What is "Pregnancy After Loss?"

 

Written by Stefany Fortin, CoreStory Clinician
[Click here to read more about her]

 


I am thrilled to join the team at CoreStory to provide remote therapy as we navigate the uncertainties of COVID-19.

You can find more about who I am, my credentials and my approach to therapy on my Psychology Today profile https://member.psychologytoday.com/us/home) and in my biography on the CoreStory website (https://www.corestoryny.com/staff/#stefany-fortin). 

When offering therapy at CoreStory, I draw on my personal experience as a mother and as a peer counsellor for pregnancy loss and on the decade of practice I had as a clinician in mental health in Canada before becoming a social worker in the U.S. As I join the team at CoreStory, I am also embarking on psychoanalytic training, a journey I think of as a personal and professional endeavor that, among other things, will deepen and widen how I will listen, think and am in this world and in the (Zoom) room.

What Is Pregnancy After Loss?

Pregnancy After Loss (PAL) is any pregnancy that follows a gestational loss (i.e., miscarriage or stillbirth); 50-60% of women who experienced a pregnancy loss become pregnant again within a year following their loss[1]

  • A common myth about PAL is that a new pregnancy acts as an antidote to a prior loss; in fact, there tends to be a new wave of grief alongside the news of a pregnancy after a loss[2]

  • Individuals who experienced a pregnancy loss are at an increased risk for post-partum psychiatric disorders, namely depression, anxiety, and post-traumatic stress disorder[3]; maternal mental health is linked with better attachment and overall better health outcomes for infants

How can therapy help?

  • The greatest challenge encountered in PAL is to address the fear of another loss and make room for grief and attachment to coexist

  • Therapy offers a space where the feelings attached to PAL can be contained, explored, and understood, which can ultimately make PAL a more manageable experience

“When we mourn our losses we also mourn, for better or for worse, ourselves. As we were. As we are no longer. As we will one day not be at all.” -Joan Didion[4]

 

[1]  Lamb E. H. (2002). The impact of previous perinatal loss on subsequent pregnancy and parenting. The Journal of Perinatal Education, 11(2), 33–40. doi:10.1624/105812402X88696

[2] Markin, R. (2018). “Ghosts” in the womb: A Mentalizing Approach to Understanding and Treating Prenatal Attachment Disturbances During Pregnancies After Loss. Psychotherapy, 55(3), 275-288.

[3] Giannandrea, S. A., Cerulli, C., Anson, E., & Chaudron, L. H. (2013). Increased risk for postpartum psychiatric disorders among women with past pregnancy loss. Journal of Women's Health, 22(9), 760-768.

[4] Didion, J. (2005). The year of magical thinking. Vintage International