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self-esteem epitomizing narcissistic personality disorder. 5, 20, 21, 22, 52, 67, 74, 122, 128, 129, 130 Recent empirical studies indicate that while fathers are less apt to articulate their grief than their wives and more inclined to find intimacy through sexual intercourse, as long as they remain emotionally available and. The extended grieving of perinatal loss amplified by infertility as well as the protracted period of decision-making and potentially attempting further pregnancies may increase the need for counseling or psychotherapy 240 as well as making couple therapy an especially valuable modality. It is quite common for a childs jealous feelings toward the new baby during the pregnancy to develop into a conviction that he or she caused the babys death. Patiently offering the availability of additional ultrasounds to assure the anxious woman that her pregnancy is fine may be very comforting and necessary. By holding their baby) or institutional protocol (.g. 164 One qualitative Swedish study 169 eloquently described how mothers facing the death of their newbornsa potentially traumatizing situationare empowered when their empathic caregivers create a sense of confidence, comfort and understanding. 175 Providing options along with the time and assistance for parents to decide what is best for them counts more than directly or covertly telling them what you think they should. Overlapping the perinatal loss with a new pregnancy may intensify grieving and anxiety if the two pregnancies become conflated, sometimes experienced as "one big pregnancy." It may also more rapidly restore maternal self-worth and satisfy the profound wish to parent, thereby easing other sources. This was twice the number of the next most commonly given complaintunresolved questions about the loss, frequently because of inadequate explanations.

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4, 11, 74, 203 In the immediate aftermath of perinatal loss, substance abuse or the development of severe psychosomatic problems warrants psychiatric consultation. 4, 7, 8, 10, 11, 13, 14, 15, 16, 38, 39, 40, 41 The tactile interaction of bereaved mothers with their dead babies is quite like that of mothers getting to know physically their live births, first touching with the fingertips and then moving. A similar dynamic may explain the significantly reduced grief among couples coping with recurrent versus a single miscarriage 265 and the commonly reported finding of prior pregnancy loss not being a significant predictor of more intense grief in a subsequent pregnancy loss. Research in the Netherlands indicated most couples who received caregiver help in viewing and saying goodbye to their dead baby demonstrated no significant grief or distress by six months postloss. For the expectant mother, pregnancy typically revives, in an often less than completely conscious fashion, experiences of being mothered. Non-randomized group assignment with support group attendees possibly grieving significantly more before grief measurement and almost half of the support group attendees only going to one to three sessions). The baby kicked and kicked. 74 Diminished self-worth, especially for women who typically feel their bodies have failed them after these losses, is probably a more serious long-term hazard to resolving pregnancy loss than grieving the loss of the baby. By appreciating how men respond differently to these losses, we may better understand the stresses upon a marriage that perinatal loss can create. Early childhood wishes bio stockholm kista to make babies become one means of defining oneself and enjoying being female. 213, 214 Ideally, both partners should participate, although an unwilling father should not preclude individual meetings with the mother.