The Seven Stages of Birth Grief

Understanding and acknowledging birth grief isn’t something our culture excels at. Women are frequently told to “focus on the healthy baby” which has the unfortunate impact of locking women into their grief and isolating them.

The Seven Stages of Birth Grief

The seven stages of grief are a fairly well known psychological pattern experienced after a loss. The stages may or may not be obvious to those who are experiencing them. Confusingly they don’t always follow a consequential order, and sufferers cycle through a couple of the stages at the same time. There may also be a need to repeat whole stages. The seven stages of grief can be applied to grief in many different areas of life, and including traumatic birth. Many people would say that a woman who has a live baby after she has given birth has nothing to grieve over. In short, they are wrong. How women meet their babies matters a great deal, and can impact on psychological health very deeply.

Shock and Disbelief: In the aftermath of a traumatic birth or an unwanted, unplanned caesarean, it’s common for women to feel totally shocked by the experience. They may be experiencing physical discomfort as well as emotional turmoil. The physical element can complicate the emotional element significantly. It often serves as a constant reminder of how things didn’t go to plan.

Denial: During the denial stage women often deny their feelings about their birth. Denial doesn’t mean pretending or imagining an event never happened, just that you aren’t quite able to acknowledge the intensity of the grief, pain, or disappointment just yet. Women often say “I’m at peace with it” during this stage. This stage is probably a very useful one because it allows women to focus on mothering a new baby rather than grieving. Often traumatised women will seek to uncover trauma in their friends after what they would perceive to be a traumatic birth, but it is wise not to do this. It’s best to simply allow your friend to feel however she feels. If the time comes that she needs support, she will know who she can trust.

Anger: Anger isn’t always present during the seven stages, some women bypass it completely. When women do experience anger it can be at their care provider, support team, or their body. Some women even feel angry at their baby. The anger stage is an important stage because it allows women to explore what happened and determine whether or not it was necessary. It’s crucial to not assign this stage value, it isn’t bad to be angry, contrary to popular belief. Anger is an important emotion and we need to be supported through it. Often women are discouraged from expressing anger, or they believe that anger makes them unlikeable or unattractive. Suppressing anger is unhealthy, we need to reframe our perceptions of anger. It’s entirely possible to express anger without breaking things. Sometimes our society confuses rage with anger, and this leaves women unable to genuinely explore all their feelings about their births, and can stunt their recovery.

Bargaining: During the bargaining stage women might say that they’d do anything for a peaceful experience at their next birth. They may think of scheduling a caesarean and research family centred caesareans, they may plan a homebirth or a freebirth. Women declare with great conviction that they will do whatever it takes to achieve the dream birth. They long to meet their next baby in the way they always hoped they would.

Guilt: Guilt is a cruel stage because women frequently blame themselves for things that were out of their control. They say they should have stayed home. Maybe they shouldn’t have had an epidural, or they shouldn’t have been impatient. Perhaps they think they should have researched more, or there’s a combination of harsh self criticisms. As it is often socially unacceptable to blame others for your circumstances, the guilt stage can be very complicated. It’s important to examine your own role as closely as possible, but it’s also important to be able to assign blame if and when necessary.

Depression: Don’t confuse this stage with PND, it isn’t related. PND may accompany birth trauma and grief, but it may also be a stand alone condition. The depression stage can be simply a slump in life, or it can be more serious and have the same symptoms as clinical depression. If this stage seems prolonged or you feel out of control or suicidal it’s vital to seek help.

Acceptance and / or Hope: This stage can mimic the denial stage because women say they accept their trauma and grief. However during the denial stage the feeling of acceptance is forced, it’s a means to end the pain and avoid the grief. In the true acceptance stage women genuinely do feel peaceful about how things played out. That doesn’t mean they aren’t disappointed, or that they never express anger. It isn’t about 100% zen, it’s simply about feeling safe with the grief and not needing to wish it away anymore. This stage can also mimic the bargaining stage because women start to look forward to future births, or realise that they don’t want another baby at all, however once again, it’s a matter of genuinely being in that feeling, not about trying to change the way you feel by replacing bad memories with good ones.

a cracked, red, orange and yellow, enamelled heart
A broken heart
Credit: Nevit Dilmen | Wikimedia Commons | CC BY-SA 3.0.

Wherever you are at on your journey through grief, there’s no rush to reach acceptance, although it may feel like there is. Sometimes knowing that what you are feeling is normal can help you to feel safer where you are at. Rushing through healing means you may not reach true acceptance and you continue to cycle back and forth through the stages. This is especially true of the anger and guilt stages, because if we don’t explore them fully, it’s impossible to find freedom from them.

The seven stages of grief are not a stencil for how women process birth grief, often you can cycle back and forth between various stages numerous times, or be in the grips of more than one stage at a time. It’s possible to completely skip one or more stages as well. Everybody grieves differently.

Understanding and acknowledging birth grief isn’t something our culture excels at. Women are frequently told to “focus on the healthy baby”. Which unintentionally locks women into their grief and isolation. The only way to move through grief is to truly embrace it. Which doesn’t mean revelling in it, it simply means that we give ourselves permission to simply be where we are at. We assign no value to it, because there are no wrong or right feelings. The seven stages of birth grief can help women to understand that what they are feeling is normal.


Birth Grief follows the pattern that all grief follows License: Creative Commons CC0.

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