief and the loss you’ve experienced is healthy and important. If you don’t have someone to talk about it with, especially someone who will meet you where you are at in your grieving process and sit with you in the loss, the acute grief symptoms may worsen over time. One reason for this is that when you are only thinking about the loss in your head, you are much more likely to end up in a rumination cycle (repeatedly focusing on specific thoughts about the loss, often related to injustice, blame, or ways it could have been prevented).
- History of anxiety or depression: If you’re already prone to depression or anxiety, the distress of your loss can make it more likely that the depression or anxiety returns, which can make processing your grief more challenging.
What can I do to cope with grief?
Getting support to cope with your grief and loss can make a huge difference in the way you experience your grieving process. At Prospera, our approach to supporting you through grief and loss will meet you wherever you are in your grieving process.
This may look like your coach being an empathetic and reflective listener who is there to hold space for you to share anything about your loss. Remember, your instinct might be to try not to think about your loss, which makes sense - no one wants to purposefully think about things that are really painful. However, one of the most important things you can do to start coping with your grief is to talk (or write!) about your loss on your own terms.
This can also look like working with your coach to build some routines, structure, and ways to take care of yourself back into your day, where you can think of your coach as someone to lean on as you re-engage with the world in small ways.
Your coach can also work with you on Cognitive Behavioral Therapy skills, which are tools that will support you in coping with the strong emotional waves that accompany grief. Whether you are feeling more down, anxious, angry, numb, or a combination of these, your Prospera coach will guide you as you learn to notice your thought and behavior patterns and will support you in implementing new skills and strategies that allow you to move through your grief.
About Prospera:
Prospera is a mental health platform for fertility, pregnancy, and postpartum. We combine personalized 1-on-1 support with evidence-based coping tools to help women navigate anxiety, depression, relationship challenges, identity changes, and the many other emotional challenges that can arise during the motherhood journey.
Our programs were developed by clinical psychologists Drs. Andrea Niles and Sarah Stanger and are grounded in evidence-based approaches, including cognitive behavioral therapy (CBT).
Need more support? Book a free consultation to learn more about Prospera and how we can help.
Sources
www.abct.org/fact-sheets/complicated-grief/
thereachinstitute.org/promoting-healthy-grief/
Get Support for the Motherhood Journey
Personalized 1-on-1 sessions and coping tools designed for infertility, pregnancy and postpartum