title: The impact of previous perinatal loss on subsequent pregnancy and parenting.
abstract: The loss of any pregnancy through miscarriage, ectopic pregnancy, stillbirth, or neonatal death presents as a significant life crisis for any woman and has far-reaching implications into a couple's future aspirations. Planning another pregnancy after dealing with a perinatal loss is difficult and plagued by ambivalence, doubts, and insecurities. Despite this ambivalence, a majority of women do become pregnant within a year following a perinatal loss. Four recurring issues surrounding perinatal loss and subsequent pregnancy have been identified in this literature review: the effect of the grief process on the subsequent pregnancy; parental coping mechanisms during the subsequent pregnancy; replacement or vulnerable child syndrome; and parenting issues with the subsequent live-born child. Issues surrounding anxiety as a coping mechanism during a pregnancy following a perinatal loss are documented consistently in the literature; however, less is known about the impact that a loss has on parenting behaviors with subsequent children. Further research is imperative to examine these issues in more detail so that evidence-based practices can be established and updated. Health care providers are in a unique position to assist these couples in dealing with the issues that a perinatal loss may place on subsequent pregnancies. By providing a reassuring and supportive environment, women can achieve a positive pregnancy outcome with the correct tools to decrease anxiety and enhance attachment to the subsequent healthy child.
authors.affiliation: E lizabeth L amb is a women's health and family nurse practitioner at Virginia Commonwealth University Health System in Richmond, Virginia. She is currently working in the specialty field of urogynecology.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Lamb