Hidden trauma in pregnancy-related losses

Photography by Anders Jildén

By Dr Kumari Valentine

October is Pregnancy and Infant Loss Awareness Month. This month is significant to me because I lost my daughter on her due date. I am a clinical psychologist, and my mission is to draw attention to pregnancy related loss and find language to articulate losses that might not otherwise be acknowledged.

I met a young man. Let’s call him Ben*, a beautiful man with soulful eyes and sorrow in his voice. Ben, like so many people I encounter, professionally and personally, had been diagnosed with depression. As we talked, part of his story involved the loss of a child during a partner’s pregnancy. Ben had tears in his eyes and talked about how much he had wanted this child. I know that few people know of Ben’s loss or Ben’s continuing sadness. There are so many men (and women) like Ben out there.

I wonder what it was like for Ben to go to work and hear his colleagues talk about their children and to see couples with children all around him. I wonder how he handles the question “do you have children?” I wonder about how he feels about the loss of fatherhood and whether this affected this Ben’s view of himself as a man. It is normal for people to consider their legacy and that children carry this on. I wonder what Ben thinks of this. Ben was diagnosed with depression, a diagnosis that is given when people show sadness (or irritability) for two weeks, consistently, and other symptoms including changes in appetite, loss of pleasure, guilt, poor concentration, difficulties with sleep, being physically worked up or slowed down, and sometimes, thoughts that one needs to end one’s life. Depression is diagnosed when these symptoms affect everyday life and make functioning difficult.

Our simplest explanation for why people become depressed is that there is a vulnerability (for example, a genetic vulnerability), that, coupled with significant stress, results in depression. There are many treatments for depression. While depression was evident superficially, no one had ever considered that Ben might be experiencing trauma.

We consider a trauma response when something significantly stressful has happened such as a violent event, death, and the person experiences intrusive thoughts (like nightmares or flashbacks), is on the alert and on guard, has a changed sense of who they are, and avoids people, places, and things associated with the trauma.

Here’s the thing – I would approach treatment differently if my focus was depression, rather than trauma. I suspect many people would think about their experiences differently if they heard about trauma, rather than depression. Of course, depression and trauma can be intertwined, but my point is still that people may be holding on to trauma and not even know it.

So why is it so important to acknowledge and articulate this loss? Amongst other reasons, suppressing or pushing away emotions is physically and emotionally hard work. Research shows that those who suppress their emotions fare worse and even visit health professionals more. Suppression or avoidance or emotion can also stop the brain from processing and making sense of events. Flashbacks and intrusive memories can then result from this lack of processing. Living with the hurt is exhausting. Having to put a mask to the world is exhausting. Feeling invalidated and alone is exhausting.

Here is my challenge – let us acknowledge that pregnancy does not always go the way we desire or that we see depicted in the movies. Men and women are affected by loss, and their losses may take different forms including feeling very traumatised. When you ask “Do you have children?”, be prepared to hear that some of those children are not in this world and to offer a supportive ear or supportive silence.

*Ben is not his real name and I have omitted details that would identify a specific person.

Dr Kumari Valentine has a PhD and is a registered clinical psychologist who is passionate about using psychological theory to help people change their lives for the better. Her personal experiences with complicated pregnancies and pregnancy-related grief underpin her work on mindfulness and overthinking. Visit her website to learn more and check out her Facebook page.

Dr Kumari has recently released a free album “Meditations for Pregnancy Related Loss”.

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