coping with perinatal bereavement
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Transcript coping with perinatal bereavement
COPING WITH PERINATAL
BEREAVEMENT
Cyndie Franklin, MSEd
Northeast Iowa Family Medicine
Residency
January 22, 2014
Objectives
Improve understanding of the process
of perinatal grief
Discuss the role of the physician and/or
healthcare professional in managing
perinatal grief
Provide information on local services
available to patients and families
About 15% of all pregnancies
terminate in spontaneous
abortion.
At least 80% of those do so in the
first trimester.
Parents mourn for what was
and for what might have been.
Regardless of the stage of the
pregnancy
Regardless of the gestational age of the
child
Regardless of the length of the parental
relationship
Perinatal and early infant loss
is complex because
One must cope with their own grief.
One must cope with their partner’s
grief.
One must cope with changes in the
relationship because of the loss.
Additional Stressors
Parenting of other children
Financial difficulties
Lack of consensus as to a “proper”
mourning period.
Grieving always takes place
within a social context.
There are few mutually
understood social rituals to aid
the perinatally bereaved.
Medical personnel are on the
front lines of this family crisis.
Understanding Grief
Grief as a series of stages:
Kubler-Ross model
Parkes/Bowlby model
Grief does not appear to be
tied to a fixed order of
emotional states.
It seems to be a more complex and
disorderly sequence of events
than stage theorists suggest.
Current thinking is that grief:
Appears related to the closeness of the
relationship with the deceased.
Is impacted by the perception of
preventability of death.
There may not be final resolution of
grief.
Normal grief is normal for
each person in its own way.
“Losing someone you love is
less like losing a very valuable
and irreplaceable possession
than like finding the law of
gravity to be invalid.”
--a Parent
Time and Grief
Time stands still
Time’s up
Doing Time
Wasting time
Looking back in time
First times
Time out
Time heals
Schwiebert, P from Grief Watch Newsletter, 2011
Perinatal loss disrupts
parents’ assumptions of life:
The meaning of the child
Personal invulnerability
Positive view of oneself and one’s child
The belief in an orderly world
Coping with grief requires a
re-definition of “ normal.”
Parents cope with their loss
by:
Establishing a sense of structure in their
life.
Gathering information about the
experiences of others.
Searching for meaning.
Blunting and sealing.
The Importance of Rituals
Rituals are tools that help us make
sense of loss
Active participation in the grief process
is the best way to cope with the loss of a
loved one.
(Kobler & Kavanaugh, 2007)
Some rituals that may help
Memory boxes
Naming the baby
Religious/spiritual
contacts and
practices
Cultural/family
traditions
See, hold, touch the
infant
Take photographs
Consider a funeral
Collect mementos
Journal or blog
Helping Children Understand
Children of all ages grieve
They may not look like they’re grieving
They often “re-grieve” a loss when they
experience a new stage of cognitive
development
They may worry that they will die, too,
or that they are to blame
Some Ways to Help Them
Understand
Use simple, honest words about death
Reassure them they are not going to die
Tell them no one is to blame for the
baby’s death
Use age-appropriate books about death
Help them find their own way to
remember the baby
Most couples will experience
at least temporary marital
conflict .
This is largely due to an
underlying disagreement in
beliefs and expectations.
Common differences
experienced by couples
Meaning each parent gives to the loss
Each partner’s view of the couple
Views of appropriate grief behavior
Individual experiences surrounding the
loss
The marital relationship is
re-stablized by:
Communication
Positive outlook on their relationship
Perception of a shared experience
Social support from outside
the marriage is also important.
Health care professionals play a
pivotal role in healing.
Physicians and health care
professionals help by:
Providing accurate information
about
what has happened
about what to expect
Information needs to be delivered in a
caring and humane fashion
Common support tactics that
DON’T work include:
Giving advice
Encouragement of recovery
Minimization of feelings
Identification with feelings
REMEMBER:
The handling of the situation
during the immediate impact of
the child’s death will be vividly
remembered by the parents!
Take Home Points
Perinatal loss is experienced as a real
and significant event that is grieved by
the parent(s) and family
With support, most parents and family
ultimately accommodate this loss
As a healthcare professional, your
actions and management of this loss
make a difference in the process of grief
Online Sources of Support
http://www.mend.org
http://www.mayoclinic.com/health/pregnancyloss/PR00098
http://www.babyloss.com
http://marchofdimes.com
http://facebook.com/pages/Share -PregnancyInfant-Loss-Support-Inc/112835372099879
Etc., etc. . .