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Pregnancy Loss/Stillbirth

Experiencing the loss of a pregnancy or baby can bring immense pain and grief. You may cry often, feel angry and hopeless, and want to blame yourself or someone else for the outcome.

Experiencing this loss may put you at greater risk for postpartum depression and anxiety, and you might also experience signs of post traumatic stress disorder. Thus, it is recommended that parents are routinely screened for depression and anxiety symptoms after a stillbirth, as well as during subsequent pregnancies. Be sure to ask your doctor if you begin to feel symptoms, as it is often difficult to distinguish between grief and depression after such an experience. (See Grief vs. Depression below.)

Some ways that may help you manage:

  • practice self-care
  • communicate with your partner/friends/family about what support looks like for you. Remember, not everyone experiences grief in the same way. Your partner may have different needs and vice versa.
  • seek out the support of others who have had a similar experience

Grief vs. Depression

Loss of a loved one is a tragic experience, and it brings on a period of immense grief and mourning. You may experience feelings of sadness, anxiety, guilt, and many other symptoms similar to those of PPD. Grief is a normal experience that is often triggered by a significant event. And while the intensity of feelings decreases over time, grief may heighten previously existing mental health illnesses. For this reason, some individuals with grief may be more vulnerable to developing depression. Symptoms of grief are very similar to those of PPD, so it can be difficult to tell them apart. Overall, PPD tends to be more persistent, with symptoms typically lasting longer than six months (when they are unmanaged) and may require professional treatment.

If you are wondering whether you are experiencing grief or depression, it’s important to talk to your healthcare provider and determine the best next steps for you.

Surrogacy

As a surrogate, you may experience symptoms of PPD for a number of reasons including feeling detached from the baby and isolated from the intended parents after birth. It’s important to remember that pregnancy-related hormones play a significant role in causing symptoms of PPD for all pregnant individuals, regardless of whether it’s one’s own pregnancy.

Feeling blue is equally common after birth in surrogacy, and this can be for a few reasons:

  • loss of contact with the intended parents
  • going through the postpartum period without the baby
  • loss of identity being pregnant after birth
  • dealing with the physical changes of the perinatal period

It’s important to remember these feelings (feeling blue or depressive symptoms) don’t usually stem from giving the baby’s guardianship to the intended parents; they are usually due to a number of biological and social factors. PPD can happen in any birthing situation, and doesn’t indicate that the relationship/match between the surrogate and the intended parents is flawed.

Some strategies of self-care include avoiding isolation by surrounding yourself with supportive friends and family, and possibly talking to other surrogates about how they dealt in their experience.

LGBTQIA2S+

The perinatal period brings about significant changes and adjustment, and LGBTQIA2S+ families are like any other in facing the associated stress and difficulties. However, those who identify as LGBTQIA2S+ may face some added risk factors, which could contribute to higher levels of PPD experienced by this group.

The risk factors include:

  • isolation from society and facing discrimination (e.g. people assume that because you’re having a baby, you’re in a heterosexual relationship)
  • social stigma, which can lead to a hesitation to seek support
  • lack of or inadequate family/social support
  • conception complications (e.g. co-parenting arrangements, in-vitro fertilization difficulties/stress , surrogacy, donors)
  • non-biological parents (e.g. they may experience insensitive questioning/assumptions about their family or not have their role validated)
  • parent roles are often tied closely to gender roles, and are often binary in nature, making identifying personal parental roles challenging
  • language, especially as it relates to interactions with the medical system throughout the perinatal period (e.g. breastfeeding vs. chestfeeding)
  • legal/policy barriers

See the resources for safe and inclusive services.

Cultural Impacts and Traditional Practices

PPD is a cross-cultural phenomenon, meaning it can affect anyone regardless of cultural identity, practice, and beliefs. Different cultures can often share similar risk factors for PPD (e.g. low income). Cultural aspects can be protective or harmful in nature; Many cultural aspects of pregnancy and the postpartum period can be protective against developing PPD, while some can have a negative impact if they don’t align with your personal goals. It can be helpful to start thinking early about what cultural practices you’d like to include in your pregnancy, postpartum period, and parenting experience. A good place to start could be talking to your partner, family members, and cultural or spiritual leaders in your community.

Adoptive Parents

Although adoptive parents don’t have the same physical experience of birthing, they’re likely to face similar emotional and mental stresses that come with a new child. They may experience the baby blues or depressive symptoms as severe as in birth parents.

Some reasons for post-adoption depression include:

  • feeling unable to form the bond you hoped for
  • work and lifestyle changes that come from adopting a child

While PPD is often associated with biological factors, adoptive parents suffering from PPD-related symptoms are encouraged to seek treatment.

It is important to recognize that post-adoption depression can occur and if you are suffering from PPD-related symptoms, you should seek treatment. Post-adoption depression is similar to any other kind of PPD in terms of symptoms and treatment can vary significantly from one individual to another. In addition to speaking to a healthcare provider, creating a set of self-care tools can be really helpful. These include exercising, healthy eating, relaxation, meditation/mindfulness, and taking time for yourself.

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