Perinatal Loss

Holding What Was Lost: Pregnancy and Infant Loss Awareness

October 15th is Pregnancy and Infant Loss Awareness Day. It is a day that asks us to pause and remember what is so often carried in silence. One in five pregnancies ends in miscarriage. Six infants out of every thousand are stillborn. These numbers matter, but they are never the whole story. Each statistic contains a world of longing, imagination, attachment, and grief.

I write for those who have experienced a perinatal loss, and for those who love them. Whether a woman goes on to have other children or experiences a subsequent healthy pregnancy, the loss does not disappear. Grief does not operate on a logic of replacement. One does not get over this kind of loss; one only learns, slowly and imperfectly, to move through it.

From an attachment perspective, the bond between a mother and her baby begins long before birth. Neuroscience tells us that during pregnancy, the brain undergoes profound reorganization in preparation for caregiving. Oxytocin pathways activate, mental representations of the baby take shape, and the nervous system begins orienting toward protection and connection. When a pregnancy or infant is lost, the attachment system does not simply turn itself off. The body continues to search for the baby who is no longer there.

Yet in our culture, this loss is often medicalized and minimized. It is framed as a “common outcome,” a “normal part of trying to conceive,” a biological event rather than a psychological and relational rupture. While it may be statistically common, it is never emotionally neutral. When the emotional toll is overlooked or prematurely normalized, grief can become complicated—driven underground, prolonged by silence, intensified by shame.

Psychodynamically, many mothers turn the loss inward. They blame themselves, replaying the pregnancy again and again in their minds: What if I had eaten differently? Exercised more—or less? Managed stress better? Taken another supplement? Gone to the doctor sooner? This relentless self-interrogation is not irrational; it is an attempt to restore a sense of control after something profoundly uncontrollable has occurred. The psyche would rather believe “I failed” than accept the terrifying truth that sometimes loss happens without cause.

For family members and friends, witnessing this grief can feel uncomfortable, even unbearable. Partners and loved ones may grow frustrated when the loss is “brought up again,” wondering why it cannot simply be left in the past. But grief does not move in straight lines. From a depth-psychological lens, it moves in cycles, surfacing when anniversaries, seasons, or moments of quiet reopen the wound. Asking someone to stop speaking of their loss is, unintentionally, asking them to grieve alone.

If you are close to someone who has experienced a perinatal loss, it is important not to assume you know the story. You may not know whether the pregnancy was planned, long-awaited, the result of IVF, or one of many losses. You may not know how far along the pregnancy was, or what meaning had already been woven into it. Let the mother lead. Let her tell you what she needs, if and when she is ready.

What helps most is not explanation, reassurance, or silver linings—but presence. Acknowledge the loss. Allow grief to take the shape and duration it needs. There is no timeline. Simple words often carry the most weight: “I don’t know what to say.” “It’s okay to cry.” “This was not your fault.” Listening without trying to fix allows the nervous system to settle and the grief to be metabolized rather than suppressed.

Attempts to minimize the loss—however well-intentioned—often deepen the pain. Phrases like “it was for the best,” “nature knew,” or “at least you didn’t know the baby” can feel invalidating, even erasing. Do not change the subject when the loss is mentioned. Do not avoid the family. Normalize the grief, not the loss.

For women who become pregnant again after a loss, joy and fear often coexist uneasily. The body remembers. Even years later, pregnancy can reactivate anxiety, hypervigilance, and depressive symptoms. Many women find it difficult to hope, as though hope itself might invite catastrophe. They may avoid baby showers, delay bonding, or refuse to prepare until the very end. This is not detachment; it is self-protection. Do not push them to “enjoy it” or “move on.” Such pressure often carries an implicit judgment that they are grieving incorrectly.

After a baby is born, grief may return in quieter, more complicated ways. A mother may imagine who the lost child would have been, what they might have looked like, how they would have fit into the family. This can coexist fully with gratitude for the child she now holds. These experiences are not mutually exclusive. Love is not a finite resource. Making space for both prevents shame from taking root.

Ritual can be profoundly healing. From a depth-psychological perspective, ritual gives form to loss, anchoring memory in symbol rather than silence. Writing a letter to the baby and reading it aloud, planting a tree, lighting a candle, releasing balloons—these acts affirm that the life mattered and will not be forgotten. They offer the psyche a place to return to, a way to hold meaning without being overwhelmed by pain.

Pregnancy and infant loss reshapes a person. It alters how time is felt, how hope is approached, how attachment is lived. Healing does not mean forgetting. It means finding a way to carry what was lost with tenderness rather than isolation.

On this day—and on all the days that follow—what helps most is simple and human: remembering, naming, listening, and staying.