October is National Pregnancy and Infant Loss Awareness Month! And as someone who supports clients around the physical changes during pregnancy and postpartum (no matter the outcome), I also know how important it is for clients to also be able to access mental and emotional support along this journey.
And, I have the pleasure of having Julie Kull, licensed clinical social worker, as a local resource for my clients seeking more support. We were able to discuss Infertility, Pregnancy and Infant Loss in depth. I’m sharing our convo here!
Jess: Julie, I am so happy that we’ve connected. We both support prenatal and postpartum families and having a professional like you to connect families with for mental and emotional support is essential in these life moments. You support families experiencing a variety of concerns such as infertility, infant loss, birth trauma and pregnancy after loss. Specifically, for someone who is pregnant after infertility and/or pregnant after loss, what are some things that can come up and how might support be helpful?
Julie: Great question! When someone is pregnant after a loss/infertility here are some of the things that I tend to see. Anxiety- fear that they will lose another pregnancy or that if they lose this pregnancy, they will not be able to get pregnant again. Isolation- being pregnant can lead to feelings of isolation. There is often survivor’s guilt that they were able to get pregnant or get pregnant again and I often hear that it can be difficult for people to connect with those that are pregnant that have not experienced a loss or infertility, but also feel so guilty and have difficulty connecting with those still trying to conceive. Disconnected from their bodies- sometimes the body no longer feels like a safe place- this can be common with infertility and loss. I also talk with people about trusting their bodies. It can be hard to trust that your body can keep this baby safe when you may be feeling like it did not keep another baby safe. Sometimes the carrying partner can struggle to connect to the pregnancy and it doesn’t feel real to them. This can lead to difficulty planning ahead for the baby and engaging in cultural norms to welcome baby (ex: baby showers). Lastly another thing that comes up is competing emotions. I think a cultural norm that we have here in the US is that people should be happy when they are pregnant when quite often there is a lot of mixed emotion. It can be really uncomfortable and confusing to try to feel these competing emotions at the same time.
Psychotherapy can be helpful for many things if you are pregnant after a loss or infertility. One of the biggest things is being able to work through many of these feelings that I listed above. Having a space where you can hear that your feelings not only are valid but often common after a loss or infertility can lead to less isolation and more connection with yourself and your pregnancy. Psychotherapy can help with feeling safe in your body again and connecting to this pregnancy while also processing the grief that you may feel around your loss or trying to conceive journey.
Jess: October is Pregnancy and Infant Loss Awareness Month. One thing that you and I have briefly discussed is that often after loss, families don’t perceive themselves as “postpartum” and thus they do not seek support in the same way as someone fortunate enough to take a baby home. What are some ways we can increase awareness around this and get people the care and support they need and deserve?
Julie: I think a little conversation around this can go a long way. Just using that terminology really normalizes for people that yes this was a pregnancy and yes after a pregnancy I am postpartum. I think normalizing that postpartum really means post pregnancy and not post having a baby or bringing a baby home. One thing that I do in my practice is to give the Edinburgh- a postpartum screener and review with clients what might be happening with their body in the postpartum phase. With clients that have an early loss/miscarriage I hear often that they are not getting the follow up visit that someone further along would get in the postpartum phase. I do think we have many wonderful providers in Madison and I think there has been progress in following up with clients after an early loss, I think overall we can do better by just normalizing this. Postpartum international has started offering loss groups. You and I belong to the Madison Postpartum Collective and services/support groups are offered for those that have had a loss. These may seem like small things but they matter.
Jess: For families experiencing loss, what general resources could you share? Resources that EVERYONE should/can have access to?
Julie: Locally we are really lucky to have some great resources:
Bereaved Parents of Madison- they have a great list of resources as well.
Kull Counseling- I offer a free support group for early loss/miscarriage on the first Thursday of the month
Nationally-
Now I lay Me Down to Sleep- photographer
Postpartum Support International- support groups
Jess: Screening for Postpartum Anxiety and Postpartum Depression within postpartum families is more common today than ever before! For practitioners or postpartum people who may not be as familiar, what are some symptoms to look out for and based on that, who should be referred/seek more support from a professional?
Julie: For PPD symptoms to look out for can include: feeling sad or blue, thoughts of hurting yourself, lack of interest in things that you used to enjoy, irritability, hopelessness, changing in eating or sleeping patterns, not wanting to get out of bed, decrease in daily activities of living such as showering.
For PPA symptoms to look out for can include: excessive worry, irritability, on edge, loss of control, panic attacks, tightness in chest.
And a little less talked about but for PPOCD symptoms to look out for can include: repetitive unwanted thoughts that often are followed by an action that must be done over and over to try to reduce the anxiety around the thought.
I think overall anyone going through the postpartum phase could benefit from psychotherapy services. It is such a time of transition and growth, so much comes up with who you are and your own development.
In general, if any of the above symptoms are impacting how you function in your life it would be helpful to contact a professional.
Jess: I work with so many postpartum people who have experienced birth trauma and yet, they are hesitant to call it that. I’ve noticed people think of birth trauma as something that happens to our bodies rather than how our bodies perceive that experience. So trauma can look different among people and I’m hoping you can speak more on this. HAPPY TO REWORD
Julie: Yes, I have heard that as well. I think the word trauma has a bit of stigma attached to it unfortunately. I really think of trauma as the emotional response someone has to a distressing event. It often causes feelings of helplessness and overwhelm and has a lot to do with your ability to cope with what has happened. Two people can experience two similar things in labor and delivery and one can perceive it as trauma while the other might not. I also think there is some misunderstanding that if you have experienced trauma than you have posttraumatic stress disorder which is not true. Only a small percentage of the population will develop PTSD after being exposed to a trauma. Even if you do not have PTSD, if you have experienced trauma during childbirth it can be really beneficial to work with a psychotherapist and a physical therapist as well. Experiencing trauma in childbirth can impact your mental health and put you at an increased risk for developing postpartum depression or anxiety. It can also impact your ability to bond with your baby.
Working with a psychotherapist can help you work through distressing thoughts, and physiological sensations associated with trauma that get stored in your body.
Jess: Any closing thoughts or pearls you’d like to share?
Julie: My last little pearl is just to normalize mental health for parents. You do not have to experience a loss, a traumatic birth or infertility to seek mental health care. The road to parenthood has unique challenges and mental healthcare should be as normalized as physical healthcare.
I would just like to thank you for asking me to be part of this. I know you are a provider that really cares for her clients and pays attention to not only what is going on physically with your clients but also mentally. I think the move providers we have paying attention to the mental health needs of parents the more people will get the help that they deserve. It goes a long way in normalizing taking care of your mental health.