A Silent Sorrow : Pregnancy Loss: Guidance and Support for You and Your Family Book

	Preface to the Second Edition	xiii
	Acknowledgments	xv
	Foreword	xix
Section I	The Grief of Pregnancy Loss
1	When an Unborn or Newborn Baby Dies	3
	Bonding with Your Unborn Baby	3
	Grieving for Your Baby	4
	The Phases of Grief	5
	Initial Shock	6
	Anticipatory Grief	7
	Acute Grief	8
	Grief Work	11
	Integration of Your Grief	13
	Anniversary Reactions	14
	Grieving Loss in a Multiple Pregnancy	14
	If You Have Difficulty Mourning	15
	Pregnancy Loss Changes You	17
	Key Points to Help You Grieve	17
2	The Mother's Experience	19
	Factors That Affect Your Grief	19
	Feeling You Failed the Baby's Father	21
	The Ways Women Grieve	22
	Your Return to the Community	22
	Key Points for Bereaved Mothers	23
3	The Father's Experience	25
	Bonding with Your Baby	25
	Your Grief and the Pressure to Move On	26
	Your Concern for the Baby's Mother	27
	The Urge to Be Strong	27
	When Your Grief Is Unfinished	30
	Key Points for Bereaved Fathers	30
4	Pregnancy Loss and Your Relationship: Grieving Together and Apart	32
	Your Relationship during the Crisis	32
	Incongruent Grief	34
	Your Grief and Sexuality	37
	How Pregnancy Loss Can Change Your Relationship	40
	Key Points for Couples	43
Section II	Pregnancy Loss Examined
5	Early Losses	47
	Issues Common to All Early Losses	47
	Experiencing a Miscarriage: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	50
	Experiencing an Ectopic Pregnancy: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	56
	Experiencing a Molar Pregnancy: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	60
	Key Points for Coping with Your Early Loss	63
6	Crisis Pregnancies and Loss	64
	Issues Common to All Crisis Pregnancies	64
	Experiencing Preterm Labor: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	66
	Experiencing Premature Rupture of the Membranes: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	70
	Experiencing Cervical Incompetence: Symptoms and Diagnosis, Treatment, Causes, Emotional Aftermath	73
	Key Points for Coping with Your Loss in a Crisis Pregnancy	77
7	Stillbirth and Newborn Death	78
	Issues Common to All Stillbirths and Newborn Deaths	78
	Experiencing a Stillbirth: Diagnosis and Treatment, Causes, Emotional Aftermath	82
	Experiencing a Newborn Death: Causes, Emotional Aftermath	86
	Key Points for Coping with Your Stillbirth or Newborn Death	92
8	Prenatal Diagnosis and the Burden of Choice	93
	Preparing for Prenatal Testing and Receiving the Results	95
	Continuing Your Pregnancy when Your Baby Is Not Expected to Live	97
	Your Hospital Stay when You End a Pregnancy	98
	How to Discuss Ending Your Pregnancy with Your Children	99
	Your Emotional Recovery after Ending Your Pregnancy	100
	Finding the Support You Need after Ending Your Pregnancy	102
	Key Points to Help You Cope with an Impaired Pregnancy	104
Section III	The Response of Others
9	Medical Care when You Lose Your Pregnancy	109
	Learning about Your Loss	109
	Your Hospital Care	111
	Special Considerations with Stillbirth and Newborn Death	114
	Communication among Medical Staff	118
	Your Hospital Discharge and Follow-up Care	119
	How You Can Improve Hospital Bereavement Services	121
	Key Points to Help You Obtain Compassionate Medical Care	123
	Bereavement Protocol	124
10	Finding Solace in Your Religion	125
	When Your Loss Feels Like Retribution	126
	When You Turn to the Clergy	126
	When the Clergy Console You	127
	When Religion May Disappoint You	128
	The Relevance of Rituals	129
	Naming Your Baby	131
	Burying or Cremating Your Baby	132
	When Ritual Is Denied	133
	Theology and Ritual	134
	Jewish Traditions	134
	Islamic Traditions	136
	Catholic Traditions	137
	Protestant Traditions	139
	Mixed Religions	139
	The Need for Special Rituals	140
	Rituals for Early Losses	141
	Rituals for Ending an Impaired Pregnancy	141
	Your Return to Faith	143
	Key Points to Help You Find Solace in Your Religion	143
11	The Response of Your Family and Friends	145
	Telling People about Your Loss	145
	Informing Close Family and Friends	145
	Telling Your Wider Social Circle	146
	Special Issues	149
	Finding the Support You Need	149
	Handling Thoughtless Remarks	151
	Coping with Social Pressures	153
	Being with Pregnant Women and Little Children	154
	Key Points to Help You with Family and Friends	157
	The Five Worst Comments You Might Hear	157
	The Five Best Comments You Might Hear	158
12	Helping Your Children at Home	159
	How to Talk with Your Child	160
	Toddlers and Preschoolers	161
	Children Age Six to Eleven	163
	Preteens and Teenagers	165
	Special Issues for You to Consider	165
	Saying Good-bye to a Baby Sibling	166
	Your Child and Religious Rituals	166
	Your Child's Peers	167
	After the Crisis	168
	If You and Your Family Need Extra Help	169
	Key Points to Help Your Children after a Loss	171
13	For Bereaved Grandparents	172
	Grandparents' Guilt	174
	Helping Your Adult Children	175
	Family Celebrations and Holidays	176
	Pregnancy after a Loss	177
	Strengthening Family Ties	177
	Key Points for Bereaved Grandparents	178
Section IV	Special Circumstances
14	The Impact of Pregnancy Loss on Your Career	181
	Making Career Decisions	181
	Men and Their Careers	183
	Your Career Choices and High-Risk Pregnancy	184
	Key Points when Pregnancy Loss Affects Your Career	187
15	Pregnancy Loss and Infertility: A Twofold Sorrow	188
	Coping with a Pregnancy Reduction	189
	When to Stop Trying to Conceive	191
	Enduring Uncertainty	194
	Key Points to Help You Cope with Pregnancy Loss and Infertility	196
16	Becoming Pregnant Again	197
	Making the Decision	197
	The Right Timing	198
	Finding Out You Are Pregnant Again	199
	Telling Others	200
	If a Loss Occurs Again	201
	Reconsidering Your Medical Care	202
	Changing Doctors	202
	Use of Technology	203
	Surviving the New Pregnancy	205
	For Mothers Who Must Manage a Subsequent High-Risk Pregnancy	208
	Parenting after Your Loss	210
	Experiencing the Birth of a Healthy Baby	210
	Problems with Child Rearing	210
	Responding to Awkward Questions	211
	Key Points to Help You Survive a Subsequent Pregnancy	212
	Appendices
A	Managing Problem Pregnancies	213
B	Rituals	226
C	Pregnancy Loss and the Environment	240
D	Resources	244
	Resources for Pregnancy Loss	244
	Resources for Loss in Multiple Gestations	248
	Resources Online	249
	Resources for Psychotherapy	249
	Resources for Genetics Information and for Ending a Pregnancy	251
	Resources for Infertility	253
	Resources for Childbirth	253
	Resources for Adoption	255
	Resources on Health and Pregnancy	256
	Glossary	258
	Bibliography	267
	Index	291