Prenatal and perinatal bereavement is a very delicate and frequent event, in front of which adults are often unprepared. When a pregnancy dies down, a deep and inexplicable pain occurs, which shakes and changes those who live it and the whole context around it. Furthermore, dealing with the theme of death is even more difficult when it is also necessary to explain it to children.
We interviewed Marta Malacrida, psychologist, psychotherapist and author of the book Prenatal and Perinatal Mourning. Suggestions and operational ideas to help children cope with loss (FrancoAngeli Editions) to ask you something more about it. It is a guide-book, which intends to help parents and educators to accompany children in the process of processing pain with special words and modalities. Marta Malacrida is also responsible for the Dynamically Center.
Read also: How to explain death to children
Prenatal and perinatal bereavement. Helping children cope with loss
A book born of pain and what followed
Marta Malacrida maintains, as she also wrote in the Introduction itself, that the book "comes from a pain and from everything that followed."
«It is born, that is, from my personal perinatal bereavement, from the set of emotions, lacerations, feelings and awareness that followed the experience of the loss of my child. It was a complicated, unexpected and very painful experience, for which neither I nor my family were prepared. When it happened, the pain overwhelmed us leaving little room for words.
However, this book is also the testimony of what can come after and through mourning. I like to think of it as a kind of manual on the reworking of mourning for parents and children who are with them, older brothers and sisters of stars who have flown away too soon, but also for every adult who, in their personal or professional role, decides to caring for and accompanying a child in reworking grief. It is a complicated and not at all obvious path, in front of which one can feel alone and unprepared. I imagined this book as a kind of antidote to loneliness in which often families, but also operators fall in the vicinity of mourning ».Read also: Death in utero: how to deal with perinatal bereavement
What do we mean when we talk about perinatal bereavement?
«Perinatal means" around the birth ", to speak of perinatal bereavement, therefore, indicates the loss of a baby or girl during pregnancy, childbirth or in the period immediately following birth. This is the simplest and at the same time broad definition that can be given. And that's what I prefer. Although there are many terms and classification systems for this event, depending on the causes, the time and the ways in which it occurs, the characteristics of the child and variables that I had not even considered, I I focused on the qualitative, relational and affective aspects of the experience.
In fact, I am convinced that speaking of perinatal bereavement undoubtedly means speaking of a week of pregnancy, pathology and medicine, but it also means speaking of love, life and death, motherhood, paternity and parenthood, family and brotherhood. , of loss. Above all, it means talking about a the silent, unexpected, deaf and cruel pain of a fracture in one's parenting project which, just as the etymology of the interruption suggests, breaks in the middle, creating a stop in the experience of life ".
What is useful to know about this trauma?
«A mourning that strikes in the vicinity of birth, that is, of Life in its fulfillment, cannot but be peculiar. I tried to highlight these peculiarities in the book, at least for how I experienced them. First of all it is a mourning against nature because it requires welcoming death where there should have been life, a task at the limit of the possible that projects parents and the whole family into an alienating and difficult to understand dimension: it is like having to make two opposites, by their nature incompatible, coexist. Secondly, it is a usually sudden, unexpected and dramatic event that wipes out the future as it was imagined.
The death of an unborn or newborn baby is an event for which one cannot be prepared and for which it is difficult to give meaning in whatever condition or gestational age occurs. If these aspects are then inserted into a cultural climate in which motherhood is often portrayed as a concentration of "beautiful things" and a happy ending, it is evident how the impact with this event can become potentially and dramatically traumatic and lock yourself up in a private and claustrophobic dimension from which it can be really tiring to get out ».Read also: Death in utero: the emotions of a mother for her unborn child
What happens in the family? How to get out?
“What happens in the family looks like a real emotional tsunami. Each story is different and I don't want to generalize. In the book, I likened the breaking of Pain into a family to a visit from an unexpected, unknown and unwelcome guest. Each member of the family reacts in their own ways and at their own pace: there are those who hide and pretend not to be there, those who in spite of themselves welcome the guest smiling but with death in their hearts, those who run away from home, those who are afraid and remain frozen at the door, those who try to bar the entrance to don't let him in. All, in different ways, impact with the unexpected guest.
There is no right way or wrong way. Certainly that visit cannot be avoided and certainly that pain will profoundly change all members of the family and their way of being together. I venture to say that perhaps, however, to really get out of it and even a little better, there are two ingredients that I consider fundamental. The first is to do it "together": with the courage, availability and profound respect that allows us to be next to each other, even in silence but together. The second is to keep as close as possible to the "truth": with the words and times possible for each one, but accepting all that this guest brings with him ».Read also: How to overcome a miscarriage
Mourning: how to communicate it to children?
“Talking about death and loss with children is a complex task, in front of which many adults are literally speechless. Even more so when death is difficult to explain, unexpected and unjust as happens in perinatal bereavement. For this reason, I think, the temptation to avoid the subject and give in to silence by (apparently) keeping the children out can be very strong. In reverse, the invitation that runs through the whole book is precisely to search with all your might, the words to tell one of the most difficult realities to explain. It is anything but simple: in the book a lot of space is dedicated to this courageous journey that accompanies adults to reflect on the words to say and not to say, on the moments, the ways, the allies and the risks to be faced in order to communicate the news of death. of the little brother or sister.
These words should be softly direct, true, clear and understandable. That is, they must tell the truth in a simple and direct way but not for this crude, they must be understandable and arrive as a clear and not overwhelming sound to the ears of children. Finally, they must be syncopated, that is, rhythmic in such a way that they can be repeated, with the appropriate variations, as often as necessary. I would like to say, however, that it is a job that is not done only with words: it is a path that must also involve the heart and body of both children and adults. In this sense, any creative, narrative or symbolic tool that helps to narrate, represent and make emotionally communicable is welcome ".
Tips to help overcome prenatal and perinatal bereavement
- It's all (a) normal. «The mourning path is all normal and abnormal at the same time. There is no recipe that always works. Too often we run the risk of wanting to classify what happens to us into categories of "right" or "wrong". The only criterion to follow is respect for oneself and for one's emotional reactions. Accept and trust yourself, your emotions and feelings, find a way to understand them and give meaning to what happens to you and not judge yourself or what you feel ".
- Welcome the pain! “The pain of mourning is inevitable. It is a dull, deep and heavy pain. Be prepared to welcome him and, as far as possible, try not to be too frightened. Welcome it and let it be. I don't believe in the hierarchy of pain: there are no series A or series B pains or griefs, just as I don't think there are those in the family who suffer more or less. There are simply different ways and ways. What matters, however, is to give space so that this pain can be elaborated and not hidden, treated, kept warm and then let go ".
- Talk about it! "If even from outside there are calls to" not think about it "and" not talk about it anymore ", to" go on ", if you feel the need, talk about your baby, your baby, your pregnancy, your pain, that that it was or that it would be. Look for people or situations that make you feel safe and tell about yourself, him or her, about you. "
- Sooner or later it passes ... «Mourning is not a disease but a physiological reaction of the body and mind and for this reason it has a physiological time. As terrible as it may be and seem infinite, it has a duration and "sooner or later passes", at least in its most acute and intense form. There are no standard times and methods, but there will come a time when you will feel less destroyed, when the memory will still be present but the suffering will leave a little space and a little breath. Keeping this in mind can help, at least a little, in the blackest pain. '
- Ask for help. «Due to a strange short-circuit, perinatal bereavement often causes one to close up, keep quiet, lead to hiding. Without forcing and with the necessary time, however, it is important to try to take a few steps outside oneself, perhaps looking for people and situations capable of listening and authentic hospitality. Look for these "islands" among loved ones, but if you feel the need, look for them also among services, professionals and organizations that can offer you help, listening and targeted and competent support ».
- Talk to your children about it. “If there are other children in the family, brothers and sisters of the stars who pass too quickly and fly away, let them participate in your story. Sharing bad emotions, tripping and falls and looking for a way to get up together is one of the most precious gifts to give to children. I know it is possible that we do not feel able or strong enough to tackle such a difficult issue, running the risk of seeing a reflection of our own sadness in the eyes of children. But it is necessary to keep in mind that a child has special antennas to intercept changes in the family climate or the sadness of mom or dad. Not giving them even a foothold to understand what's going on can be confusing and make the whole family's reworking process much more complicated. No great explanations or in-depth discussions are necessary, only the willingness to accept their questions as long as possible, give some answers and pause together, for a while, in the weird atmosphere of mourning ".
- Dedicate time to you and you! "An important thing to consider is that, for children in the family, the first and perhaps the most serious loss at the beginning concerns their parents, and the feeling that the mourning, as well as the little brother, has wiped out their smiling faces, together with the family atmosphere built up there. Parents, often, in the first moments after a bereavement, may not be present because they are engaged in visits, hospitalizations, treatments or they may not yet have the strength to be there. What strikes a child most, at least initially, is this loss. However, this can be remedied. One way is precisely to dedicate quality time to be together, to repair, to rebuild and to give meaning together with presence and absence. Also in this case there are no established recipes, times and methods. What is important, I believe, is the desire and the authenticity with which this piece is added to the process of reworking mourning ”.
- Remember. Guard. "" Memory is a way of meeting, "says Gibran. Creating a shared memory of the boy or girl who are no longer there can give relief, make present and convey positive affects useful for the re-elaboration of grief. Even for a child, building an emotional representation of the little brother or sister who is not there can help to understand and at the same time give meaning to her absence. Everyone can and should try their own way to remember. In the book I just told our way and tried to outline some suggestions ».
- Tells. “I am convinced that the power of storytelling, of creating and telling stories, can also be a useful tool for the re-elaboration of grief. Building a narrative around the events of mourning, the lost boy or girl can bring with it numerous benefits because it helps to bring order between thoughts, emotions and events, makes it communicable to oneself and to others, "plugs the holes" of memory, perhaps through some typical expedient of stories, makes present even those who are not there and colors with emotions and meanings the passage of the stars even more silent and fast but full of light. Building and sharing these stories with the children in the family, then, can be a very useful tool to make the pain of absence at least a little lighter ».
- Let it go. Give excess love. "If the grieving process has run its course, if the processing is well under way, there comes a time when you can let go of the Pain. For some strange reason this step can be really complicated. Because you can feel guilty, because you are afraid of letting go, along with the pain, even the memory, because it may seem like you don't deserve it, because you get a little attached to pain. Here, however, I believe that one can let go of the pain, the most excruciating one, the one that blocks and does not restart and maintain nostalgia, a bit like collecting shells on the beach after the destructive power of a storm. In the shell of nostalgia there is the memory, there is also a bit of beauty, there is the ability to love in absence and, perhaps, the desire to invest the love that remains in the future that remains after mourning, when life starts again ».
- termination of pregnancy
- prenatal bereavement
- perinatal bereavement