For parents who have been through a termination for medical reasons, it is important to know you have a right to feel every bit of this loss and grief. Social stigma and religious/cultural beliefs are powerful – sometimes people believe they should hide or be silent about abortions and terminations. For some people, this adds to an overwhelming feeling of isolation commonly felt among newly-bereaved parents. But for people who have had to make this heartbreaking decision – your feelings and reactions are as valid as they are for anyone else

Having just made the difficult decision to end a pregnancy because of a prenatal diagnosis, many parents struggle with intense guilt, self-doubt and self-blame. These are quite common  for bereaved parents but may be extra painful and isolating if you had to actively give medical permission to end a baby’s life.

You may also feel some relief – sometimes this is because the waiting and dread of the past few weeks and days has ended, sometimes it is because of worries that the baby may have been suffering or in pain, or perhaps due to concerns for your own health if you continued the pregnancy. You may have been clear about the decision you had to make but still feel deep pain about the circumstances and the loss of your baby. Some people feel a mix of relief and heartbreak at the same time.

Your feelings might change several times in the course of a day, or from hour to hour.

You can experience the joy and heightened emotion of childbirth and meeting your baby on the same day as immense sadness and loss. You may be taken aback by this. Whatever emotions you notice in the first few hours, days and weeks, they are real and valid. Try to recognise they are part of giving birth and grieving, rather than questioning, judging yourself or pushing them away.

Parents find themselves torn away from their expectations – a pregnancy countdown, giving birth to a healthy baby, the anticipation of bringing a newborn home. Instead, they are plunged into an unfamiliar and unpredictable present – practical decision-making about autopsy, funeral, choosing a name for a baby who has died and creating memories. This can feel totally confusing, bewildering and surreal.

A termination for medical reasons usually involves scans, tests and appointments leading up to the procedure. Understandably, people may experience this as a series of traumatic events. You may replay moments repeatedly in your mind, such as the scan where you received bad news or the moment you had to sign paperwork. This might happen even more at night when things are quiet and you have fewer distractions. You may go over and over the decision in your mind, wondering what went wrong, whether you are to blame. Some people have nightmares or flashbacks. You might find yourself avoiding smells, noises or places that trigger a traumatic memory – lots of people describe driving on different routes to avoid hospitals or ultrasound clinics. When you can’t avoid these triggers, you might feel the effects in your body – it often takes people back to the moment of feeling unsafe – so you might shake, sweat, feel breathless or your brain might shut down, among other reactions. This can be distressing and unfamiliar.

Once you recognise what is happening, start experimenting with ways to calm your body down and come back to the safety of the present. Depending on what the triggers were, sensory cues can sometimes help with this, such as carrying a small bottle of essential oil to distract you from smell, headphones and music to distract you from a noise, or a small and soothing object that you can carry in a pocket to bring your sense of touch into the present.

Processing trauma usually takes time.

You may feel numb and detached immediately afterwards and find your distress increases over the following weeks. For a lot of people, as they integrate the trauma, intense reactions reduce over the next few months and they become naturally less sensitive to triggers around them. If there is no reduction over the first few months and these experiences continue to cause distress or start to increase, please talk about this with your doctor or counsellor. Experiencing traumatic events isn’t a type of PTSD in itself, the official diagnosis of PTSD is when symptoms don’t reduce over months and the effects start to impact a person’s daily life over a longer period.

It is really common for grief and shock to affect people’s ability to make decisions, remember facts, concentrate on tasks and understand complex information. Some people describe it as “brain fog” or trouble with “cognitive functioning”. Some people even say “I think I have lost my mind”. Whatever the language, it can be unsettling and unfamiliar. However it is a usual response to the shock and sudden upending of your life. Brains get overwhelmed by the enormity of what has happened and are working extremely hard to try and make sense of it, so they often don’t work as well for a while after bereavement.

In a similar way, bodies can experience distress after a bereavement. Sleeping and eating patterns are commonly affected. Grieving people often suffer headaches, upset stomachs, sore shoulders or back pain, among other things. You may need GP or other health appointments more frequently in the weeks and months afterwards. The connections between the body and grief or trauma are real, especially when you have experienced such physical loss through a pregnancy ending. It is important for professionals and support networks to take this aspect of grief seriously.

You might find yourself physically craving your baby – sometimes known as “empty arms syndrome”. This kind of pain and longing is hard to describe but allowing it can reduce the distress. Some people find a physical way of expressing it helps, such as curling up with your baby’s blanket, or other mementoes if you have them. This can start to build a continuing bond with your baby – a way of connecting with them that you return to at times when you long for them most intensely. Try and listen to your body and do what is most soothing for you in that moment.

Pre-existing mental health diagnoses such as anxiety and depression, thoughts of suicide or a history of trauma can resurface after a termination. If you need to reach out to a health professional, doctor or counsellor. This doesn’t mean your grief is a mental illness or a diagnosis, but it may still be useful to ask for additional support at this time. Checking whether professionals have some experience with grief and loss work will help you to feel heard and supported. It is OK to ask about this.

Our resource, The Time After a Termination, provides more information for moving through the time after TFMR and includes practical topics such as creating memories, registering birth/death, financial support and more.