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Caring for Families Who Have Previously Endured Multiple Perinatal Losses
KEY POINTS
- 1.
Parents with a history of multiple previous fetal/neonatal losses may find it difficult to care for a critically ill newborn infant. The fear of losing yet another child can be heartrending and traumatic.
- 2.
An individual’s fundamental beliefs about themselves and their future children are not only disrupted by a pregnancy loss or undesirable perinatal diagnosis, but are often accompanied by psychological sequelae.
- 3.
Cultural silence and the disenfranchised nature of the repeated losses of children contribute to prolonged, amplified, and sometimes, delayed grief reactions.
- 4.
Neonatologists and other healthcare providers often feel ill-equipped to address the emotional and grief aspects of reproductive loss.
- 5.
A well-informed team of clinical care providers with basic knowledge about the unique aspects of perinatal loss coupled with an understanding of the grieving process and beneficial communication modalities can lay the foundation for a healthy grieving trajectory for families enduring a reproductive loss.
Reproductive Story
Reproductive psychologists Jaffe and Diamond observed that individuals envision their future family with an array of hopes and dreams long before conception, and the trauma occurs when those expectations fail to come to fruition. They found that individuals’ fundamental beliefs about themselves and their offspring is disrupted by the experience of perinatal morbidity or mortality, which can be devastating. Although the grief trajectory is highly individual, Jaffe and Diamond found the following themes to be consistent among those grieving a reproductive loss: not only has the child died, but a part of them has died as well; there is a loss of hopes and dreams for themselves and the child; and there are feelings of failure at the most basic level. The extent of loss can be multilayered. Neonatologists and all care providers in neonatal intensive care units (NICUs) live this story repeatedly with the families they care for. For parents who have had a history of multiple fetal/neonatal losses, caring for a critically ill newborn infant can abrade and reopen all the wounds that had seemingly healed over time. The fear of losing yet another child can be heartrending and traumatic; it can reaggravate all the previous trauma and nightmares that they believed had subsided.
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