Q & A with Dr. Deb, DACM, L.Ac.: 6 Questions on Pregnancy Loss
By: Tracy Gilmour-Nimoy, M.S., Lmft
Tags: Pregnancy Loss, Mental Health Awareness, Womens Health, Miscarriage, Mental Health

Hi friends!

Today’s blog post is a Q & A with my dear colleague, Dr. Deb, and we’re answering questions related to infant and pregnancy loss.

Dr. Deb is a Doctor of Acupuncture and Chinese Medicine, with decades of personal and professional experience working in women’s health. Like you, and/or someone you know, Dr. Deb experienced a loss. Her first baby, Mia, passed at term, due to a cord accident.

Earlier this year, I also delivered my first baby, Addison, stillborn, in the 3rd trimester.

Deb and I are both passionate about maternal mental health and determined to facilitate conversation regarding pregnancy loss — something that is not uncommon, though it is still uncommonly talked about.

We want to say a special thank you to those who submitted these questions, gifting us the opportunity to have a real conversation about this taboo topic.

So, grab a coffee, tea, water, or whatever else you need, and join us as we get the conversation rolling!

Question 1: When the pain is invisible to others, how do you manage to find your smile in the mirror again?

Dr. Deb: I remember feeling sad all day every day and though I may have looked fine, I wasn’t fine — I was at my worst, and people around me were completely unaware of what I was going through.

I think we’re all pretty good at hiding our pain, because in a lot of ways (culturally and socially), we tend to sweep pain and sadness under the rug. There is this expectation that people need to just grin and bear it, because we are not really taught how to cope with loss, and in turn, others are not taught how to support us.

I had to find ways to support myself, and the way that I learned to cope with the pain is by surrounding myself with a supportive network, and giving feedback on how they can support me.

I make sure to practice my self-care, or as I like to call it, “ME time” (M for meditate, E for exercise). I’m all about healing the healer, so for me, that looks like meditating, exercising, acupuncture, going to a chiropractor, and therapy.

Finding things that help to recharge, are essential.

Tracy: The biggest thing for me, is the acknowledgment that I will never be the same and that’s ok. I won’t get over it, but I will get through it.

Here’s the thing about grief — it’s a human condition. We all experience grief and loss, and something so significant such as the loss of a child, changes a person. The pressure or expectation that we need to return to who we were, is unfair and unrealistic. Recognizing that the loss is profound and that it will impact me for life, has freed me from that pressure.

As time passes, my relationship to my grief changes. It is less raw and consumes me in different ways.

This doesn’t mean that I’m over it, that I love my child less, or that what happened to me is ok — what happened will never be ok. Instead, it means that I’m finding ways to move forward, knowing that I’m moving forward as a different version of myself.

We talk a lot about post-traumatic stress, but what we don’t talk enough about is post-traumatic growth. Post-traumatic growth is a positive transformation that occurs after a trauma. It’s how people who have been through incredibly catastrophic events, are able to take that experience and find some sense of purpose, or ability to make changes and move forward (not on). Post-traumatic growth is a beautiful thing and it’s very real, but it doesn’t negate the trauma which has occurred.

Since my loss, I’ve dedicated a portion of my clinical practice to working within maternal mental health — something I would not have done, if I didn’t have a personal connection to it. It is an honor to be able to do this work, but If given the choice, my choice will always be to have my child. Thus, it is important to recognize that if there is post-traumatic growth, the trauma is still very real for that person.

Oh, and of course, lots of therapy, reading, and writing!

Question 2: As a family member or friend, how can I support parents who have experienced a loss, without trying to make them feel better?

Dr. Deb: The biggest thing is acknowledging the loss and giving them the space — space to talk and cry about what happened; space to be human. And it’s ok for you to be human, too.

It’s ok for you to cry with them, for you to not know what to say. Tell them this, and ask how you can support them.

They might want you to drop off food, go on a walk, or sit with them. You can help them access support, because grieving will take up all of their energy. You can research therapists, support groups, and resources, so that they don’t have to.

My sister found therapists, programs, and support groups for me. She did all of the legwork from enrollment to transportation, because she knew I didn’t have it in me to do it myself.

When speaking to those who have experienced the loss of a child, don’t compare your loss to theirs. Yes, your loss or breakup is also painful, and no, it’s not the same.

I would often hear, “you can have another baby,” which I hated, because it does not acknowledge the loss I have experienced.

Even if a woman has a healthy baby after a loss, it does not replace the baby that she didn’t get to take home. You would never say this to a person who lost their parent or sibling, so I never understood why someone would say this about the loss of a baby.

Remember that even though they’ve had a loss, they were pregnant and now they are postpartum. Women often don’t take any time off after a loss, and are frequently back to work days later. It’s important to recognize that in addition to the emotional loss, there’s also a physical loss that’s occurring within their body.

Acknowledge all of this, and encourage them to take time for their mind and body to heal.

Tracy: We are such an anti-grief and anti-pain culture, that our discomfort leads us to want to make things better for a grieving person, because we can’t stand to see them in pain.

We tend to say things like, “everything happens for a reason,” “look on the bright side,” or “you’ll be a mom one day”.

Comments like this are not supportive — they’re dismissive and can be quite harmful to your grieving loved one. Instead of making them feel loved and cared for, which I’m certain is the intention of most, it will create a divide between you and that person.

It will make them feel ashamed or as if something is wrong with them, when in reality, feeling depressed, lonely, and helpless, are normative, emotional responses to grief.

Listen to what they’re saying and hear their pain — don’t dismiss it. There is nothing that you can say to make them feel better, and that’s ok. They’re not looking for you to fix them, they’re looking for you to sit with them as they bear the unbearable.

Be a witness to their grief. Tell them you have no words; tell them you love them. Tell them it’s ok to feel whatever it is that they are feeling.

In terms of logistics, there is a lot that needs to be done when there’s a loss. With a late term loss, there’s medical intervention — most commonly, a labor and delivery. A woman who has a stillbirth goes through the same physical symptoms and recovery, as a woman who births a live baby, with one exception; their postpartum body will be a constant reminder of what they’ve lost.

Dropping off food, sending postpartum/wellness products, are all thoughtful gestures. There are often funeral arrangements and nurseries to clear out, so offering to coordinate these things can also be very helpful.

Remember that they’ll be in moment-to-moment survival mode, and taking on these tasks will feel far too big.

Check in with them, ask them what their needs are. Do not hold them to expectations. Keep sending them cards, texts, and calls, even when they don’t respond. You’re reaching out for them, not for you, and their responses are not personal.

Honor what they feel comfortable sharing. Let them know you’re there to listen, but don’t pester them with questions, especially questions about future pregnancies.

Having a healthy baby will feel impossible to them, and you have no idea how their fertility has been impacted. Let them be the ones to bring up these topics.

I found asking trusted family members and friends to handle all incoming messages for me to be crucial, because early on, I didn’t have the emotional capacity to talk to anyone.

It’s important to note that this impacts not only the person who was pregnant, but their larger support network as well. Don’t forget to check in with the non-pregnant partner and family, and continue to check in with them even when time elapses. A lot of people reach out at the onset, but this sort of loss is lifelong — it will continue to impact them far beyond when people stop asking about it.

Question 3: As a provider, how do I support clients/patients who have experienced pregnancy loss?

Dr. Deb: Reach out to them and offer support. If you can’t see them face to face, offer to call them or video chat, as a way of staying connected.

Help them to explore their methods of self-care, and encourage them to access mental health services, whether that’s in the form of therapy or support groups. Pregnancy loss is often a financial stress, so try to find low-fee or free resources that might be helpful.

In my practice, I talk a lot about the physical symptoms of grief and the toll grief takes on the body. In Chinese medicine, the lung organ is connected to the emotion of grief. People commonly get colds/flus after a loss, so I always recommend extra protection for the lungs.

Tracy: As a therapist, it’s key to normalize grief instead of pathologizing it. Grief can’t be treated, but it can be supported, and there’s a difference between pain and suffering.

So much of grief work in therapy is holding space for that person, providing psychoeducation about grief and trauma, reducing shame, assessing that basic needs are being met, and encouraging them to feel, process, and grieve, while making sure to tend to your own needs as a clinician.

Providing them with specific grief and perinatal loss resources, is essential. There are a lot of organizations, websites, books, and podcasts, out there, and reading/hearing about the experiences of others can be really beneficial for patients.

Free them of the expectation that there’s a normal to get back to, and help them explore what their new baseline or normal will look like.

Often times after a loss, conversation surrounding future pregnancies will come up in therapy. Remember that pregnancy after loss is completely next level. They have gone through a pregnancy (sometimes a full pregnancy), labor, delivery, and a postpartum recovery, and they still don’t have their baby. These things are a lot when everything goes well, so the thought of having to do it again for the chance of MAYBE having a baby, is overwhelming. Your client/patient has experienced a trauma, and their body has failed them. Their fears are big, and they are based in reality, because they’ve already lived through the worst outcome imaginable. For them, the nightmare is no longer a baseless fear, it’s their lived experience.

It’s important to treat this as a trauma response, versus encouraging them to be excited, or saying they know what to expect because it’s not their first pregnancy (yes, these things have been said to me by therapists!). Anyone who has had a loss, will fear continued loss — how could they not?

The biggest thing when seeking therapy for pregnancy loss, is to find a provider who specializes in this AND to make sure it’s the right fit. I’ve personally met with providers who specialize in this, and they still didn’t get it. The maternal mental health specialty is quite broad, so make sure to find a therapist who has experience with loss, which is really a subspecialty.

The most important factor in the efficacy of mental health treatment is the provider-patient relationship. If your therapist is not the right fit, ditch them! There are so many gifted therapists out there, and I’m certain there’s a therapist for everyone, you just have to find them.

For non-mental health providers (physicians, doulas, nurses, dieticians, etc.), it’s important to have a basic understanding of trauma and grief, and practice from a trauma-informed lens.

A woman who experiences a late loss, is often cleared at the 6-week postpartum mark, but it’s important to take her mental health into account, too. The physical recovery is often easier and quicker than the emotional one. A woman who has a stillbirth, will not have an extra pot of time to pull from, such as baby bonding. Remember that just because there isn’t a baby at home, doesn’t mean that she will be ready to go back to work after 6 weeks.

Consult with mental health clinicians, provide adequate mental health resources and referrals, and be mindful of language and settings.

Do not ask how they are when you know they’ve just experienced a loss, because, spoiler alert — they’re probably and understandably not doing well. Offer condolences, let them know you’re thinking about them, and check in on them (or have someone from your office do so), in between visits, if you can.

Try to have a select few individuals from your team interact with them, so they don’t have to keep retelling their story, and please make sure that whoever contacts them is aware of the circumstances. I remember being congratulated by one of the nurses at my doctor’s office, which was excruciating.

When they come in for an exam, don’t place them in a room full of baby photos. This is a huge trigger for individuals who have experienced infant loss, and it’s one that can be easily avoided.

Show up, not only as a provider, but as a human. Patients will remember providers who were there when things went well, but they will never forget someone who showed up for them when their life exploded.

Remember that their history will impact future pregnancies, even if future pregnancies and deliveries are successful.

Question 4: My friend and I had close-together due dates — she had a late loss and I recently gave birth to a healthy baby. How can I be supportive instead of triggering, while still celebrating my own joy?

Dr. Deb: First, it’s important to acknowledge that your friend not only had a loss, she had a baby — a child. Check in with her and ask what her needs are.

Does she want to talk, or is she needing space? Acknowledge that you know your baby may bring stuff up for her, and continue to check in.

Understand that if she does need space, her response to your joy is not about you — it’s about her experience and her grief. Don’t put her in an uncomfortable position of saying that she isn’t in a place to talk about your baby, and instead, be the one to initiate the conversation so that she doesn’t have to.

Tracy: I experienced this a lot. I’m at the age where a lot of my friends are having children, and I had several close friends who were due around the same time that I was.

The most hurtful thing is when there is zero acknowledgment or contact. Your friend has experienced a profound loss and pretending it didn’t happen, is immensely hurtful.

What I found most helpful, was when my friends initiated the conversation with me. They would ask me directly, “when we speak on the phone, is it upsetting to hear my baby cry?”, “If I see you, do you want me to leave my baby home?”, “Is it upsetting if I talk to you about my baby?”

Have an open dialogue with them and be the conversation starter. They love you, they love your baby, and I promise you, they are happy for you. No mother who experiences the loss of a child wishes it on anyone. And, in the same breath, you having a healthy baby, is likely triggering for them, and this isn’t your fault.

Check in with them and respect their needs. If they give you feedback, listen. If you say something hurtful, apologize.

Be mindful of what you send them — please don’t mail them a baby announcement or invite them to your baby shower. If you have a friend who has experienced a late loss, they’ll probably never go to another baby shower again, especially if they had one for the baby they did not get to take home.

Understand that they will probably mute you on social media and won’t like or comment on any of your pregnancy or baby related posts.

Continue to check in with them, because their needs might shift with time. And above all, recognize that like you, they are also a mom. Women are not stripped of this title when there is a loss.

Question 5: How do I support the non-pregnant partner who has also experienced a loss?

Dr. Deb: The non-pregnant partner is often forgotten, so it’s crucial to acknowledge that they have had a loss, too.

Give them the space and opportunity to grieve. So often, the non-pregnant partner is perceived as the rock or the holder of strength, but they too, need support. Ask them not only about how their partner is doing, but how THEY are doing.

Let them know that it’s ok for them to grieve, even though it wasn’t their body.

Tracy: It’s important to recognize that everyone grieves differently. There’s no right way to grieve; we do not get a pass or fail in grief, and partners will often grieve differently, though the occurrence of grief is simultaneous.

It’s important to normalize this for both non-pregnant and pregnant partners, who might have different thoughts, feelings, or experiences.

Question 6: How do you honor your child who has passed?

Dr. Deb: I have planted rosebushes or trees on many of her birthdays.

Anytime I see a butterfly, I like to think it’s my Mia, greeting me. I’ve become obsessed with butterflies, collecting them from anywhere I travel to.

I collect heart shaped rocks since learning about them in a support group for infant loss. I find them in nature and have had many given to me as gifts. Whenever I see a heart rock, it reminds me of Mia, and I smile. We used to let balloons fly from the cemetery on her birthday, too.

Anything to help you stay connected and feel a little bit closer!

Tracy: The relationship between mother and child starts far before birth, so any woman (or parent) who has experienced infant or pregnancy loss, has already formed a relationship with their child.

When someone dies, and this is true for all grief, our relationship with the person who has passed, doesn’t disappear — it changes.

I have a memory box filled with different mementos from the hospital where I delivered Addison. I like to look at her pictures and place my hand on her molded handprint.

When my husband and I visit her gravesite, we always purchase two bouquets — one for her and one for us to keep in our home.

These are ways for us to stay connected to her, even though we don’t have her with us in the way that we should.

To my readers, thank you so much for taking the time to read this post about a topic that’s close to my heart. By reading this post, you’re helping to destigmatize pregnancy and infant loss, and that’s HUGE!

To learn more about Dr. Deb and the impactful work she’s doing, check out her website and connect with her on social media:

Website

https://www.pushsandiego.com

Instagram

@push_san_diego

For grief and perinatal loss resources, click the “Grief Resources” and “Perinatal Resources” tab on my website. There’s support, and you are not alone.

The questions in this article were submitted to us by varying providers, followers, and individuals, seeking information on this topic. Dr. Deb Davies, DACM, L.Ac, was interviewed by Tracy Gilmour-Nimoy, M.S, LMFT, PMH-C. The article was written and edited by Tracy, with approval and input from Deb.

This article was originally published on the TGN Therapy Blog. Click the link below to learn more about the author, and be sure to subscribe for information about new blog posts!

https://tgntherapy.com/blog

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