34 Grief and Loss Across the Lifespan
of being autonomous. Her partner may feel a similar loss of independence as
she or he is now tied more tightly to the pregnant woman and may be relied
upon for economic, emotional, and other support. Although these losses are
generally welcomed as a sign of maturation and movement toward a chosen
goal, they are losses nonetheless. The greatest loss is experienced by the fetus
at delivery as she or he is thrust from the womb where every need has been
met without any demand but growth. The moment of delivery requires the
baby to breathe, do the work of swallowing to get nutrition, respond to stimuli,
and lose the protected, darkened calm of the uterine environment. We tend
to focus only on the growth of maturation, but nearly all maturation involves
these types of poorly recognized losses as well.Loss as Experienced by a Fetus
Little is known about the experience of a fetus. The time of conception (when
egg and sperm join to become one cell) through the development of multi-
celled spheres that exist after cell reproduction for approximately 2 weeks is
a time called the germinal period. From 2 to 6 weeks postconception (8 weeks
from the time of the last menstrual period), the embryo grows and primitive
nervous and circulatory systems develop. At the beginning of the third lunar
month, the rudiments of all systems are present and the entity is called a fetus.
The fetus is approximately one and a half inches at this point (12 weeks of
gestational age) and grows to approximately 20 inches by the end of the 40th
week of gestation. The genitalia and facial features develop during the third
to fourth lunar month and bones begin to harden. The fifth and sixth months
are a time of rapid growth. Sensory development occurs and eye movements
begin between 16 and 24 weeks, with patterned eye movements that indicate
sleep/wake cycles occurring by around 36 weeks of gestation. It is believed
that shades of light and dark are perceived, but with little stimuli from the
external environment, it is unlikely that any interpretation of these light/dark
patterns can occur. Likewise, fetuses respond to auditory stimulation between
24 and 28 weeks of gestational age (Birnholz & Benacerraf, 1983), indicating
the ability to begin taking in stimuli from the external world. Despite these
sensory developments, most sense-making and meaning-making rely on expe-
rience with the environment; the stimulus of light changes or auditory input
likely makes no sense when the fetus has no context (or cortex for that matter)
with which to interpret the sensations.
Some speculate that the mother’s emotional state has bearing on fetal
experience because the chemical and metabolic substances that cross the pla-
centa via the mother’s blood supply may have physical effects on the fetus such
as increased heart rate, and so on (Ding et al., 2014). Indeed, recent research
shows strong associations between mother’s anxiety and depression and the
neonate’s birth-weight and temperament, as well as other complications of
pregnancy (Glover, 2014). It is possible that the fetus experiences the physical
aspects of some emotions (oxytocin leading to warm and comfortable feelings;
adrenaline leading to anxious feelings), yet again, with no prior experience
through which to interpret these sensations, it appears unlikely that the sensa-
tions affect the fetus in cognitive or emotional ways. Further, we know that