- Meeting abstract
- Open Access
Subsequent pregnancy: healing to attach after perinatal loss
© O’Leary; licensee BioMed Central Ltd. 2015
- Published: 15 April 2015
- Unborn Child
- Parent Bond
- Perinatal Loss
- Maternal Fetal Medicine
- Bereave Parent
The paralysing feelings of grief after perinatal loss can cause an overwhelming feeling of being abandoned, creating confusion, disorientation and hopelessness, altering future pregnancies for parents, children alive at the time and those that follow. Research with parents’ pregnant following loss, elderly bereaved parents with no intervention, and children born after loss, some now adults, show the importance of guided intervention in the pregnancy that follows.
Parents who suffered losses fifty or more years ago were offered little guidance or rituals in healing , followed doctors’ advice and, even those that requested to see their baby were told it was for the best if they didn’t. The message was to “buck up,” get pregnant again, frequently living a life time in the shadow of the experience. Parents’ unresolved grief and tendency to not share what happened often became an emotional burden carried by siblings into adulthood [2–4].
The professional’s goal is not to sever parents bond with the deceased baby but to help them create memories that recognize the psychological/spiritual dimensions of the relationship that does not end  to integrate the deceased baby into their lives [5, 7] as they embrace a new unborn baby; important in lieu of the research that fear of loss can hinder attachment to the child born after [6, 8].
A framework for understanding pregnancy loss and the pregnancy that follows is integration of the models of attachment and loss that honours their parenting relationship with both the deceased baby and new unborn baby . Research in maternal fetal medicine and prenatal psychology suggests there is a deep connection developing during pregnancy, maternal/fetal programming occur in parallel [9–11] and are bidirectional [11, 12]. Prenatal diagnostics, genetic screening, and fetal surgery have changed the medical and cultural status of the maternal-fetal relationship, suggesting attachment begins at an earlier stage. Investment is a more active process of involvement in the pregnancy  whereas attachment is concerned with the development of feelings for the baby as the parent seeks: to know, to be with and interact with, to protect, to avoid separation or loss and to gratify needs of the unborn child . It is not just prenatal caregiving  but developing a relationship as unresolved histories of early relational trauma or loss often remain actively dysregulated in the intra-psychic mind of a parent, becoming a powerful source for some prenate’s stress . A prenatal attachment framework alters representations of the unborn child in parental behaviors using the message that “the baby is already here” while sustaining a continued bond to the deceased baby  as a family member in order to attach to the child that follows.
Parents’ need information on how to tell surviving children about their deceased sibling. Children need to know it’s okay to cry, be given appropriate information at their developmental age, reminded it’s not their job to take care of the parent, involved in family rituals, find a meaningful symbol to connect, and someone who will listen to their feelings . Adults who were a subsequent child and research with parents raising children after a loss all shared surprisingly common themes; sensitivity/nurturing to others, curious and sadness of not knowing sibling; a deep understanding of death and were not afraid to be present to grieving people [2, 3]. The theme that was different reflected children whose parents had supportive intervention at the time of loss or in the pregnancy that followed who described feeling loved and overprotective verses adults whose parents lacked support; half felt loved and cherished while others felt invisible in their families . Parents who have support and guidance are very intentional in raising their children [17, 18]. Within the context of loss common patterns and reactions of grief emerge throughout the continuum of life as we all rework pieces of our grief. Reconciling and healing is a process, not an event.
- O’Leary J, Warland J: Untold Stories of Infant Loss: The Importance of Contact with the Baby for Bereaved Parents. Journal of Family Nursing. 2013, 19 (3): 1-24.Google Scholar
- O’Leary J, Gaziano C: The experience of adult siblings born after loss. Attachment. 2011, 5 (3): 246-272.Google Scholar
- O’Leary J, Gaziano C: Sibling grief after perinatal loss. Journal of Pre and Perinatal Psychology & Health. 2011, 25 (3): 173-193.Google Scholar
- O’Leary J, Gaziano C, Thorwick C: Born after Loss: The invisible child in adulthood. Journal of Pre and Perinatal Psychology and Health. 2006, 21 (1): 3-23.Google Scholar
- O’Leary J, Warland J, Parker L: Prenatal Parenthood. Journal of Perinatal Education. 2011, 20 (4): 218-220. 10.1891/1058-1243.20.4.218.View ArticlePubMedPubMed CentralGoogle Scholar
- O’Leary J, Thorwick C: Attachment to the Unborn Child and Parental Representation of Pregnancy Following Perinatal Loss. Attachment. New Directions in Psychotherapy and Relational Psychoanalysis. 2008, 2 (3): 292-320.Google Scholar
- O’Leary J, Thorwick C, Parker L: The baby leads the way: Supporting the emotional needs of families’ pregnant following Perinatal loss. Edited by: Ragland, K. 2012, Mpls, MN, Self published: O’Leary, aplacetoremember.com, 2Google Scholar
- Côté-Aresenault D, Donato K: Emotional cushioning in pregnancy after perinatal loss. Journal of Reproductive and Infant Psychology. 2011, 29 (1): 81-92. 10.1080/02646838.2010.513115.View ArticleGoogle Scholar
- Sandman CA, Davis EP, Buss C, Gynn LM: Exposure to prenatal psychobiological stress exerts programming influences on the mother and fetus. Neuroendocrinology. 2012, 95 (1): 7-21.View ArticlePubMedGoogle Scholar
- Thomson P: “Down will come baby”: Prenatal stress, primitive defences and gestational dysregulation. Journal of Trauma & Dissociation. 2007, 8 (3): 85-113. 10.1300/J229v08n03_05.View ArticleGoogle Scholar
- Dirix C, Nijhuis J, Jongsma H, Hornsta G: Aspects of Fetal Learning and Memory. Child Development. 2009, 80 (4): 1251-1258. 10.1111/j.1467-8624.2009.01329.x.View ArticlePubMedGoogle Scholar
- DiPietro J: Maternal influences on the developing fetus. Maternal Influences on Fetal Neurodevelopment: Clinical and Research Aspects. Edited by: AW Zimmerman & SL Connors. 2010, 19-32. Chapter 3View ArticleGoogle Scholar
- Moulder C: Towards a preliminary framework for understanding pregnancy loss. Journal of Reproductive and Infant Psychology. 1994, 12 (1): 65-67. 10.1080/02646839408408869.View ArticleGoogle Scholar
- Condon J: The assessment of antenatal emotional attachment: development of a questionnaire instrument. British Journal of Medical Psychology. 1993, 70 (4): 359-372.View ArticleGoogle Scholar
- Walsh J: Definitions matter: if maternal –fetal relationships are not attachment, what are they?. Archives of Women’s Mental Health. 2010, 13 (5): 449-451. 10.1007/s00737-010-0152-8.View ArticlePubMedGoogle Scholar
- Jonas-Simpson C, Steele R, Davies B, Granek L, O’Leary J: Children who grieve and mourn a baby sibling: A research-based documentary Always With Me: Understanding experiences of bereaved children whose baby sibling died. Death Studies. 2014, [Epub ahead of print]Google Scholar
- O’Leary J, Warland J: Intentional Parenting of Children Born After a Perinatal Loss. Journal of Loss and Trauma. 2012, 17 (2): 137-157. 10.1080/15325024.2011.595297.View ArticleGoogle Scholar
- Warland J, O’Leary J, McCutcheon H: Born after a loss: The experiences of subsequent children. Midwifery. 2011, 27 (5): 628-633. 10.1016/j.midw.2010.06.019.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.