27
TWO
Perinatal Attachment and Loss
Samantha is a young physician who wanted to complete her medical residency before
trying to start a family. She was concerned when she had not gotten pregnant after
“a year of trying!” Yet once she was urged to have sex with her husband every other
day for a month, she got pregnant right away and was jubilant. Her joy turned to
fear after the anatomy ultrasound at 17 weeks gestation indicated that her fetus* had
a skeletal disorder which would eventually be diagnosed as osteogenesis imperfecta
(OI), a disorder where the bones break very easily. Indeed, the fetus she had come to call
“Sweetpea” already had a broken femur. After lots of soul-searching, discussion with
her husband, and exploration of the science of cure and care for individuals with OI,
she and her husband elected to interrupt (terminate) the pregnancy. She knew that she
and her husband’s lives would be “turned upside down” if they had the baby, and
she also wanted to spare the baby the pain and suffering that individuals with OI
experience.
Samantha was distraught when some friends quit talking with her because she
“aborted her baby.” Meanwhile, she was grieving the baby she had loved. She had
elected to have labor induced and to hold Sweetpea as she died. This both comforted
and traumatized her. A year and a half later, she delivered a healthy little boy. She
will always remember Sweetpea and she finds it very unfair that women who have to
make such difficult decisions are stigmatized when all they are trying to do is spare
their child pain. She remembers Sweetpea every year on anniversaries of her birth/
death and due dates.
Objectives
After reading this chapter the reader will be able to:
■ Understand the prenatal and postpartum attachment process as a frame for
the way loss is experienced during and soon after pregnancy.
■ Describe the ways that biological changes in pregnancy impact attachment
and the subsequent experience of loss.
■ Think about the role of technology in mediating perinatal attachment, diag-
nosis, and loss.
■ Analyze how social norms define perinatal loss and constrain options and
sympathy after such losses.
* Throughout this chapter we use the medically correct word fetus even though we recognize
that most pregnant women would use the word “baby,” which is what we would encourage
clinicians to use if that is the woman’s preferred language.
