Caring for couples can look different from client to client. It is important to understand the dynamic of the couple prior to the pregnancy, during pregnancy and at the birth to create a plan to care for couples who have experienced perinatal loss. 

Understanding the history of the couple initially either during intake with the client or with both during the intake session should be addressed. How they met, how long they have been together, married, etc. can demonstrate how they communicate, strengths and weaknesses as a couple and interaction if sitting together in session. History about how they decided to become a family or if the pregnancy was a surprise. What has family support looked like for them?

Once you know a bit about the dynamic, you can begin to process through the experience and start to break down any difference in how they experienced the event. It may be that one party had a totally different experience than the other. So therapists should explore what those stories looked like, if possible together during a session as appropriate. It happens many times, that one person had no idea that the other was experiencing fear or worry or frustration with a provider, etc. You may recognize two different reactions/responses to both emotional and physical pain. 

You may see the strengths and weaknesses for this couple. It can be helpful to identify how they care for each other and for themselves. In exploring this it is possible to support not only self care but couple care. Allowing each person to know what they need and what their partner needs to feel safe, and healthy and cared for. You may also be able to identify ways to encourage connection. How can they support and encourage relationship and intimacy after this experience. Couples frequently struggle with intimacy for a variety of reasons after loss; fear of pregnancy, fear of pain, sensations may remind women of the birth experience, etc. It is helpful to have candid and honest conversations about how this may impact their sexual and intimate relationship with each other. Havign open conversations may help to lessen guilt associated and be able to allow for alternate wasy of being close without having sex if a couple is not ‘ready’. 

Encouraging couples to stay connected, develop awareness of how to communicate effectively and ask for help are all important parts of working with and supporting couples after perinatal loss. It is a trying time for many couples and with the support of a therapist who can direct and encourage communication couples can not only feel cared for in the process of healing, but also gain the ability to care for themselves as well as each other.

About Teresa M Eltrich-Auvil

Teresa M Eltrich-Auvil MS, NCC, LMHC Teresa is a perinatal mental health specialist, the WA state Climb Out of the Darkness Lead and has specialized training in infant mental health, infant loss, and equine assisted psychotherapy.

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