In Today’s Issue:

🔗 The best links I found this week
📖 Deep dive: Part 3 of 3: What Moms Should Expect The First Year After A Stillborn
🩷 Self-care moment: Supporting a Colleague After a Stillbirth Case

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🔗 My Favorite Finds This Week

📖 Essential Reading A comprehensive guide for healthcare professionals working with families experiencing perinatal and neonatal loss, with practical approaches to compassionate care. (Amazon)

🧠 Understanding Trauma and Grief Explore the important connection between traumatic experiences and grief responses, with insights on how they intertwine. (BrainWise Media)

🌱 Self-Care During Grief A thoughtful collection of resilience-building activities that have genuinely helped others navigate through the overwhelming experience of loss. (Speaking Grief)

📚 Comprehensive Resource List An extraordinarily thorough compilation of support resources, organizations, and materials specifically curated for families experiencing babyloss. (Reddit)

📖 Deep Dive

Part 3 of 3: The First Year After A Stillborn Patient is Discharged

Note: This deep dive will be a three-part series about supporting pregnancy loss patients and families after hospital care.

Today will be part three in a series diving deeper into what families experience in the first 24 hours, the first week, and now, the first year after stillbirth. Let’s kick things off with a profound quote from Handbook of Parinatal and Neonatal Palliative Care, I’m reading this week,

Since we launched Forget Me Not Bereavement Boxes about 3 years ago, I’ve had the opportunity to meet with hundreds of nurses and hear their perspective on what it’s like to find yourself in this situation. Some have recalled it as a sacred experience, especially those veterans who seem to just have the natural knack and know all the right things to say.

That’s not the case for a lot of nurses. Many have anxiety (rightfully so) when they are tasked with an IUFD during their shift.

It's my hope that with our brief time together every Thursday morning, we can reframe supporting fetal demise as not just a clinical challenge, but an opportunity to provide profound human connection during life's most vulnerable moments—a skill that can be learned, practiced, and mastered with the right guidance and support.

Below are common experiences that bereaved families experience the first year after a loss.

“Stages of Grief” Are Out

When families leave your care, they're entering what many describe as "returning to a world that doesn't understand." While their lives have been forever changed, the world around them often expects them to "move on" far too quickly.

Research shows that grief after stillbirth doesn't follow a predictable timeline. Instead of the outdated idea of "stages of grief," families experience what researchers now call "grief work"—an active, ongoing process that continues throughout the first year and beyond.

"The process of recovering from the loss of a baby takes time. A period of two to four years seems to be about average for parents, but five or more years of grief is not uncommon." [2] What many bereaved parents discover, however, is that grief doesn't follow a linear timeline with a clear endpoint. Instead, grief evolves—becoming less raw but remaining a part of their identity as they learn to hold both profound sorrow and moments of joy simultaneously.

The Mental Health Impact

In a longitudinal study examining grief patterns after pregnancy loss, only 41% of participants showed a normal decline of grief scores, while the remaining 59% experienced either pervasive or delayed grief resolution. [3]

The numbers are sobering: Nearly half (49.8%) of women experience depression or anxiety following stillbirth, according to the Stillbirth Collaborative Research Network. [4]

Factors That Add to Grief Intensity

1. Poor social support: Social isolation and lack of acknowledgment from family and friends is strongly associated with complicated grief reactions.

2. Relationship issues: Lack of support from a partner and poor marital relations significantly intensify grief responses.

3. Absence of living children: Childless women who suffer a loss have measurably higher levels of grief than women who already have children.

4. Pre-existing mental health conditions: Women with neurotic personality characteristics before loss show greater likelihood of developing intense grief reactions.

5. Ambivalent attitudes toward the pregnancy: Conflicted feelings about the pregnancy correlate with more complex grief processes.

6. Higher investment in pregnancy reality: Mothers who had named their baby or purchased items show higher levels of grief-related yearning.

Understanding these risk factors allows you to identify families who may need additional support before discharge. [5]

Barriers to Healing Support

In a recent interview, Joyal Mulheron, an activist for bereaved families, highlighted two critical gaps in the support system. First, there are currently no practice standards for grief and bereavement therapists in the United States, creating significant variability in care quality. Second, many families aren't emotionally ready for therapy immediately, with some needing 8-9 months before therapeutic interventions become effective.

Compounding this challenge is the financial burden. Mulheron notes that about one-third of Americans cannot absorb an unexpected $400 expense, yet the average funeral or memorial service costs approximately $9,000—creating financial instability precisely when families are most vulnerable. [7]

So, while getting professional help can help support bereaved parents through their grief, it’s not a financial option for most. That being said, there is a plethora of free resources. This is probably the most exhaustive list of resources for bereaved families I’ve ever seen. Thank you, Reddit! 

A Simple Framework: Validation, Information, Connection

• Validate their experience and emotions

• Provide information about what to expect

• Create connections to ongoing support

These three elements, delivered in the brief time you have with families, create a foundation that supports them through the entire first year of grief and beyond.

🩷 Self-care moment

Creating Emotional Boundaries While Providing Compassionate Care

"We cannot selectively numb emotions. When we numb painful emotions, we also numb joy, gratitude, and happiness." — Brené Brown, research professor and author [8]

A 2-Minute Practice for Emotional Boundaries:

1. Before entering a bereavement situation, take three deep breaths

2. Set a brief intention: "I will provide compassionate care while honoring my own emotional needs"

3. After caring for a family experiencing loss, take a moment alone

4. Acknowledge any emotions that arose without judgment

5. Physically "brush off" by sweeping your hands down your arms and legs

6. Reset with three more deep breaths before moving to your next task

This simple practice helps prevent compassion fatigue while allowing you to remain fully present for families in crisis.

👎 I didn’t learn anything new

👍 Good information

💯 Very valuable

📝 Citations

1. _{McGrath, J. M. (2020). Handbook of Perinatal and Neonatal Palliative Care. Springer Publishing Company.}

2. _{Lacey, J. & Payne, S. (2001). "Guidelines for health care professionals supporting families experiencing a perinatal loss." Paediatrics & Child Health, 6(7), 469-477.}

3. _{Lin, S. X., & Lasker, J. N. (1996). "Patterns of grief reaction after pregnancy loss." American Journal of Orthopsychiatry, 66(2), 262-271.}

4. _{The Stillbirth Collaborative Research Network. (2024). "Pregnancy after Loss: Understanding Grief and Recovery." Journal of Perinatal & Neonatal Nursing, 38(1), 78-92.}

5. _{Kersting, A., & Wagner, B. (2012). "Complicated grief after perinatal loss." Dialogues in Clinical Neuroscience, 14(2), 187–194.}

6. _{Gold, K.J., Treadwell, M.C., Mieras, M.E., & Laventhal, N.T. (2017). "Who tells a mother her baby has died? Communication and staff presence during stillbirth delivery and early infant death." Journal of Perinatology, 37, 1330-1334.}

7. _{Mulheron, J. (2024). Interview on The Loss Encounters podcast. "Understanding Support Systems for the Bereaved." February 22, 2024.}

8. _{Brown, B. (2012). Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. Gotham Books.}