PERSPECTIVES: Reflections From the Field: The Role of Occupational Therapy After Perinatal Loss
Perinatal loss (PNL) is considered the loss of any pregnancy or infant from the time of conception up until 1 year after a woman delivers. One in 4 women will experience PNL while 1 in 3 women will experience perinatal mood disorders such as anxiety, depression, and/or posttraumatic stress disorder whether they experience a healthy pregnancy and delivery or experience PNL. In this article, authors describe variable aspects to current processes of care related to PNL. The authors describe the potential value of occupational therapy in supporting mothers who are parenting after PNL and discuss how a diverse group of providers could contribute to supporting mothers and families with unmet need for services following PNL.
Perinatal loss (PNL) is any loss of a pregnancy or infant and includes miscarriage, termination for medical reasons, stillbirth, neonatal death, and sudden infant death syndrome (Côté- Arsenault et al., 2019). PNL continues to be prevalent in the US. In 2016, infant, neonatal, and post neonatal mortality rates as a total were reported as 5.87 per 1,000 births (Ely et al., 2018). Per the American College of Obstetricians and Gynecologists, 1 in 3 pregnancies end in miscarriages (Wilcox et al., 1988).
A common result of PNL is the diagnosis of perinatal mood and anxiety disorders (PMADs; Kendig et al., 2017). The impact of PMADs and PNL on the quality of life and overall functioning of mothers is long-lasting and significant (Hanish et al., 2019).
Perinatal depression is one of the most common complications of pregnancy and postpartum, affecting 1 out of 7 mothers in the United States (Kendig et al., 2017). Perinatal anxiety disorders impact 11% to 21% of mothers every year (Kendig et al., 2017). Perinatal depression and anxiety disorders have been shown to link to negative perinatal outcomes that will impact mothers, parents, and infants. Perinatal post-traumatic stress disorder (P-PTSD) can also arise after traumatic experiences, occurring from conception to 6 months postpartum (Cirino & Knapp, 2019). Given that childbirth itself can be a traumatic experience and a possible cause of P-PTSD, it is important to recognize the complex trauma that is associated with PNL (Cirino & Knapp, 2019). PNL affects multiple areas of mother’s lives including self-care, activities of daily living, social engagement, and other meaningful occupations and roles of the individual (Hanish et al., 2019).
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