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Altered Motherhood and the Out-of-Order Loss of a Pregnancy

Even with loss, your motherhood is valid and can co-exist with your grief.

Keisha Wells, a Georgia-based licensed professional counselor, is an author and advocate for the bereaved who enjoys supporting others in developing their voice and identity through loss, as well as finding hope and empowerment in the midst of grief. As a twin angel mom, she brings sensitivity to the difficult topic of pregnancy loss. Here, we discussed grief related to pregnancy loss.

Meredith Resnick: In From Three Heartbeats to One: A Gentle Companion Offering Hope in Grieving Pregnancy and Infant Loss, you've named the experience of pregnancy loss “altered motherhood.” How did this poignant term reveal itself to you?

Keisha Wells: I appreciate this question. Despite the physical absence of my twin sons, I do not deny my motherhood or identity as their mother. My motherhood is valid. Yes, it is altered or different in the fact that I never imagined I would experience this form of loss or mother in this way, but I do. With love, with pride, with joy, and with tenderness, I mother my sons in my heart daily as any mother does for her beloved child.

Meredith: You’ve said, about pregnancy loss, that “often with this forced and out-of-order loss, many are so stifled by the pain, guilt, and shame … they don't believe they have the right to publicly honor their baby, to celebrate the life they created.”

Keisha: Public grieving speaks to our right to be genuine and not filter our emotions or edit the truth of our grief journeys for others. Often with pregnancy and infant loss, there is such great stigma that our hurts, our needs, our traumas, our babies are not spoken of. We mask our grief—going internally—because we lack support and understanding. For many, their little ones fade into the background of their lives.

My position is that any person impacted by perinatal loss has the right to acknowledge the precious life created. And they have the right to do so openly and as they choose. This is a stance of conviction and assertiveness. As more move in this right, we eradicate shame in this area and normalize healthy grieving of all lifetimes—no matter how long or brief. Our babies, our children matter.

Loss profoundly transforms us—even our identities—as it takes a great deal from us, including future hopes and moments to never be experienced. Still, grief and loss cannot defy love. And the love we have for our precious babies, their lives, deserves honor. Changing the sullen narrative about what remains after loss and how to celebrate a life and love so deeply and openly that it disarms pity and shame is empowering. Honoring your baby may manifest as naming your little one and speaking their name; planting a garden to nurture and grow in their honor; or creating rituals or traditions to remember your baby such as lighting a candle on special dates. Honor can also look like volunteerism and supporting others on their grief journeys. Ultimately, this is your love to own, your baby’s life to honor—there is no right or wrong way to do it. Be empowered in this fact. You have the right to cultivate your narrative of life after loss.

Meredith: “African-American women are at higher risk for premature birth, and so we are losing our babies. If you’re dealing with that and you don’t have anybody to talk to and you’re a person of color, that’s added sorrow.” You shared this with the New York Times after the loss of your sons. Have you seen changes? How did you cope?

Keisha: In 2007, unlike now, there were limited support resources for families affected by perinatal loss. So little was spoken or written about pregnancy and infant loss then. I cultivated support by attending counseling and connecting with others via a local support group and online chatrooms and message boards. I received comfort in these spaces but also desired to connect with moms and families that look like and hurt like me with multiple losses, which propelled me to do this work. Our grief journeys are unique. I understand the many universal emotions and experiences of this loss. I believe this helps me relate to and support others on a deeper level. It is a privilege to offer hope and hold space for others in this way.

Meredith: "Out-of-order loss" is how you refer to pregnancy loss. Please, say more.

Keisha: Navigating this path is a lifelong journey. I work with individuals to identify their rights in loss, create and maintain a plan for self-care in managing the vast and unpredictable emotions they experience on this path, and ultimately, be patient with themselves in cultivating life after loss. Maintaining my faith and spiritual connection with my sons, as well as the gift of serving and supporting others, are powerful sources of strength for me on my grief journey. Creating community with family and other loss parents also sustains me.

Meredith: Research shows that “approximately 86% of psychologists are white, and less than 2% of American Psychological Association members are African American.” Some research has demonstrated that provider bias and stereotyping are relevant factors in health disparities. Despite decades of effort to increase cultural competency (which includes sensitivity), and decrease bias (and bring unconscious fears or perceptions to consciousness) racial disparities still persist. Even after controlling for income, insurance status, age, and symptom presentation, barriers for BIPOC persist.

Keisha: Every person seeking health care, including mental health services, deserves to be seen, heard, and valued—not dismissed. Providers must recognize and challenge their internalized biases and cultural stereotypes that discount the experiences, needs, and concerns of BIPOC. It is imperative we continue such discussions but, most importantly, make intentional actions to increase equal and quality care. Education, compassion, and cultural competence are vital as demolishing systemic racism is literally a matter of life or death.

*Read the full commentary in Counseling Today.