Ana Carcedo: "Perinatal and conventional grief are very different"

Pregnancy and motherhood are part of a complex area of ​​life and in which there are many emotions involved.

For better or for worse, expecting a baby significantly alters the daily lives of women who have conceived, and this implies the appearance of important expectations about what it is to raise a child or daughter. For this reason, the fact of losing the baby is a serious blow at a stage of special vulnerability in terms of emotional balance.

To understand more about the perinatal grief process, We have interviewed the psychologist Ana Carcedo Bao, an expert in perinatal psychology.

• Related article: "Perinatal psychology: what is it and what functions does it perform?"

Interview with Ana Carcedo Bao: the keys to perinatal grief

Ana Carcedo Bao is a psychologist and founder of the PsicoPerinatal maternity psychology center. She currently attends both in her therapy center located in Madrid and through the online format, by video call.

On this occasion, she tells us about perinatal mourning, a phenomenon that affects many women who unfortunately lose their baby.

In your experience as a psychotherapist, what are the aspects of abortion that generate the most discomfort in the short and medium term in women who have suffered it?

For me there are two key moments around the perinatal loss, which are the first time the news of the loss is communicated to the parents and the following process of mourning that is not allowed.

Regarding the first, the lack of support and empathy on the part of the professionals who accompany that moment so difficult and painful usually generates a lot of discomfort and is recorded in sentences that have a very emotional charge. painful.

In consultation, when I work on those traumatic memories, I usually see how a "there is no heartbeat", "curettage woman, pregnant woman", "you are very young, you will already have another pregnancy" or "better now than later", become important targets when it comes to working on that memory stored as very painful or traumatic.

Depending on how the emotional support of the professionals is, it will have an important effect on how one lives and how one stores that memory of the loss, and therefore will be a factor to assess for the repair of said experience.

The second important aspect is that after this first medical phase, what the parents find is a void, an absence of support and emotional accompaniment, as well as a duel which receives little consideration. All this means that the loss is lived in solitude and without support to be able to express what they feel, or find a place where they can feel heard and accompanied.

Is it common for an abortion to leave long-term psychological sequelae?

Perinatal loss is a unique experience that each person will face differently depending on their resources and abilities. It will also depend on how that loss has occurred in order to be able to bear in mind its more or less traumatic impact.

What is known is that between 10% and 30% of women (and also of couples) suffer from clinical symptoms of anxiety, depression, Post traumatic stress, and complicated grief during the months and years after the loss.

It is usually evident during the pregnancy following the loss with symptoms of perinatal anxiety or depression, as well as many difficulties in establishing the bond with the new baby (not wanting to count it until very late in the pregnancy, avoiding regular purchases until the last phase, always talking with the possibility of loss, not thinking of a name until the end, etc.).

The step from imagining being the mother of a baby who will grow up to be an adult, to knowing that person will not be born, can be very hard. Does it usually cause problems in the couple's relationships that were expecting the boy or girl?

It is usually a very hard stage, which is lived in a very different way. What I find myself in consultation many times is a mother with a lot of emotional burden and a father who somehow acts as a support.

This lack of harmony can sometimes generate conflicts in the relationship, also seeing that the times and mechanisms coping strategies may be completely different, although at base there may be the same intensity of suffering.

Psychological support at this stage can help a lot to integrate these difficulties and be able to find a point where jointly a form is given to the pain that allows the couple to advance in harmony towards the future.

Are there differences between the psychological grief that women who have suffered an abortion go through and the grief that anyone goes through when losing a loved one, for example, due to natural death due to age?

Of course. Perinatal grief and conventional grief are completely different. Intrauterine death is silenced, hidden and surrounded by taboo. This means that the phases or stages of mourning are not allowed in the environment and the social and family response that is so necessary in any loss process is not found.

Not "giving permission" to cry that immense pain, to talk about it, to be able to say goodbye, to be able to feel what is being experienced, prevents that a process so natural and inherent to one's life can be normalized, in addition to becoming a key factor in avoiding a duel complicated.

A loss is a blow that you have to accept, but for this you need to be able to talk about it, to be able to support yourself and to be able to feel that what is felt is absolutely valid and normal, because simply from nature itself it breaks with everything expected. A postpartum without a baby is one of the most painful experiences a woman can face, and yet one of the loneliest that costs so much to watch and accompany.

Grief is a unique and dynamic process, but it is known that proper emotional support by professionals, the family and social environment, make it possible to re-elaborate and place it in the life story of the person in order to move towards the future.

What are some of the techniques and methodologies used in psychotherapy sessions to help women who have suffered a miscarriage?

As an expert clinical psychologist in the perinatal area and in trauma, I have learned to look at the person above the technique, although my integrative training It helps me every day to be able to incorporate various techniques that help each person to be able to elaborate their pain and their difficulties in a healthier and more functional.

When the experience of loss is loaded with a lot of trauma around the process, I usually use techniques such as EMDR (Eye Movement Desensitization and Reprocessing). Grief processes, however, mobilize many different tools such as working with thoughts (from a more cognitive approach) as well as working with the emotions that are occurring.

We are going to need a lot of emotional containment, and present resources, such as Mindfulness. It is for all these reasons that under a model of reciprocal interaction therapy (strategic therapy, cognitive, systemic and interpersonal in addition to those developed in the model), we will be able to address in a much broader way all the needs that they emerge.

And how is the process of recovery and emotional improvement taking place?

It is important to know that pain is like the waves of the sea, sometimes they are small and even though they are there they are bearable, but there are other moments, when least expected, that can come a big wave and throw us to the ground, especially in the early stages of recovery, as very specific dates that remind us or reactivate the painful moment of loss.

As everything that happened is repositioned, what takes place is a kind of reorganization, in which, without forgetting the loss, and often keeping it very much in mind for a lifetime, life can be redone, the ability to connect with the present and give another format to so much pain without generating so much suffering in the present, and therefore continue advancing towards the future. future.