Reproductive loss

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Reproductive loss, sometimes reproductive grief, describes a potential emotional response to unsuccessful attempts at human reproduction or family-building. These experienced losses may include involuntary childlessness generally, pregnancy loss from all causes (including ectopic pregnancy, spontaneous abortion, induced abortion, and traumatic injury), perinatal death, stillbirth, infecundity and infertility from all causes (including voluntary, coerced or accidental sterilization, and post-menopausal infertility), failed attempts to conceive, failed fertility treatments, failed gestational surrogacy procedures, and losses related to all dimensions of the adoption process. [1] [2] [3] Responses to miscarriage, stillbirth, selective reduction and neonatal death are a subtype of reproductive loss called perinatal bereavement. [4]

Reproductive loss is categorized as a non-definite loss that elicits as unique grief response and can be prone to social grief disenfranchisement. [5] Responses to reproductive loss may be gender-specific. [6] However, per the Journal of Social Philosophy, processing these experiences is complicated by the lack of "settled cultural—or philosophical—understanding of what exactly is bad or grief-worthy about the death of an embryo/fetus or the failure of a pregnancy to produce a surviving child." [7] Perinatal losses have been described as uniquely ambiguous in that they are "loss of a future with a family member who has not yet been integrated into family life yet maintains a psychological presence within the family system." [8] The ambiguity of the reproductive loss may be central to its experience of the bereaved; Maureen Corrigan called stillbirth a "nightmare that hasn't been quite categorized." [9]

Scholarship in the journal Social Work has argued that reproductive losses can be "significant life course events that may affect identity, social role, self-image, and conceptualization of a woman's reproductive history and human sexuality across the entire range of practice settings." [10] L. Serene Jones of Yale Divinity School found that both American mainline Protestant and feminist communities had little discourse on the concept of reproductive loss or grief. [6]

Late-term fetal demise has been found to be a risk factor for post-traumatic stress disorder in formerly pregnant women. [11]

Creative works about reproductive loss include the Up opening sequence, the film Private Life , the painting Henry Ford Hospital, and the memoir An Exact Replica of a Figment of My Imagination .

See also

Related Research Articles

<span class="mw-page-title-main">Miscarriage</span> Natural death of an embryo or fetus before its independent survival

Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical loss. Once ultrasound or histological evidence shows that a pregnancy has existed, the used term is clinical miscarriage, which can be early before 12 weeks and late between 12-21 weeks. Fetal death after 20 weeks of gestation is also known as a stillbirth. The most common symptom of a miscarriage is vaginal bleeding with or without pain. Sadness, anxiety, and guilt may occur afterwards. Tissue and clot-like material may leave the uterus and pass through and out of the vagina. Recurrent miscarriage may also be considered a form of infertility.

<span class="mw-page-title-main">Stillbirth</span> Death of a fetus before or during delivery, resulting in delivery of a dead baby

Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The term is in contrast to miscarriage, which is an early pregnancy loss, and Sudden Infant Death Syndrome, where the baby dies a short time after being born alive.

<span class="mw-page-title-main">Grief</span> Response to loss in humans and animals

Grief is the response to loss, particularly to the loss of someone or some living thing that has died, to which a bond or affection was formed. Although conventionally focused on the emotional response to loss, grief also has physical, cognitive, behavioral, social, cultural, spiritual and philosophical dimensions. While the terms are often used interchangeably, bereavement refers to the state of loss, while grief is the reaction to that loss.

Dilation and evacuation (D&E) is the dilation of the cervix and surgical evacuation of the uterus after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.

Prenatal development includes the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal development until birth.

<span class="mw-page-title-main">Complications of pregnancy</span> Medical condition

Complications of pregnancy are health problems that are related to pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal disorders. Severe complications of pregnancy, childbirth, and the puerperium are present in 1.6% of mothers in the US, and in 1.5% of mothers in Canada. In the immediate postpartum period (puerperium), 87% to 94% of women report at least one health problem. Long-term health problems are reported by 31% of women.

<span class="mw-page-title-main">Perinatal mortality</span> Medical condition

Perinatal mortality (PNM) refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Perinatal means "relating to the period starting a few weeks before birth and including the birth and a few weeks after birth."

Disenfranchised grief is a term coined by Dr. Kenneth J. Doka in 1989.This concept describes the fact that grief isn’t acknowledged on a personal or societal level in modern day Euro-centric culture. For example, those around you may not view your loss as a significant loss, and they may think you don’t have the right to grieve. They might not like how you may or may not be expressing your grief, and thus they may feel uncomfortable, or judgmental. This is not a conscious way of thinking for most individuals, as it is deeply engrained in our psyche. This can be extremely isolating, and push you to question the depth of your grief and this loss you’ve experienced. This concept is viewed as a ”type of grief”, but it more so can be viewed as a "side effect" of grief. This also is not only applicable to grief in the case of death, but also the many other forms of grief. There are few support systems, rituals, traditions, or institutions such as bereavement leave available to those experiencing grief and loss

Pregnancy and Infant Loss Remembrance Day is an annual day of remembrance observed on October 15 for pregnancy loss and infant death, which includes miscarriage, stillbirth, SIDS, ectopic pregnancy, termination for medical reasons, and the death of a newborn. Pregnancy and infant loss is a common experience that has historically been complicated by broadly applied social and cultural taboos to stay silent, a condition that the World Health Organization advocates reversing in favor of open expression. A growing number of public figures have come out in support of open expression, with many leading by example through the disclosure of their personal experiences of pregnancy loss and infant death.

<span class="mw-page-title-main">Grief counseling</span> Therapy for responses to loss

Grief counseling is a form of psychotherapy that aims to help people cope with the physical, emotional, social, spiritual, and cognitive responses to loss. These experiences are commonly thought to be brought on by a loved person's death, but may more broadly be understood as shaped by any significant life-altering loss.

Reproductive immunology refers to a field of medicine that studies interactions between the immune system and components related to the reproductive system, such as maternal immune tolerance towards the fetus, or immunological interactions across the blood-testis barrier. The concept has been used by fertility clinics to explain fertility problems, recurrent miscarriages and pregnancy complications observed when this state of immunological tolerance is not successfully achieved. Immunological therapy is a method for treating many cases of previously "unexplained infertility" or recurrent miscarriage.

<span class="mw-page-title-main">Placentitis</span> Medical condition

Placentitis is an inflammation of the placenta. The main forms of placentitis are:

Immune tolerance in pregnancy or maternal immune tolerance is the immune tolerance shown towards the fetus and placenta during pregnancy. This tolerance counters the immune response that would normally result in the rejection of something foreign in the body, as can happen in cases of spontaneous abortion. It is studied within the field of reproductive immunology.

Childbirth-related post-traumatic stress disorder is a psychological disorder that can develop in women who have recently given birth. This disorder can also affect men or partners who have observed a difficult birth. Its symptoms are not distinct from post-traumatic stress disorder (PTSD).

Prolonged grief disorder (PGD), also known as complicated grief (CG), traumatic grief (TG) and persistent complex bereavement disorder (PCBD) in the DSM-5, is a mental disorder consisting of a distinct set of symptoms following the death of a family member or close friend. People with PGD are preoccupied by grief and feelings of loss to the point of clinically significant distress and impairment, which can manifest in a variety of symptoms including depression, emotional pain, emotional numbness, loneliness, identity disturbance and difficulty in managing interpersonal relationships. Difficulty accepting the loss is also common, which can present as rumination about the death, a strong desire for reunion with the departed, or disbelief that the death occurred. PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used.

A pre-existing disease in pregnancy is a disease that is not directly caused by the pregnancy, in contrast to various complications of pregnancy, but which may become worse or be a potential risk to the pregnancy. A major component of this risk can result from necessary use of drugs in pregnancy to manage the disease.

Early pregnancy bleeding refers to vaginal bleeding before 14 weeks of gestational age. If the bleeding is significant, hemorrhagic shock may occur. Concern for shock is increased in those who have loss of consciousness, chest pain, shortness of breath, or shoulder pain.

<span class="mw-page-title-main">Miscarriage and grief</span>

Miscarriage and grief are both an event and subsequent process of grieving that develops in response to a miscarriage. Almost all those experiencing a miscarriage experience grief. This event is often considered to be identical to the death of a child and has been described as traumatic. But the vast majority of those who have suffered both have say they are nothing alike. They describe losing a child as being in a category of its own when it comes to grief. "Devastation" is another descriptor of miscarriage. Grief differs from the emotion sadness. Sadness is an emotion along with grief, on the other hand, is a response to the loss of the bond or affection was formed and is a process rather than one single emotional response. Grief is not equivalent to depression. Grief also has physical, cognitive, behavioral, social, cultural, and philosophical dimensions. Bereavement and mourning refer to the ongoing state of loss, and grief is the reaction to that loss. Emotional responses may be bitterness, anxiety, anger, surprise, fear, and disgust and blaming others; these responses may persist for months. Self-esteem can be diminished as another response to miscarriage. Not only does miscarriage tend to be a traumatic event, women describe their treatment afterwards to be worse than the miscarriage itself.

Mental disorders can be a consequence of miscarriage or early pregnancy loss. Even though women can develop long-term psychiatric symptoms after a miscarriage, acknowledging the potential of mental illness is not usually considered. A mental illness can develop in women who have experienced one or more miscarriages after the event or even years later. Some data suggest that men and women can be affected up to 15 years after the loss. Though recognized as a public health problem, studies investigating the mental health status of women following miscarriage are still lacking. Posttraumatic stress disorder (PTSD) can develop in women who have experienced a miscarriage. Risks for developing PTSD after miscarriage include emotional pain, expressions of emotion, and low levels of social support. Even if relatively low levels of stress occur after the miscarriage, symptoms of PTSD including flashbacks, intrusive thoughts, dissociation and hyperarousal can later develop. Clinical depression also is associated with miscarriage. Past responses by clinicians have been to prescribe sedatives.

Perinatal bereavement or perinatal grief refers to the emotions of the family following a perinatal death, defined as the demise of a fetus or newborn infant. Despite the not-uncommon circumstance of miscarriage and pregnancy loss, and the recognized subsequent psychological impact, including potentially complicated grief, "very little research exists documenting the efficacy of different interventions."

References

  1. ↑ Earle, Sarah; Foley, Pam; Komaromy, Carol; Lloyd, Cathy (January 2008). "Conceptualizing reproductive loss: A social sciences perspective". Human Fertility. 11 (4): 259–262. doi:10.1080/14647270802298272. ISSN   1464-7273. PMID   19085263. S2CID   5899885.
  2. ↑ "What is Reproductive Loss?". kateyzeh.com. Retrieved 2023-04-12.
  3. ↑ Letherby, Gayle (2015-04-03). "Bathwater, babies and other losses: a personal and academic story". Mortality. 20 (2): 128–144. doi:10.1080/13576275.2014.989494. ISSN   1357-6275. S2CID   145406517.
  4. ↑ Fenstermacher, Kimberly; Hupcey, Judith E. (November 2013). "Perinatal bereavement: a principle-based concept analysis". Journal of Advanced Nursing. 69 (11): 2389–2400. doi:10.1111/jan.12119. PMC   3675189 . PMID   23458030.
  5. ↑ Nondeath Loss and the Web of Life (Book review: Counting Our Losses by Darcy L. Harris), Magda, LoriA. Death Studies, Jan2012; 36(1): 88-94. 7p. ISSN: 0748-1187.
  6. 1 2 Jones, L. Serene (April 2001). "Hope Deferred: Theological Reflections on Reproductive Loss (Infertility, Stillbirth, Miscarriage)". Modern Theology. 17 (2): 227–245. doi:10.1111/1468-0025.00158. ISSN   0266-7177.
  7. ↑ Roth, Amanda (June 2018). "Experience as Evidence: Pregnancy Loss, Pragmatism, and Fetal Status: Experience as Evidence". Journal of Social Philosophy. 49 (2): 270–293. doi:10.1111/josp.12234. S2CID   150131245.
  8. ↑ Shannon, Ellen; Wilkinson, Brett D. (2020-04-01). "The Ambiguity of Perinatal Loss: A Dual-Process Approach to Grief Counseling". Journal of Mental Health Counseling. 42 (2): 140–154. doi:10.17744/mehc.42.2.04. ISSN   1040-2861. S2CID   218944608.
  9. ↑ Corrigan, Maureen (2008-12-18). "Maureen Corrigan's Best Books Of 2008". npr.org.
  10. ↑ Price, Sarah Kye (2008). "Women and Reproductive Loss: Client—Worker Dialogues Designed to Break the Silence". Social Work. 53 (4): 367–376. doi:10.1093/sw/53.4.367. ISSN   0037-8046. JSTOR   23718880. PMID   18853673.
  11. ↑ Abiola, Lucile; Legendre, Guillaume; Spiers, Andrew; Parot-Schinkel, Elsa; Hamel, Jean-François; Duverger, Philippe; Bouet, Pierre-Emmanuel; Descamps, Philippe; Quelen, Caroline; Gillard, Philippe; Riquin, Elise (2022-07-20). "Late fetal demise, a risk factor for post-traumatic stress disorder". Scientific Reports. 12 (1): 12364. Bibcode:2022NatSR..1212364A. doi:10.1038/s41598-022-16683-5. ISSN   2045-2322. PMC   9300686 . PMID   35859001.
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