How Stillbirth Affects Your Mental Health and How to Cope

About six months ago, Lolly Wool's son Samuel was born without a heartbeat.

"You hear no cry. It's one of the worst silences you can ever imagine," she shared.

She has felt overwhelmed by the grief since.

"You spend nine months planning and sharing in the excitement of the baby that you are about to welcome into the world," she said. "Then, without any warning, the floor falls out from under you when you hear the words 'There is no heartbeat.' The shock, panic, devastation and anger flood you."

Wool, M.ED., is the vice president of operations for virtual programming at Lightfully Behavioral Health in California and one of many parents who have experienced this type of loss. Statistically, 1 in 175 births is a stillbirth. A stillbirth is defined as the death or loss of a baby at or after 20 weeks of pregnancy.

A stillbirth can affect your mental health in many ways. We asked doctors to help explain the details and coping strategies.

How experiencing a stillbirth can affect your mental health

Parents who experience a stillbirth are at a much higher risk for symptoms of PTSD, anxiety and depression, according to a 2021 study in BMC Pregnancy and Childbirth. Further, a 2016 study in BMJ Open journal found parents who held their baby after the stillbirth experienced even higher rates of emotional and relationship difficulties. Here's what that might entail:

Grief, loss and depression

Your mood will obviously take a hit.

"Most commonly, mourning the life of the child, as well as the life the woman envisioned with that child in her family, can lead to deep feelings of loss and despair," said Daniel Roshan, M.D., a board-certified, high-risk maternal-fetal OB-GYN in New York City. "Every woman and partner will process these emotions differently."

For Wool, grief feels different each day.

"It feels like a constant aching for what is missing. It feels like shame or self-blame; maybe I could've done something to prevent this from happening. It is painful to get through the day. It is anger and jealousy when you see others with new babies or another woman pregnant," she said.

PTSD or trauma symptoms

Having a stillbirth can be traumatizing, potentially resulting in flashbacks, nightmares, avoiding anything that reminds you of the stillbirth, feeling emotionally numb, struggling with daily functioning and more, according to Linda Kondilis, Ph.D., a reproductive health psychologist and owner of Orama Wellness in Atlanta.

Anxiety

After experiencing a stillbirth, you may worry, "Will it happen again?" Kondilis said. It's understandable your mind may be plagued with worries about the future. Will you ever get to have a healthy baby? How will people respond when you tell them what happened? Will you feel able to handle it? These are all normal responses.

If you continue to experience pregnancy loss, Roshan suggested talking to a high-risk maternal-fetal medicine doctor.

Coping with a stillbirth

Other than practicing self-compassion and validation, how do you get through each day with such overwhelming pain? Here are some suggestions:

Memorialization

To honor their baby's memory, Kondilis said her patients have planted a tree or plant in their yard; donated money to an organization; created a memorial box of keepsakes, such as hospital bracelets, footprints and handprints (which the hospital may help with); or gotten tattoos.

Wool said making sure Samuel is present in her everyday life has been crucial.

"It looks like having pictures of him in our house. It is talking with my other children about him. It is telling people that I have four kids when they ask, 'How many children do you have?' It means having a stocking on the mantel for him for Christmas," she shared.

While these gestures don't take away her ache, she said, they do bring a small bit of comfort.

Connecting with support groups, friends and family

While you deal with the emotions of going through a stillbirth, it can be helpful to know you're not alone and other people understand your pain.

"In my city, we have an amazing bereavement group at Northside Hospital in Atlanta called Heart Strings," Kondilis said.

While nothing can cure the grief you feel, being around people who love and support you can help you manage.

"Connect to loved ones, communities that have been through this via social media or local [groups], if available, to prevent isolation," Kondilis added. "Isolation can make the mental health symptoms worse."

Talking to a therapist

If a support group isn't your thing, therapy is an additional option for one-on-one support.

"It is paramount for women to be supported through these emotions by those closest to her and by mental health professionals when appropriate," Roshan said. "Discussing how she feels after pregnancy loss in a supportive and safe environment is critical for coping and processing [and] for healing to begin."

He encouraged talking about the multitude of emotions you may be feeling.

You can find reproductive therapists and support groups in Psychology Today's database. Roshan added that obstetricians can sometimes refer you to therapists or psychiatrists, too. Giddy telehealth is another resource for healthcare professionals.

Redirecting self-blame

As Wool mentioned, you may feel you were at fault for what happened or could've done something to prevent it from happening. You may feel extra guilt on top of that if the emotional pain keeps you from getting things done, such as laundry or work. While this is understandable, it's not helpful or fair to yourself.

Kondilis recommended several skills you can try. The first is psychoeducation.

"Even if people have been through grief, it is so helpful to remind them [of] all the ways grief can present itself," she said. "There is not [a] right or wrong way to grieve. People will try to blame themselves for having symptoms we would expect them to have after a trauma like a stillbirth."

Another example is redirection, a way to show self-compassion. If you have thoughts such as "If only I had…" or "I am responsible," rewrite these narratives and address all the hypothetical interventions in order to lift your guilt, Kondilis said. For example, many of the causes of stillbirth are out of your control.

"Know that most miscarriages are due to chromosomal problems and structural defects, and it's not due to something you did or didn't [do]," Roshan explained.

Thirdly, consider behavioral interventions and exposure.

"We might redirect behavior slowly to help them process, increase pleasurable activities or address any avoidance," Kondilis said.

For example, when a couple she worked with started experiencing fewer trauma symptoms, they worked on going into the baby's room.

"First, it was walking in the room; next, it was sitting in the room, eventually going through the baby's items and deciding what to do with the items," she said.

Find support and resources

Other tools Kondilis listed are acceptance, self-advocacy, not internalizing the pressure or judgments other people put on you, and finding supportive outlets. These tools can be beneficial for all people involved, not just the person who directly experienced the stillbirth.

"Having a stillbirth impacts a woman in ways that are deep and change you," Wool said. "It also has [a] significant impact on the woman's partner. All the tools that can be helpful for a woman navigating this are just as important for their partner."

She shared two resources: Share Pregnancy & Infant Loss Support and Rachel's Gift, organizations that provide support in various ways.

What you're going through is beyond terrible, but you're not alone in experiencing it or getting through it. You deserve the support you need, so don't feel bad about reaching out and taking care of yourself.