Pregnancy and Infant Loss Risk Factors and Treatment Issues

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By AllCEUs Counseling CEUs and Dr. Dawn-Elise Snipes. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

Pregnancy and Infant Loss
Risk Factors &
Treatment Issues
Dr. Dawn-Elise Snipes PhD, LPC-MHSP
AllCEUs Counselor Continuing Education

CEUs available at: https://www.allceus.com/member/cart/index/product/id/1350/c/

Objectives
– Identify risk and protective factors for
– Prematurity/Miscarriage/Stillbirth
– Sudden Infant Death Syndrome
– Explore treatment issues for the family
Risk Factors for Miscarriage/Stillbirth
– Miscarriages occur before 20 weeks.
– Prevalence: 10-25% of all pregnancies (or more)
– ~20% of miscarriages happen in the first trimester
– 1-5% of miscarriages happen in the second trimester
– Stillbirths occur after 20 weeks
– ~1:100 births in developed countries (24,000/year in the US) and 3:100 in less developed areas

Risk Factors for Miscarriage/Stillbirth
Prematurity
– Prematurity
– Impacts 1 in 10 births in the US
– 17% of preterm infants die
– Many times the cause of the preterm labor is unknown but risk factors are similar to those for miscarriage
– Although the infant is born alive, the parent
– Is deprived of the idealized pregnancy
– Has to leave the hospital without baby (psychological and hormonal implications)
– May not be able to hold or even touch baby for days or weeks
– Knows that the statistics for complications and death are grim
SIDS
– The peak incidence of SIDS occurs between 1 – 4 months of age
– 90% of cases occur before 6 months of age
– Babies continue to be at risk for SIDS up to 12 months
Risk Factor Summary (What do you notice?)
Risk Factors for SIDS
– Unhealthy pregnancy
– Drug exposure (including nicotine)
– Low weight gain (nausea)
– Placental issues
– History of infections (STDs, bacterial vaginosis, UTIs)
– Child factors
– Prematurity
– URI within 4 weeks
– Low birth weight
– Siblings who died of SIDS
– Sleep environments
– Stomach or side sleeping
– Loose blankets / inappropriate sleep surface
– Smoke exposure
– Bed sharing
– Overheating

Treatment Issues
– General
– In the birth parent
– Grief (complicated)
– A person looks at the pregnancy as part of themselves and when it is lost, there is an emptiness, searching and incompleteness
– Depression (up to 55%)
– Guilt and self anger: Shouldas, “I didn’t do it right”
– Guilt for having happy feelings
– Feeling incompetent: “The most natural thing in the world”
– Relief esp. for unplanned or problematic pregnancies
– Postpartum depression
Treatment Issues
– General
– Complicating Issues
– If it required the birth process or a DNC
– Waiting for a natural miscarriage to occur after a fetus has died in utero can be psychologically debilitating for parents
– Having to go to the OBGYNs office for follow up
– Seeing other newborns in public
– If it was a multiple delivery and one baby survived
– If it resulted in the parent becoming sterile
Treatment Issues
– General
– In the other parent
– Grief (complicated)
– Anger
– Relief
– Difficulty understanding why the pregnant parent is taking it so hard
– Anxiety about having another pregnancy
– Determination to get pregnant again as quickly as possible
Treatment Issues
– General
– In extended family
– Grief
– Anger/blame
– In the siblings
– Lack of understanding of what happened
– Relief
– Disappointment
– Resentment that parents aren’t instantly okay
For the Siblings
– It is important to remember the developmental capacities of children including egocentrism and making assumptions based on their limited knowledge.
– Younger children may view a new sibling like a present and want to know why you can’t just get another one
– They may feel rejected or like they are not enough when parents are grieving the loss of this child they never got to see or interact with
– They may fear that the parents will “make them go away” too and become more anxious
– They may be happy because they now have parents all to themselves which may cause friction with the grieving parents
Interventions
– Learn about what happened and implications for the future (Everyone) to help reduce guilt, blame, and anxiety.
– Understand the grief process is not linear and is not the same for any two people—even in the same family
– Remember like other losses, this grief will take time to process and may flare up for a year or more
– Decide, when you are ready, what to do with your maternity clothes and baby items
– Consider joining a support group or seeing a counselor
– Consider commemorating the child’s life with a birthstone or scrapbook (ultrasounds etc.)

Interventions
– Practice self care
– Recognize that the body has gone through a trauma and pregnancy induced adaptations will take time to resolve
– Give yourself permission to grieve and also to be happy
– Recognize that another pregnancy will not lessen the grief and may actually increase anxiety and depression

For the Partner
– Talk, listen and process together and with your own supports
– Practice your own self care
– Help eliminate triggers in the immediate environment if wanted
– Reaffirm the loss was not your partner’s fault
– Help share the news with friends and family so your partner is not bombarded with questions or sympathy
– Recognize that your partner’s body has to go through the postpartum process.
Summary
– Pregnancy and infant loss are devastating
– Many times there is no clear explanation for why it happened which flies in the face of closure
– Often times well meaning family and friends may probe for “explanations” and it feels like they are blaming the birth parent.
– Parents may share some similar reactions, but they also may have very different reactions, so it is important not to assume you know how either one feels.
– Prematurity, miscarriage, stillbirth and infant death all have unique issues, but all represent a loss

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