Past obstetric trauma or loss

Past obstetric trauma or loss
This includes previous miscarriage, termination, adoption or stillbirth, a history
of traumatic labour and delivery, infants born with a disability or deformity, and,
for some couples, prolonged infertility prior to conception.
The loss of a baby, a miscarriage, abortion or infant relinquished for adoption
or removed by child-protection services may leave grief for the rest of a parent’s
life. When a woman becomes pregnant again this previous emotional trauma is
reawakened in a powerful way. The trauma is not just remembered, but relived
as the physical changes and landmarks associated with the progression of
pregnancy are reached. Unless there has been some resolution of the previous
loss, it can be hard to make space psychologically for the new baby. Some
individuals or couples will need an opportunity to discuss and work through a
previous loss if it becomes too preoccupying.
Pregnancy is also a time when old wounds can begin to heal. A lost baby
cannot be replaced by having another one but previous psychic pain can be
relieved by the experience of a new baby surviving and thriving. For some
couples the experience of death and loss is eased by the practical and emotional
realities of parenting the new baby.
Previous obstetric difficulties, including prolonged infertility or an infant
born with a hereditary disorder, may also affect the transition process. It may be
more difficult to enjoy and anticipate the pregnancy and the infant and, as with
other obstetric losses, feelings of grief and anger may be reactivated.
A woman and her partner who already have an infant with a hereditary
disorder may suffer apprehension and fear of repetition in a new pregnancy.
Every couple has a right to thorough investigation and discussion of genetic
determinants and risks so that becoming pregnant again is an educated choice.