Perinatal death is a profound loss impacting many families. Understanding its definitions, causes, the nature of grief, and available support systems can help individuals and families navigate this difficult experience.
Defining Perinatal Death
Perinatal death encompasses the loss of a baby during a specific period around birth. The World Health Organization (WHO) defines the perinatal period as commencing at 22 completed weeks of gestation and ending seven completed days after birth. Other definitions may extend the gestational age to 20 weeks or the postnatal period to 28 days of life.
Two primary categories are distinguished: stillbirth and neonatal death. Stillbirth refers to the death of a fetus before or during birth. In the United States, stillbirth is defined as fetal death occurring at or after 20 weeks of pregnancy, or with a minimum birth weight of 350 grams, while the WHO defines it after 28 weeks of gestation.
Neonatal death is the death of a live-born baby within the first 28 days of life. The first seven days are early neonatal death, with deaths between 7 and 28 days considered late neonatal death. Both are components of perinatal mortality.
Common Underlying Causes
Perinatal deaths stem from various factors, often involving interactions between the mother, fetus, and placenta. One significant category involves placental problems, such as placental abruption or insufficient placental function. These issues can restrict nutrient and oxygen flow, compromising fetal development and survival.
Fetal conditions also contribute to perinatal mortality. These include genetic abnormalities, structural anomalies, and infections acquired in utero.
Maternal health conditions are another broad cause. Pre-eclampsia, characterized by high blood pressure, and uncontrolled diabetes can increase the risk of perinatal death. Other maternal factors include infections and chronic illnesses. Complications during labor and delivery, such as birth asphyxia or umbilical cord issues, can also be a cause. Despite investigation, the precise cause often remains unknown.
Navigating Grief and Loss
Perinatal loss leads to a profound and complex grieving process for parents and families. This grief extends beyond a physical presence, involving the loss of a hoped-for future, unspoken dreams, and the imagined identity of the child. The emotional impact can be long-lasting, often exacerbated by societal responses.
Many parents experience “disenfranchised grief,” meaning their loss is not fully acknowledged or socially supported. This lack of recognition can lead to feelings of isolation, self-blame, shame, guilt, anger, or a sense of failure.
Grief is a highly individual journey with no prescribed timeline or “correct” way to react. Common emotional responses include shock, intense sadness, emptiness, and a sense of injustice. The loss affects partners, who may grieve differently, potentially straining their relationship. Siblings and grandparents also experience grief, sometimes called “double grief” for grandparents mourning their grandchild and their child’s pain. The absence of ritual or a tangible child can complicate the grieving process.
Support and Resources
For individuals and families navigating perinatal loss, various forms of support are available. Medical follow-up is important for physical recovery and to understand findings from medical investigations. This provides clarity and addresses future health considerations.
Emotional and psychological support helps process grief. Counseling and therapy with professionals specializing in perinatal loss offer a safe space to explore emotions and develop coping strategies. Grief support groups provide an opportunity to connect with other parents who have experienced similar losses. These groups foster community, reduce isolation, and validate the grieving process.
Community and peer support organizations provide resources and a network for bereaved families. Many offer online platforms or helplines. Memorializing the baby, through creating memory boxes, planting a tree, naming the baby, or remembrance ceremonies, can aid the grieving process. Seeking support is an important step toward healing.