Pregnancy loss can be one of the most difficult things a person can go through. Although it’s not often talked about, with it can come a process of grief and mourning just like any other death.
Perinatal bereavement is the process that parents go through immediately after the loss of an infant through miscarriage, stillbirth, neonatal loss, or elective termination for fetal anomalies, or in the first month after birth.
Jump ahead to these sections:
- What Is Perinatal Bereavement Care?
- Who Typically Uses Perinatal Bereavement Care?
- How Can Professionals Get Perinatal Treatment Certifications?
- Where Can People Find Perinatal Bereavement Support Groups?
Like any other loss, everyone will navigate perinatal bereavement differently, but having the right care and support can make all the difference. When looking through blogs about grief, you may be wondering just what perinatal bereavement care looks like, who uses it, what training looks like, and how to access support.
Let’s answer some of these questions and get you started on finding support or helping support someone else.
What Is Perinatal Bereavement Care?
Perinatal bereavement care is highly personalized and depends on the needs of the grieving parent or parents.
What makes perinatal bereavement different from the loss of an older person is that perinatal deaths can often occur suddenly and without warning at a time when people are looking forward to the next phase of their lives and the prospect of building a family. These losses can occur without explanation, and it’s not always possible to determine the cause of death – which can make it difficult for families to feel closure.
It’s not uncommon for people who experience pregnancy or infant loss to go into an extreme state of stress, depression, or develop PTSD.
It’s pertinent for perinatal bereavement care providers to have an understanding of trauma-informed care. Most people will register perinatal loss as a traumatic experience.
Providers skilled in trauma-informed care prioritize trustworthiness, transparency, safety, empowerment and choice, collaboration and mutuality, and peer support. They also understand the role of cultural, historical, and gender issues in perinatal loss.
Who offers perinatal bereavement care?
Typically after a perinatal death, the healthcare professionals present will refer the parents to a social worker or mental health professional like a psychologist. In some cases, it may be recommended for parents to attend partner therapy in addition to individual care.
It’s not just mental health professionals that offer perinatal bereavement care. Any healthcare professional who comes into contact with grieving parents should have some training or awareness around perinatal bereavement. This includes but is certainly not limited to nurses, midwives, OB/GYNs, fertility specialists, ultrasonographers, emergency room providers, genetic counselors, home health providers, doulas, and more.
What does perinatal bereavement care look like?
Care starts with how providers communicate and the language that they use to discuss delicate matters with their clients. Words like “baby” and “death” may be triggering to some, while others will appreciate this direct language. It’s helpful to have both parents present for any important conversations and to provide an interpreter when necessary. Active listening and space for silence are just as important as respectful communication.
Part of perinatal bereavement care can mean helping parents form a relationship and create meaning around the child they have lost.
Here are some ways specialists help them do that:
- Using the infant’s name, if the parents have given one
- Letting parents choose whether or not they want to see or spend time with their infant after the death or while they are on their way out
- This also means preparing parents if the baby has physical abnormalities or is extremely premature.
- Making meaning of the experience with a provider that resonates with the parents
- This could mean a spiritual or religious advisor.
- Understanding the cultural differences about how people navigate death and grief
- Allowing families to hold, bathe, or dress the baby if they wish
- Taking pictures or videos
- Some birth photographers specialize in capturing these moments for families so that they always have them to look back on.
- Suggesting books about miscarriage and stillbirth
- Making keepsakes like a lock of hair, hand or footprint mementos, or hospital bracelets
Perinatal bereavement care doesn’t stop immediately after the death. People may experience grief for years after, although it will change and evolve over time. Aftercare means following up with people who have experienced a perinatal loss six months, a year, and even years after it happens.
Who Typically Uses Perinatal Bereavement Care?
Anyone who is coping with a miscarriage or who experiences a perinatal loss can benefit from bereavement care. Of course, this means the gestational parent or parent who carried the child, but it can also include the partner or other parent if there is one and even siblings and other close family members or caretakers.
Bereavement care may be especially important for people who have experienced multiple pregnancy losses or have had difficulties with fertility. Everyone registers grief differently, and the necessity of care depends on the person.
It’s important to point out that not just gestational parents experience perinatal loss. Adoptive parents, people who have used a surrogate, and anyone else who is on a pregnancy or parenthood journey can experience a perinatal loss. The grief may be complicated and unconventional, but it is just as valid and worthy of care and support.
No matter if it’s a parent, partner, or sibling, anyone close to pregnancy can experience perinatal bereavement.
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How Can Professionals Get Perinatal Treatment Certifications?
Perinatal treatment certifications are broad and not often required by professionals. This means that providers who seek certification often do so on their own time using their own resources.
These certifications mean taking the extra step to offer crucial support to people going through a heartbreaking, yet not uncommon, occurrence.
1. Have a foundational practice
As mentioned before, all sorts of providers can and should be knowledgeable about perinatal bereavement support.
If you are interested in pursuing certification, ask if your clients or patients could benefit from it. This could include all sorts of healthcare providers like nurses, OB/GYNS, midwives, ultrasound techs, and physicians. It also includes genetic and fertility specialists, social workers, funeral directors, hospice workers, and mental health professionals.
2. Find an organization
Gundersen Health Organization is considered the “gold standard” in perinatal bereavement education. Their training focuses on perinatal death through miscarriage, ectopic pregnancy, stillbirth, and newborn death.
This two-day training is the only educational offering available to help prepare for the Hospice & Palliative Credentialing Center's perinatal loss care certification exam – which is the standard certification for perinatal bereavement care.
There are other more unconventional ways of becoming certified or trained in perinatal bereavement. Many doula and midwifery training programs make space for education on pregnancy loss.
Stillbirth Day trains grieving parents, healthcare professionals, and anyone who wants to be a support system for people who have experienced a stillbirth.
Cornerstone Doula Trainings offer full-spectrum doula training that encompasses working with pregnancy loss from a social justice perspective. Their trainings are available in person in California and Oregon, as well as online.
Finding the right certification program means not just using what seems to be the most popular but also finding a program that aligns with your values and views on perinatal support.
3. Keep learning
There is always room for more education, understanding, and knowledge when it comes to supporting people through perinatal bereavement. Much of this education comes with time and hands-on experience.
Allow your experiences spent providing care to keep humbling you and pushing you to seek further education.
Where Can People Find Perinatal Bereavement Support Groups?
Many people who experience perinatal loss describe feeling completely alone in the process and not knowing where to turn. They’re not alone.
People find healing in community. Perinatal bereavement support groups are available in person and online for parents who have experienced a pregnancy or infant loss.
Here are some to check out:
1. Return to Zero H.O.P.E.
Return to Zero began as a film made by parents Sean and Kiley who had experienced an infant loss. The movie has helped many who have experienced stillbirth. Sean and Kiley then went on to form their non-profit as a community for bereaved families and their healthcare providers to spread awareness, education, and support around pregnancy loss.
On their website, you can find a list of local support groups and organizations dedicated to perinatal bereavement in the U.S.
2. Postpartum Support International
Founded in 1987 by Jane Honikman in Santa Barbara, California, Postpartum Support International is an organization dedicated to increasing awareness amongst public and professional communities about the emotional changes people experience during pregnancy and postpartum.
This also means spreading awareness around perinatal loss and grief, which is why they offer an online Pregnancy and Infant Loss Support Group. The group is led by their trained professionals and allows bereaved parents to find support, and access resources and useful information.
What’s Perinatal Bereavement? Care + Training Explained
Whether you experienced a perinatal loss or you’re comforting someone who had a miscarriage, knowing where to turn for bereavement care is critical for your or your loved one’s healing.
While there are specific certifications and professionals that offer bereavement care, some parents may find support in more unconventional providers like spiritual or religious advisors.
No matter what your journey looks like, there is care available for you. You are not alone on this journey.
- Fenstermacher Ph.D., CRNP, Kimberly, and Judith E. HUPCEY, EdD, CRNP, FAAN. “Perinatal Bereavement: A Principle-based Concept Analysis”. National Institutes of Health, Fourth, March 2013. ncbi.nlm.nih.gov