In Today’s Issue:

🔗 The best links I found this week
📖 Deep dive: Lessons From a Perinatal Psychologist
🩷 Self-care moment: Vulnerable

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🔗 My Favorite Finds This Week

📊 The latest data on perinatal mortality in the United States (CDC Perinatal Mortality Data)

🤰🏾 A study reveals Black women are at a 43% higher risk of miscarriage compared to White women, according to a 2021 study published in The Lancet (RCOG)

👣 Bereavement Certification from the MISS Foundation. Online or virtual. (MISS Foundation)

📖 Deep Dive

Lessons From a Perinatal Psychologist with Dr. Emily Guarnotta, PsyD, PMH-C

This week, I had the privilege of interviewing Dr. Emily Guarnotta, a psychologist and certified perinatal mental health provider, whose work focuses on supporting families through infertility, miscarriage, stillbirth, and postpartum challenges. She also started Phoenix Health, an online therapy for moms specializing in mental health for infant loss.

Dr. Guarnotta emphasized a truth that every L&D nurse should know: the way families are cared for during their hospital stay after loss can set the tone for their entire healing journey. She shared,

For many families, their interactions with hospital staff after the death of a baby are among their very first steps into a world forever changed.

Emily mentioned that at her clinic, less than 30% of families reported having a truly positive experience at the hospital after perinatal loss. Most families described their experience as neutral, and about 30–40% described it as negative.

What Makes Perinatal Bereavement Unique?

Perinatal bereavement is a profoundly complex form of grief. The loss of a baby is not just the loss of a future; it is the death of a child–a reality that is often minimized or misunderstood by society. Dr. Guarnotta highlighted that many families struggle to access mental health care that truly understands these nuances. General mental health providers may lack the specialized training to support families through this type of grief, sometimes inadvertently causing more harm than good.

The Numbers: How Common Is Perinatal Loss?

• According to the World Health Organization (WHO), the infant mortality rate has shown a slight increase to 5.61 per 1,000 live births in 2023.

• About 1 in 175 births in the U.S. ends in stillbirth, resulting in over 20,000 stillbirths annually.

• Approximately 15% of recognized pregnancies end in miscarriage, and 2.5% of women experience recurrent losses.

• Black women are at a 43% higher risk of miscarriage compared to White women, according to a 2021 study published in The Lancet

• Globally, perinatal mortality rates can be even higher, with some low- and middle-income countries reporting rates above 30 per 1,000 births.

The Psychological Impact: What the Data Shows

Perinatal loss significantly increases the risk of mental health challenges for both mothers and partners:

• Depression: Up to 41% of women report depression in the year following a stillbirth or early neonatal death-double the risk compared to after a live birth.

• Anxiety and PTSD: Within 1–2 months of loss, 18–32% of women experience anxiety disorders, and 11–30% exhibit depressive symptoms. Post-traumatic stress is also common, with 20% of women manifesting symptoms after perinatal loss.

• Long-term effects: Women with a history of perinatal loss are about 35% more likely to require psychiatric treatment postpartum. Partners are also at increased risk: 66% of male partners of women with recurrent miscarriage report anxiety, and 19% report depression.

• Cultural barriers: Parents often face a cultural taboo around expressing perinatal grief, leading to feelings of marginalization and complicating the mourning process.

What Families Need Most: Insights from Dr. Guarnotta

Dr. Guarnotta shared that the presence and compassion of L&D nurses during this time can have a lifelong impact:

She emphasized that nurses do not need to “fix” grief or put a positive spin on it. Instead, the most healing thing is to be present, listen, and acknowledge the depth of the family’s pain. Avoiding dismissive language like “it’s just the baby blues” or “every mom feels sad after birth” is crucial. Grief after the death of a baby is not something to be minimized or rushed.

Dr. Guarnotta described the journey of grief as non-linear and ongoing:

She encourages nurses to see their role as creating a safe space for families to express their pain without judgment, and to honor the loss in a way that feels meaningful to each family.

Final thoughts

Dr. Guarnotta expressed deep appreciation for the work L&D nurses do, acknowledging how challenging and meaningful it is to support families at such a vulnerable time:

For more expert tips on mental health and bereavement care, follow Emily on Instagram.

🩷 Self-care moment

Embracing Vulnerability

Self-Care Moment: Embracing Vulnerability

Brené Brown’s research on vulnerability and wholeheartedness is especially relevant for those supporting families through loss. She teaches that vulnerability is not weakness, but the “courage to show up and be seen when we have no control over the outcome.”

As L&D nurses, being present with grieving families means allowing yourself to feel–whether that’s sadness, empathy, or even uncertainty. This openness is what makes your care so impactful, but it can also be emotionally taxing.

Try This:

• Take a moment after a difficult shift to acknowledge your feelings, without judgment.

• If you notice heaviness or self-doubt, remember: “Vulnerability is the birthplace of connection and the path to the feeling of worthiness.”

• Reach out to a trusted colleague or friend to share what’s on your mind. Sometimes, simply saying “today was hard” is an act of courage.

Your willingness to show up–imperfect, human, and present–is what families remember most. As Brené says, “What we know matters, but who we are matters more.”

👎 I didn’t learn anything new

👍 Good information

💯 Very valuable