Maternal Mental Health Week — Pregnancy Loss Edition

Why mental health support after loss must go further than what we are currently offering

This week is Maternal Mental Health Awareness Week.

And this year, I want to use it to shine a light on something that still doesn't get the specific, informed attention it deserves.

The mental health of women after pregnancy loss.

Not just in the weeks immediately following. Not just when the grief is at its most acute and visible. But in the months and years that follow, through subsequent pregnancies, through the postnatal period, through the quiet moments when a woman wonders why she still doesn't feel quite like herself.

Because the conversation around maternal mental health, as important as it is, often misses bereaved mothers entirely. Or addresses them only partially, with a grief framework that doesn't reach the full depth of what they are carrying.

This week I want to change that conversation, even just a little.

What the Research Is Telling Us

A study on women's mental health after pregnancy loss found something that should stop every practitioner and healthcare provider in their tracks.

A woman may not have sought mental health treatment at the time of her loss. She may believe herself fully recovered. And yet a future pregnancy can put her at significant risk for mental health complications.

Let that land for a moment.

The loss doesn't have to feel current for it to still be present. The nervous system holds what the mind believes it has moved on from. And without proper, informed support in the aftermath of loss, support that addresses not just the emotions but the neurological and physiological layers underneath, unresolved trauma can resurface, often at the most vulnerable moments.

A future pregnancy is one of those moments. The postnatal period is another.

The Statistics we cannot ignore

According to the American Psychological Association, approximately 10 to 15% of women worldwide experience postnatal depression. That is already a significant number — and that is the general population.

For women who have experienced pregnancy loss, the risk is higher.

Women who have experienced miscarriage or stillbirth are at a greater risk of developing postnatal depression compared to those who have not experienced loss.

Pregnancy loss is a significant risk factor, not a footnote, not a consideration to be added at the end of a perinatal mental health assessment. A primary risk factor that should be shaping how we support every bereaved mother who goes on to have a subsequent pregnancy and birth.

And yet in most clinical settings, the connection between previous pregnancy loss and postnatal mental health risk is not routinely screened for, not consistently communicated to the women themselves, and not factored into the support offered in the postnatal period.

Why the standard mental health response isn't enough

When a woman presents with mental health difficulties after pregnancy loss — whether in the immediate aftermath or in a subsequent postnatal period — the standard response tends to be one of two things: a referral to general counselling or grief support, or a prescription for medication to manage the symptoms.

Both of these can have value. Neither of them, on their own, addresses what is actually happening.

Pregnancy loss is not just grief. It is reproductive trauma. And reproductive trauma has a neurological, physiological, and identity-level dimension that general mental health support was not built to address.

Neurologically — the amygdala has been sensitised, the nervous system remains dysregulated, the hippocampus has not been able to file the loss safely in the past. This is why a subsequent pregnancy can reactivate the trauma response even in a woman who believes herself recovered. The brain has not yet received the signal that it is safe.

Physically — chronic nervous system dysregulation affects the immune system, the thyroid, the gut, the hormonal system, and the HPA axis. The body is carrying what the mind hasn't fully processed. In the postnatal period — when the body is already under significant physiological demand — this load can become overwhelming.

Emotionally — identity has been disrupted. A future self was lost. The innocence around pregnancy is gone. The relationship with the body has shifted. These are not simply emotional symptoms to be managed. They are fundamental dimensions of a woman's experience that require specific, informed support.

When we offer only mental health support that addresses the emotional surface — without the neurological, somatic, and identity layers underneath — we are treating the symptom while the cause remains untouched.

What bereaved mothers actually need

For the woman reading this, whether you are in the aftermath of loss, navigating a subsequent pregnancy, or in a postnatal period that feels heavier than you expected, I want you to know this:

What you are carrying is not a mental health problem to be managed. It is a whole-body, whole-brain response to something genuinely overwhelming. And you deserve support that understands the full picture.

That means support that:

• Addresses your nervous system — not just your emotions
• Recognises the physical symptoms as part of the same picture
• Holds the identity disruption as a real and legitimate dimension of your experience
• Understands the specific risk factors that come with pregnancy loss in subsequent pregnancies and the postnatal period
• Does not rush you toward recovered before you actually are

This is not standard mental health support. This is specialist care. And it is what every bereaved mother deserves access to.

For the practitioners and providers reading this

If you work with women in any perinatal capacity, as a midwife, GP, obstetrician, psychologist, counsellor, doula, lactation consultant, or any allied health professional, this week is an invitation to expand your lens.

Pregnancy loss history should be part of every perinatal mental health assessment. Not as a box ticked, as a genuine clinical consideration that shapes the support offered.

Women who have experienced loss are at higher risk. They may not present as visibly distressed. They may have told themselves — and told you — that they are fine. But the nervous system does not lie. And if the loss was not properly supported at the time, the risk remains.

Screening for the physical symptoms of unresolved trauma. Asking about nervous system function alongside emotional wellbeing. Understanding the neurological dimension of reproductive loss. These are not optional extras for practitioners in this space.

They are the baseline for ethical, effective care.

This is what maternal mental health awareness week means to me

It means more than a social media campaign. More than statistics shared and then scrolled past.

It means asking harder questions about the standard of care we are offering bereaved mothers. About the gap between what they need and what they are receiving. About what it would actually look like to support a woman through pregnancy loss in a way that addresses the full picture — not just the part that is most visible, most comfortable, or most covered by existing frameworks.

Pregnancy loss is not just grief. It is reproductive trauma. It affects the brain, the body, the nervous system, the identity, and the long-term mental health of the women who experience it.

And this week, and every week, those women deserve better than what we have been offering.

If this article resonated — share it with a provider, a practitioner, or a woman who needs to read it.

And if you are a practitioner who wants to be genuinely equipped to support bereaved mothers at this level, the Pregnancy Loss & Trauma-Informed Specialist Certification was built for you.

About Sharna

Sharna Southan is a Reproductive Trauma Neuroscience Specialist and founder of the International Institute for Reproductive Loss & Trauma Leadership — creator of the world's first neuroscience-informed framework for pregnancy loss recovery. Training practitioners globally. Supporting women through specialist care. Hosting the top-ranked podcast What I Wish I Knew After Pregnancy Loss.

If this resonated — share it with someone who needs it.