In Today’s Issue:

🔗 The best resources I found this week
📖 Deep dive: Recurring Miscarriage or Infant Death

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🔗 The Best Resources I Found This Week

💔 “Not Broken” – A Fertility MD on the Emotional Impact of Recurrent Miscarriage
Reproductive endocrinologist Dr. Lora Shahine explains how recurrent miscarriage can feel like living with a chronic illness—grief, self‑blame, and PTSD symptoms that often get minimized, not treated. Great context to understand what your patients are carrying in with them.
(Dr. Lora Shahine)

🌀 Lola&Lykke Experts Answer: The Emotional Roller Coaster of Recurrent Pregnancy Loss
Short, nurse-friendly explainer on why each new miscarriage can intensify fear, shame, and even relief—and why there is no “right” way to feel. Good grounding if you’re walking into a room with repeated miscarriages and want a quick psychology refresher.
(Lola&Lykke)

🩺 Navigating Perinatal Loss (Written for Clinicians)
Psychiatric Times breaks down how to distinguish grief from depression/PTSD after perinatal loss, and why language, memory-making, and support groups are core parts of care—not extras. This one’s more clinical, but really validates what you’re already doing at the bedside.
(Psychiatric Times)

🎙 Working with Grief with Dr. Joanne Cacciatore
In this podcast episode, Dr. Cacciatore talks about traumatic grief after the death of a baby or child and what it means to “bear the unbearable” as clinicians without trying to fix or rush it. A good listen on your commute if you want more of her voice behind this week’s deep dive.
(Being Well Podcast)

📖 Deep Dive

Recurring Miscarriage or Infant Death

You know that moment. You open the chart, see “recurrent miscarriage” or a prior stillbirth/infant death, and your whole body braces before you even knock.

What does the data tell us?

An NIH‑hosted review on recurrent miscarriage found that over 40% of couples with recurrent miscarriage report high stress, and about half of women and one in five partners are at risk for depression.​

Compared with couples who had only one miscarriage, those with recurrent losses showed more severe and longer‑lasting mental health effects, especially in later pregnancies.​

So yes—your gut is right.

This is not “a tough case.” This is traumatic bereavement layered on top of itself.

Okay, you already knew this was traumatic. Here’s what the best grief experts and actual parents say it feels like when this isn’t their first time—and here’s how to walk into that room differently.

A common mindset parents have walking into a delivery after a previous death or miscarriage

Parents after recurrent miscarriage or a previous stillbirth often describe losing far more than the baby.

In one clinical report on recurrent miscarriage, women talked about a “loss of innocence”—no way to ever recapture simple joy about a positive test.​

They described being “always holding their breath,” hyper‑focused on bathroom trips, symptoms, and every twinge.​

Another mother, reflecting on multiple miscarriages, put it this way:

That’s the emotional baseline many are walking in with.

Not “nervous.” Not “a little anxious.”
Already betrayed by their body and, often, by prior care.

What Grief Experts Say to Prepare Nurses

Dr. Joanne Cacciatore, a leading researcher on traumatic grief after the death of a baby or child, uses a phrase that hits hard: “traumatic death provokes traumatic grief.”​

She explains that when a child dies, parents can feel “frighteningly uprooted,” with their basic ability to trust the world “gravely threatened.”​

She also reminds professionals:

For families who have been through this more than once, that brokenheartedness can come with:

• Emotional anesthesia (feeling numb and detached) and, at the same time, intense waves of panic.​

• Physical sensations—tight throat, phantom heaviness in the arms, knees buckling when they see other babies.​

• Deep ambivalence about the current pregnancy: “I’m terrified to hope, but I can’t stop hoping.”​

When you walk into that room, you’re stepping into that whole world—not just “a history of two losses.”

So what do you do with this as an L&D nurse?

One mother after multiple miscarriages, noted: "With each miscarriage, people were finding it more difficult to know what to say. They found it easier not to say anything." That silence? It stings.

As nurses, you can break it thoughtfully. Experts advise starting with a thorough chart review—note babies' names, gestations, past experiences.

1. Chart review: what to look for (and why it matters)

Before you walk in, scan for more than parity.

Look for:

• Prior losses listed as “SAB” or “IUFD” without names

• Notes like “hx fetal demise” with no follow-up documentation

• Discrepancies between obstetric history and family language (e.g., G5P1 but parents reference “our three babies”)

This tells you two things:

1. The chart may not reflect the emotional reality.

2. You may be the first person to acknowledge those babies out loud.

2. Ask directly: “What helped last time—and what really didn’t?”

This is where you can avoid repeating harm without making them re‑tell every detail.

Simple scripts:

Then:

Pause. Let them answer in their own language.

Research on traumatic bereavement keeps coming back to this: giving families choice and control in a situation where they’ve had almost none is protective.

3. Language that signals safety (without forcing disclosure)

Instead of asking “Is this your first loss?”
Try one of these:

Option A – neutral, open door

Option B – name-aware, if documented

You give control.
You don’t require a story.
You don’t pretend this is new.
You say what previously happened ie: death, miscarriage rather than loss

4. Acknowledging prior babies by name (when invited)

If names are shared, use them once—and then follow the parents’ lead.

Research consistently shows that name acknowledgment validates parenthood and reduces disenfranchised grief.
(Cacciatore, 2017; BMC Pregnancy & Childbirth)

📚 Read more here:
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1447-5

5. Assume they’re braced for impact, not “overly anxious”

Instead of reassuring (“Everything looks fine!”) right away, start by normalizing their fear:

That tells them you see trauma, not pathology.

You’re not labeling them as “difficult” for needing more updates, more scans, more explanation.

6. Remember: you don’t have to cure anything

Borrowing Dr. Cacciatore’s framing can be freeing:

Your job is not to cure traumatic grief.

Your job is to be that “fully present, openhearted provider who is not afraid and not avoidant” on one of the hardest days of their life.​​

The way you walk into that room, say their babies’ names, and invite them to teach you what helped and what hurt—especially when this is not their first time—can become one of the few memories that doesn’t add to the trauma.

7. One advanced practice shift worth trying this month

Add a “prior losses acknowledged?” checkbox or smart phrase in your documentation.

Not for billing.
For continuity.

Because nothing is more painful for families than having to re-teach their grief every admission.

How did today’s deep dive land for you?

(Select one)

⭐️ It was extremely helpful and gave me new insight

👍 Helpful, mostly a good refresher

✅ I didn’t learn anything new, but it validated what I already do

😕 It missed the mark

Citations

Farren J, Jalmbrant M, Ameye L, et al. Pregnancy loss: consequences for mental health. BMJ, 2023. NIH/PMC.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9937061/

Farren J, et al. The posttraumatic impact of recurrent pregnancy loss in both women and men. Archives of Women’s Mental Health, 2023. NIH/PMC.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9835763/

Gold KJ, Sen A, Hayward RA. Depression and posttraumatic stress symptoms after perinatal loss in a population‑based sample. Journal of Women’s Health, 2016. NIH/PMC.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4955602/

Thieleman K, Cacciatore J, Hill M. Traumatic bereavement and mindfulness: A preliminary study using the ATTEND model. Omega: Journal of Death and Dying, 2014. MISS Foundation.
https://www.missfoundation.org/wp-content/uploads/2018/04/ATTEND-pre-post-Thieleman-Cacciatore-Hill.pdf

Tommy’s. Three years on, I’m not the person I once was (PTSD after multiple miscarriages).
https://www.tommys.org/about-us/charity-news/diagnosed-PTSD-trauma

Seleni Institute. The Emotional Roller Coaster of Recurrent Miscarriage. 2024.
https://seleni.org/advice-support/the-emotional-rollercoaster-of-recurrent-miscarriage

👋 That’s a Wrap!

Before you go: Here are ways we can help your hospital

Education: Please share our newsletter with your co-workers. Our priority is empowering nurses with the tools to support patients with modern, evidence-based bereavement education.

Bereavement boxes: Our bereavement boxes were designed out of a need for a modern high quality solution for families suffering from miscarriage, stillborn, or infant death.

Reply to this email “Sample” to get a free sample sent to your hospital.

What we prioritize:

1. Tools for hospitals to create a bereavement experience for families to begin their grief journey

2. Educating nurses with modern bereavement standards and continuing education.

3. Helping hospitals build a foundation of trust and support, so bereaved families feel seen and cared for—now and in the years to come.

These boxes were born out of our own personal losses, including Jay’s (CEO) 15 years of experience working in labor and delivery as a CRNA and witnessing time and again how the hospital experience can profoundly shape a family’s grief journey, for better or for worse.

Until next week,

Trina and Jay
Co-founders of Forget Me Not