Helping Clients Navigate Infant Loss

When someone loses a parent they become an orphan. When they lose a spouse, we call them a widow. But there’s no name for a parent who loses a child. 

This loss is often a tragedy too painful for words. As a society, we don’t know how to respond to this type of loss, which leaves parents feeling isolated, pressured to “move on,” and unsure of where to turn for support. When they do reach out, parents often receive placating responses like “you can always try again” or “at least you didn’t get too far into a certain trimester.” Sentiments like this minimize and painfully invalidate their personal experiences—and at the same time, people often don’t know what to say in the face of such immense loss. 

As clinicians, we can also feel the pressure of the lack of known or acceptable responses when these clients walk through our doors. In my practice, I specialize in working with mothers and families navigating infant loss, and I’ve found certain things that can truly support these families in their unique grief. 

Understanding Infant Loss

All losses are unique, and people experience them differently. With that said, I’ve still found it helpful to know the official terminology around loss, so we don’t have to rely on our clients to be able to articulate it themselves or educate us. 

Early pregnancy loss or miscarriage defines a loss prior to 20 weeks gestation. Losses after 20 weeks are called stillbirth, and neonatal death describes when an infant passes after birth, but within the first 28 days of life. Some parents experience recurrent losses, often miscarriages, and the trauma of these experiences become compounded. 

The reality is, though, that these distinctions and descriptions often mean little to a grieving family. A loss is a loss, and having language to describe it doesn’t change that fact. Grief around pregnancy is unique, as we’re not only grieving the loss of the infant. We’re also grieving the child that could have been, the parent we could have become, and the milestones that we’ll miss. Since the parent and baby never had the chance to develop a relationship outside of the womb, the infant can become idealized, and the parent must grieve what could have been, rather than what was. 

Common Responses to Infant Loss

In my practice, I’ve seen a wide variety of responses to infant loss. Some early losses are met with a combination of grief and relief for an unexpected pregnancy. Some parents experience anger toward their healthcare providers, or toward themselves. Others will experience really deep grief, and may struggle with postpartum depression or anxiety. 

Guilt and shame are also common responses to loss, and this often manifests as parents trying to understand the question “What did I do wrong?”—even though usually, the answer to that question is that they did nothing wrong. It’s also important to note here that the postpartum experience is especially challenging for a lot of women, as they struggle with hormonal changes, postpartum bodies, physical and emotional pain—but they have no baby to help them justify or come to terms with these experiences. 

Despite this physical impact, mothers aren’t the only ones grieving in these moments. Pregnancy and early infant loss impacts families and partners as well, and the impact on the relationship is often quite severe.Couples who lose a pregnancy are more likely to break up following that loss, for a variety of reasons. 

In my experience, I’ve seen one primary driver of this is a deep chasm between each partner’s grieving process. Maybe one partner wants to focus on the future, while the other isn’t ready to do that yet and still needs to process their anger and grief. In these situations, both partners feel misunderstood, or that the other partner “doesn’t care.” One partner may blame the other for aspects of the loss, or they may feel like the other is blaming them. By normalizing different grief reactions and discussing upfront the best ways they can support each other, partners can learn to grow together during this difficult time rather than growing apart. 

How You Can Offer Support

What can we as providers do to support these parents and families though this tragedy? Begin with just allowing space for whatever grief stage they’re in, without expectation or judgment. Go at their pace, and remember that you can’t rush a river. Normalize their experience, and share resources and stories of others who have experienced the same thing they’re going through. I’d recommend connecting them with a support group for people who have experienced pregnancy loss or neonatal death, which can go a long way in breaking down some of the isolation and stigma these families often feel. 

As I mentioned before, everyone experiences these losses differently, but one key role you can play is to help them identify what, if any, action steps they’d like to take in the following months, and then help them take those actions. This may look like making an official complaint to their hospital or OB provider—or it may look like helping them plan a memorial or other event for their child.

Help them understand that their grief won’t completely go away, but that over time it’ll become easier to bear. Loss is traumatic to begin with, and is often magnified by the challenges of our medical system and the medical emergencies associated with this kind of loss. 

Know that the mother may need trauma processing around her birth/loss experience, and offer this gently and when they are ready. I’ve found that often, these parents need to process their grief before trauma. Our responses as professionals need to meet the client where they are emotionally first. Attunement and unconditional positive regard is key.

If you’d like more information around perinatal loss and supporting parents and families in this tragic space, I recommend Postpartum Support International as a good starting place. This organization provides support for providers as well as women and their families, and it’s a great place to find support groups and local resources you can recommend to your clients. 

And lastly, I encourage you to care for yourself as you support clients navigating infant loss in your practice. Vicarious trauma is a real danger in the work we do, and this loss in particular may have touched many of us personally. We can be an invaluable resource to our clients in these moments, but only if we’re making sure to honor our own humanity and needs, too. 

Even with all that said, what I think is so beautiful about the work we do is the incredible growth, strength, and resilience we have the opportunity to witness in such dark places. I consistently stand in awe of the post-traumatic growth I witness in my office, and if we can share some of that hope with our clients, we can help them heal as well.