Addressing the Diversity of Experiences in Working with PAL Clients

In working with women who are pregnant again after loss (and their partners), I have realized my task is both simple and complex. While I seek to help clients by normalizing their experience of loss, I also must attend to individual experiences of grief, anger, and fear, as well as moments of joy, relief, and connection.

Certain commonalities do emerge across the experiences of individual with whom I work: the daily weight of grief, the fear of trying again and how to manage the daily anxiety about a new pregnancy, and how to best honor the baby who died while welcoming a new baby into the family.

Amidst all of these recurrent themes, there are details that are unique to each individual or couple I see. When I see individuals and couples, I am able to get to know them in ways that allow me to attend to their unique history. Everyone’s story matters. The course of grief and the way someone approaches a new pregnancy is very much informed by their past experiences. I try my best to hear everyone’s narrative as fully as I can.

The person sitting on my couch may have no living children or she may have 3. She may be religious or she may be an atheist. She may have terminated a pregnancy in the second trimester or may have miscarried in week 6 of the pregnancy. She may have chosen to name her child. Her father may have died last year. And her sister may have a child with special needs. All of these details matter in my understanding of the person with whom I am sitting.

My training has taught me to pay attention to the multitude of ways in which a person may identify. I am accustomed to looking within myself to try to understand where my experiences and identifications might diverge from another’s.

What is even more challenging is to be a therapist with a pregnancy loss history and not assume too much about a particular client’s experience. Just because I experienced my loss and subsequent pregnancies in a certain way does not mean that others will have those same experiences.

In my experience, the key to conducting successful therapy with others who have shared a certain type of life event is staying open and curious about my client’s experience.   I will not always do this perfectly and there will be times when I ask a question or make a suggestion that is rooted in my own journey through loss. Rather than try to make someone else’s experience fit into my own subjective framework for dealing with pregnancy after loss, I strive to understand the ways in someone’s history informs how she is dealing with the current situation. I do this by listening and asking a lot of questions.

Each individual is unique and each narrative a complex tapestry of threads that includes but is not limited to the pregnancy loss. One of the most important aspects of my job is to bear witness to the struggles of another. In bearing witness to the pain of my client, my hope is that she will feel less alone, regardless of our similarities and differences.

*Photo Source: “Happy Bench Monday!” by Cathy McCray @ Flickr, licensed with Creative Commons 2.0.

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About the Author:

Rachel Freedman
Rachel E.K. Freedman, Ph.D. is a licensed psychologist in Bethesda, Maryland who specializes in perinatal loss. After experiencing her own termination for medical reasons (TFMR) and finding very few in-person resources, she started an in-person TFMR support group that has run for the past 8 years. Rachel went on to have two healthy pregnancies and now is the proud parent of two girls. She also writes and speaks on topics pertaining to perinatal loss, trauma, and women’s issues. She can be reached at

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