Stillbirth and suicide risk

by Claudia Ravaldi

Perinatal bereavement is a particularly feared life event due to its known consequences on the psychophysical well-being of mothers , couples and children born later.

Numerous studies over the years have attempted to describe and frame perinatal bereavement, precisely defining its physiological characteristics (which are summarized here ) and also all the risks associated with bereavement of this kind. Over the years CiaoLapo has dealt with the fine line between physiology and pathology reactive to a traumatic life event (in particular, for further information here , here and also here ): perinatal death still represents a taboo event in our country, little known and codified on a social level and even less known and codified on a professional level. Being an event, that of perinatal death, which “falls” into the category of “rare” events (can 6 out of a thousand births really be considered rare?), Perinatal bereavement ends up being misunderstood, and poorly treated, or, in some cases , confused with psychiatric pathology, and therefore treated as such (improperly, because bereavement is not a disease). Knowledge on “physiological” perinatal bereavement is not widespread, knowledge on the pathological aspects related to perinatal bereavement is even less known, and very few experts are able to distinguish “physiological” bereavement from “complicated” bereavement (up to a few years ago, for example, it was thought that the collection of the child’s memories or the request to be able to see him were related to serious psychiatric sequelae: false). If we add to this general confusion the general difficulty in making a correct classification and a correct diagnosis of postpartum depression and the various mental disorders related to motherhood, it is easy to understand how today, in Italy, it is not obvious to receive a correct diagnosis and a fair treatment following perinatal bereavement.

Numerous studies, since the 1970s, have tried to establish the difference between “normal” and “pathological” bereavement: in particular, numerous studies conducted on mothers, have tried to establish the incidence of postpartum maternal mental illness and its aftermath.

In many countries, for example, maternal death is carefully classified according to all causes, including suicide. The reasons are obvious: knowing well the physical and mental risks to which mothers are exposed allows to activate targeted prevention strategies, so as to reduce the risk and improve the outcomes, whenever possible.

Perinatal bereavement bursts into the lives of women, mothers and couples who are often totally unaware of this (rare) eventuality. This life event, particularly bloody due to its high traumaticity, is an event that in half of the untreated cases results in complicated mourning, that is, it causes the development of a mental pathology.

Perinatal bereavement is associated with a double risk of postpartum depression compared to the general population, which in turn is associated with an increased risk of suicide.

From all this it is clear that the six women out of a thousand live births who lose a child at term of pregnancy or in the first week after birth (about 4000 every year in Italy) would need adequate support and pre-ordered follow-up: The “physiological” course of perinatal bereavement should in fact be adequately monitored, so as to promptly intervene in the event of complications (possible, and fearful, as some important scientific works ).

In this regard, a recent study on postpartum suicide suggests investigating the link between perinatal death and attempted maternal suicide.

The numbers, the work suggests, are small (because fortunately the annual number of stillbirths per year is small) but not negligible: correct follow-up of mothers affected by stillbirth and perinatal death and in-depth knowledge of the characteristics of bereavement physiological and complicated bereavement would favor the timely diagnosis of postpartum complication and therefore its correct treatment.

After the death of my son, I remembered all the patients I had met during my career who were looking for my help for perinatal pain that over the years had turned into a real pathology (depression, anxiety, substance addiction). ). Knowing the potential risks of what had happened to me gave me the impetus to take care of myself, and above all, to deepen and clarify the knowledge on this topic.

There is a big difference between the “symptoms” of bereavement and its pathological sequelae. Promoting a physiological development of the mourning process, counteracting the development of psychiatric pathology, intercepting medium and high risk situations to protect paternal and maternal mental health is one of the many missions of CiaoLapo.

Mourning is not a disease, but it can become one.

If you think you need help, you can contact your doctor, the hospital where you gave birth, your clinic and the regional office of CiaoLapo.

If you have doubts about your current state of post-bereavement well-being you can download for free and read our two self-help books, “Crossing Mourning” and “Little Principles” –

If you feel “desperate”: After the loss of a desired child, the feeling of despair is profound, albeit transient (over months). It is normal to feel hopeless and without any plans, just as it is completely normal to ask for help. Don’t be afraid to ask and seek the best help for you.

Every bereaved parent (myself included) has had to responsibly care for their bereavement. It was difficult, heavy and tiring. But it’s always worth it.

I thought that after his death, I should live for two, rejoice for two, love for two.

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