Dr. Solimar Santiago-Warner (00:00)

Well, if we're going back to the place where you learned

the prognosis of your pregnancy or where you learn that your baby died and any of the other losses and traumas that occurred your body naturally is going to do the things that it needs to do to try to protect itself it's kind of like Oh girl we

We're going there again? Are are you serious? Let's brace ourselves. Oh my goodness. No, no, no, no. Run, run abort. Like, you know, let's just go. Let's just go. Let's just go. then you're like, No, I have to stay. Like, I because I have to continue to do this, or you know what? This is too much. I'm gonna go.

Pauline (00:59)

Hi everybody and welcome back. I'm excited to be here with you today. I'm Pauline Walfisch, accompanied by my faithful co-host Megan Nelson. Megan, introduce our guest today.

Megan (01:13)

Hi everyone, I'm Megan Nelson and

Today we are here. It is the month of October, and October is Pregnancy and Infant Loss Awareness Month, and we wanted to bring on a guest to discuss the nuances of grief and loss and support surrounding pregnancy and infant loss. So today's guest is Dr. Solimar Santiago Warner She is a licensed clinical social worker and a certified parinatal mental health specialist. Her work focuses on perinatal mental health and palliative.

care, especially with reproductive loss, and she teaches grief and bereavement at NYU and Fordham.

She also runs a private practice and has written and presented widely on trauma-informed care in the NICU and perinatal palliative settings. Dr. Santiago Warner, welcome to the show.

Dr. Solimar Santiago-Warner (02:07)

Oh thank you. Thank you so much for having me. Megan and and Pauline. I'm really glad that we're having this conversation. especially during

Pregnancy and Infant Loss Awareness Month. Pregnancy and infant loss is incredibly common. And yet it can still be much of an isolating experience We often don't have a shared language of how do

Megan (02:33)

Mm.

Dr. Solimar Santiago-Warner (02:34)

we talk about it, which means that grieving parents are sometimes left carrying not only

the loss.

itself, but also the discomfort of that silence of the people around them. this is kind of you know I I'm I'm thinking that this is an area that we can definitely you know touch upon.

Pauline (02:55)

Dr. Santiago Warner, we're gonna call you Solimar today because you told us it was okay.

Dr. Solimar Santiago-Warner (03:00)

Yes. Absolutely.

Megan (03:02)

Yeah.

Dr. Solimar Santiago-Warner (03:03)

Please call me Solimar. The the doctor stuff, that's like the formality that we put on papers for CEUs.

Pauline (03:10)

Yeah. And also

you worked hard for it. So you should you should put it up you should put it down. But we're gonna be casual here today. We're gonna talk about you know the

Dr. Solimar Santiago-Warner (03:14)

Thank you. Thank you. I appreciate that. Thank you. Yeah.

Pauline (03:22)

impact of pregnancy and infant loss and what that how that shows up for people. The thing I love about your work is how you talk about how it shows up in the body and all of the different complications. but before we get into that, I was just hoping that

for people who are maybe listening and not familiar with the clinical terms that we're using, like what is perinatal palliative care?

Dr. Solimar Santiago-Warner (03:49)

Perinatal palliative care is working with birthing people whose babies are diagnosed

with a life limiting diagnosis, but the parents are continuing, they choose to continue with the pregnancy. And so the work is, you know, we support families at diagnosis through the pregnancy, how do we say hello and goodbye to their baby? And there's a lot, there's several diagnoses that

We have clear data of what the prognosis is going to look like. So we can quote unquote prepare of what that you know that that illness, that trajectory is going to look like, and how we are going to do end of life and comfort care. But most of the diagnoses in pediatrics.

i it's still like unclear, but we know

Pauline (04:45)

Mm-hmm.

Dr. Solimar Santiago-Warner (04:45)

that based on the information, we know that their life is going to be limited. And so the work is really about

memory making, meaning making, having these conversations, supporting families through the process, not only like what's going on medically for for the birthing parent who is carrying but also how do we support the family through that? And then postpartum, which is still something that is still missing in the literature of perinatal palliative care, we tend to be very

baby focus which is important but we tend to forget that there was a body a birthing person that carried and they are going through their postpartum

Milestones, and this is where a lot of my embodied work comes in because my focus is that I don't want to replace any of the theories or any of the of the modalities that we use to support people that are going through grief and bereavement, but let's talk about how the body is also a part of that narrative and what is coming up for individuals as

They're going

through their bereavement process. So perinatal palliative care, does that. There are a few programs in the United States that offer this, no

Pauline (06:11)

Not every hospital does. And so just

just to be clear, this is this is a pregnant person who is carrying a baby that is not expected to live. They're planning to deliver a baby that they know they may not take home. Sometimes they know they will not take home. And sometimes they know that they will take home, but maybe not for long.

Dr. Solimar Santiago-Warner (06:35)

Right. And so then we support families through all these different types of scenarios and incorporate other resources in the community. There's some

Palliative or home hospice agencies. And again, not all of them know how to work with this particular population because there's so

many layers and so many nuances. So oftentimes,

when I worked at Columbia, the program was is called Neonatal Comfort Care Program, which is a perinatal palliative care program. And my job, you know, aside from like doing the clinical.

work and like supporting families through that process and afterwards was connecting with with the community on how we can support the family so that included

Megan (07:22)

Mm-hmm.

Dr. Solimar Santiago-Warner (07:23)

working with other social workers working with other providers yes this is their area but really providing them with insight and the logistics of what it is when we are working with a pregnant person and then the postpartum period and

And

then the thing about

Pauline (07:40)

Yeah.

Dr. Solimar Santiago-Warner (07:40)

this type of work, and this is how I got into, you know, really expanding it, is that I worked with these families postpartum, so post-bereavement, for about a year and a half, and many of them ended up actually

being pregnant again, having a subsequent pregnancy and everything, you know, was fine as expected. and then a f a few of them have dealt with recurrent losses. And so you know, helping them with that. And then at the time when I was at the hospital, there's gotta be a limit, right? Of like how long I can work with them so then I would transition the care.

But

now that I'm in private practice, I work with families for years and depending wherever they're at in their in their journeys.

Pauline (08:31)

Yeah. I I love when we get to do that, right? Because whether somebody has loss or a live birth and a healthy child, every pregnancy is different. And so to be able to come back to the therapist that you have a relationship with who understands what you went through in an earlier fertility journey, pregnancy, loss, and to be able to just pick up knowing that this person

holds your story, knows your history, and can see you today through the lens of all of the things that you've been through. Is it's it's one of the most exciting things for me when that when we get to do that work.

Dr. Solimar Santiago-Warner (09:10)

Yeah.

Absolutely. I mean we become part of the narrative, which is a privilege, right? And an honor.

Megan (09:16)

Hmm, yeah.

Dr. Solimar Santiago-Warner (09:17)

And I think that all of us, right, that do this work, you know, I think people ask us, like, why do you do it? And I think it's that resilience. We bear witness also to the strength, right? And and the power of of how humans can

work through so many difficult things and still find meaning and purpose, right? And you know, we have vicarious traumatization, but there's also vicarious resilience. And I think that for many of us that's why we do the work that we do.

Megan (09:49)

A hundred percent, yeah. It

Pauline (09:53)

Yeah. So if you don't know what

those terms are, right? Like vicarious trauma is like when we as the therapist are witnessing something traumatic we can also experience the negative effects of that. And then vicarious resilience is like we also get to see you thrive and make meaning and we get to join in that too. So it's it's yeah, being witness

Megan (10:15)

Yeah, and the joy and the yeah. I think

Pauline (10:19)

to those experiences.

Megan (10:22)

The one word

that I wanna highlight is the word that you said it's an honor to walk with these people. Like it really is. It does feel sacred and that yes, we don't get to choose like what necessarily we absorb, but that it isn't all trauma. I always tell my clients when they're

about to maybe have their second child or or have a have a delivery that I'm like, okay, you know, just let me know. Like I'm invested in this too. You know, 'cause it is really you do get really highly invested and it's so beautiful.

Dr. Solimar Santiago-Warner (10:58)

Yeah.

Pauline (10:59)

And I I can imagine that for somebody who might be listening who maybe has had a recent loss or is in the middle of this experience, that they might think that what we're talking about is like looking on the bright side or minimizing their experience, right? They haven't lived through the phases of this, So they might be listening to us and being like, Yeah, there's no there's no good that's gonna come out

Megan (11:26)

Mm.

Pauline (11:27)

of this.

Right? Like I can't possibly make meaning of this thing that's happening. What would you say to somebody who might be feeling that way?

Dr. Solimar Santiago-Warner (11:36)

I would say your truth is your truth, you know, and however you are seeing this and walking through these unknown waters

is how you're doing that and there's no right or wrong way of doing it. And I think that that's the most important thing. which gets into how

as society, right, as as family members, these type of losses get so dismissed.

And I think that we also live in a world where it's like, if we work really hard and if we do the right things, then we can get to a certain level, right? Or we can get healed. And also with everything else going on, there's like all these like instant gratification and things like that. So when parents hear things like,

Things happen for a reason, right? Like those those type of sayings.

Megan (12:27)

We can name them all if we want to. We can name all

the

Pauline (12:30)

And we should we I

mean we should for the purpose of like mm, take these out of your vocabulary.

Megan (12:35)

Yeah.

Dr. Solimar Santiago-Warner (12:35)

Yes, yes, yes.

Megan (12:36)

So my you

Dr. Solimar Santiago-Warner (12:37)

I mean

Megan (12:38)

can always have another baby and

Dr. Solimar Santiago-Warner (12:40)

you're young, you can always try

again.

Pauline (12:42)

Don't say it.

Dr. Solimar Santiago-Warner (12:44)

happens for a reason.

Pauline (12:46)

bad.

Dr. Solimar Santiago-Warner (12:47)

God has

a purpose.

yes, that was gonna be my thing at least.

Megan (12:50)

Pretty much anything that starts with at least Yeah.

Dr. Solimar Santiago-Warner (12:55)

just eliminate that out of your vocabulary. And the reason for that is

People come from a good place and people do not want to see others suffer and they want to help and they want to heal. The problem with these sayings and these things is that it dismisses the experience, it dismisses this person's reality, and it's already an isolating experience to begin with, what people don't understand is that when that mom

you know when that birthing person let's say they have to they have to go to their postpartum appointment right for any one of us who has had a positive outcome right we're going to that postpartum appointment we're getting tracked you know the idea is is that we're gonna get cleared yada yada for that person that appointment means

would they know that I lost my baby? Do I have to sit in the waiting room with

All these people. Am I gonna see another baby? I don't even know if I can get on that train. I don't know if I can even like, get out of the car, get out of of my house and like walk around, there's so many different layers and aspects of that. Just to go to that appointment, right? It's already

Pauline (14:10)

Right.

Dr. Solimar Santiago-Warner (14:10)

such an isolating experience.

Pauline (14:12)

for many people

it's going back to the place where they learned that something was wrong.

Dr. Solimar Santiago-Warner (14:18)

Absolutely, and then again the body speaks before you know we catch up. So if if you're feeling and I can talk a little bit more about that, about like the anniversaries and like

Megan (14:32)

Mm.

Dr. Solimar Santiago-Warner (14:32)

you know like what comes up, but I know for for many folks they're like

logically, right? They're like, I know I have to do these things, but I don't understand why I'm I'm still feeling, you know, what like why is my breathing off? Like why am I feeling so nervous?

Well, if we're going back to the place where you learned

the prognosis of your pregnancy or where you learn that your baby died and any of the other losses and traumas that occurred your body naturally is going to do the things that it needs to do to try to protect itself it's kind of like Oh girl we

We're going there again? Are are you serious? Let's brace ourselves. Oh my goodness. No, no, no, no. Run, run abort. Like, you know, let's just go. Let's just go. Let's just go. then you're like, No, I have to stay. Like, I because I have to continue to do this, or you know what? This is too much. I'm gonna go.

Pauline (15:30)

we do a lot of the same work. So like we're we spend a lot of time of like what does that actually mean? What am I noticing in my body? But if you haven't done this work, this is literally like my stomach hurts. I have to pee. I feel like I'm gonna throw up. The hairs on the back of my neck. I have goosebumps, right? It's a lump in my throat, my chest is tight, I have a headache.

Megan (15:49)

I have a lump in my throat. My chest hurts. Yeah. Yeah.

Dr. Solimar Santiago-Warner (15:50)

Yeah.

Pauline (15:53)

I haven't had a headache

Dr. Solimar Santiago-Warner (15:54)

Okay.

Pauline (15:54)

forever. All of a sudden today I have a headache, right? And so it sometimes it's really clear and sometimes it's not clear. And you really have to kind of tune in and listen to your body like it's talking to you and get curious

about what it's trying to say.

Dr. Solimar Santiago-Warner (16:10)

Exactly. Yeah. And again, you know, I don't want to say

that because you're feeling a sensation on your body that that means that there is some that there's a meaning behind it or that there's something unresolved. It's just simply like we're responding to something in the environment, in in what is happening. And so, you know, like you said, Pauline, like let's lean in and and be a little bit curious about what that means, you know? So one of the things that comes up is

in my practice I have a lot of people that come and they say they come to me about a year afterwards

and they're like, you know

I don't know what's going on. I feel like I I thought I was like doing well and that I moved forward and that I was like doing the things. And then all of a sudden, like I'm not sleeping well. I'm noticing like all these different sensations in my body. I feel more tired, I'm feeling more weepy, and I don't know what's going on because things

are going well, so to speak. And because you know, before we we met up for the consultation or for that first assessment, they already gave me a preview of like their history, And usually, you know, I see I see people that I have dealt with, you know, reproductive loss.

do ask them like is does is there anything about this season, any dates, any things that like come up that is significant, that is important to you? And so then that's that's when they start to say, it's gonna be a year, it's gonna be the anniversary or

This was the due date, or this was the date that I learned about you know the diagnosis, or when I learned that my baby didn't have a heartbeat, And so we talk about that, and again, you know, I I try to emphasize that we we don't have to

subscribe like a meaning to it per se

but just like let's just pay attention of what our body is saying like how is it responding to such an important moment in your life where it is going to make you reflect you know on some level reprocess yeah and I say that grief

it's a lifelong process, and the reason for that is because as you are going through life.

you are going to, learn and see things from different points of views, and there's different understanding. there was a life in a certain person before loss and then post loss is different,

Megan (18:55)

I always say it's like the door

that gets opened that you can't shut again.

Dr. Solimar Santiago-Warner (18:59)

Right. And so

post loss, it's like you it's like looking at the world from a very different lens. So those first couple of years especially, a lot of it is going to be about like, I I didn't experience this before in this post loss like world, in this post loss body.

This looks different. This feels different, right? And what am I learning about myself in this different version of myself? And so I use that kind of language with folks because I think that we tend to be very hard on ourselves because we wanna be healed and we wanna like be at a certain

pace or place in life

Pauline (19:49)

The shoulds.

Dr. Solimar Santiago-Warner (19:50)

right and then when that doesn't happen then we're hard on ourselves and so I say no this is about practicing self compassion because your mind, body and spirit has gone through so much. And another thing is is that

people need to understand that the gestational stage does not matter. a loss is a loss and what that means for you, that is what we are honoring and that's what we're respecting. So I think that that at times in society there tends to be this comparison like this person's loss is greater because they were further along versus someone who had an earlier loss and that's not true at all.

You know, it depends on you as a person like what are you carrying and what that

feels for you and how is that impacting your life and how are you moving through all of these different places in your life and that's what we are here to do we're here to like help navigate kind of like the passenger seat because we're not even driving the car we're just like sitting there with you and just helping you walk through this process.

Megan (21:04)

We

talk about this Pauline and I both run different infertility groups and even in my group talking about embryo loss too and how that is worthy of grief. like this

Dr. Solimar Santiago-Warner (21:18)

Yes, absolutely.

Megan (21:22)

and it's sometimes the first time where someone has said that that like

This was your future child and your hopes and your dreams and you worked so hard to get to this point and course that there's grief behind that.

Dr. Solimar Santiago-Warner (21:37)

Absolutely. People don't talk about that unless you are part of this like little world, right? That

is like the club that like nobody wants to be a part of, but you know, now we're in it. And yes, you know, the the embryos or and even like what do we do with you know when we've decided or we no longer can carry, you know, we we're we're we're no longer expanding our families or we can't for whatever reason. But we have these embryos.

The loss, the grief that comes with that. Like, what are we gonna what are we gonna do with the embryos? You know, because many people would say, Well, why don't you, you know, there's all these different suggestions. Yeah, yeah, yeah. And it's like,

Megan (22:16)

People say just donate just yeah. Yeah.

Pauline (22:18)

Yeah.

Dr. Solimar Santiago-Warner (22:19)

but these are my my babies, these are my embryos,

right?

Pauline (22:23)

We did a podcast

a few weeks ago with somebody who, because of a divorce was forced to say goodbye to their embryos. And, you know, it's a lot of grief because it is the lo that loss of your imagined future. It's not that you're losing somebody who is here and you held or you felt or

ever had a heartbeat and still you're losing the imagined plans for your future.

Megan (22:54)

Potential, yeah.

Dr. Solimar Santiago-Warner (22:56)

Right. The loss of hopes, dreams, that future ideas of what, you know, family,

what that may have looked like. the identity piece, right? You know, about being a parent, what you envisioned of parenthood looking like there's all of these different layers

That we don't talk about in society so openly and have this understanding, but when we talk about it, one-on-one or like in these smaller group settings, there's so much that comes. And we can look at every type of reproductive loss and look at all of the themes, the symbolic losses that come with that, right?

Pauline (23:40)

Like like the loss

of a typical experience, right? The loss of being able

Dr. Solimar Santiago-Warner (23:45)

Yes.

Pauline (23:46)

to like surprise, find out you were pregnant, the loss of being able to go into labor, right? There's so many things that are are people are

Megan (23:59)

Greeting.

Dr. Solimar Santiago-Warner (23:59)

There's

still grieving, yeah.

Pauline (24:00)

Yeah.

Dr. Solimar Santiago-Warner (24:01)

And trying to make sense out of that and also

Megan (24:03)

Yeah.

Dr. Solimar Santiago-Warner (24:04)

trying to understand am I allowed to grieve this? Because that's another thing that comes up, you know. Sometimes people don't even realize that this is grief. They just think that they're being negative or that they just can't shake these like feelings off and it's like no, this is this is what grief looks like or

they may share this with a provider and that provider may pathologize what they're saying, right? They may say that like, there's something wrong with you, or like you're depressed and all of that, and it or or maybe we we should give you some medication to kind of like you know help with these thoughts. And the reality is that we don't medicate grief, you know, this is a natural response.

to losing, you know, something, someone, thought, idea, whatever that you care about so deeply.

Megan (24:58)

Can you talk us through in your work how you describe the layers of loss?

Dr. Solimar Santiago-Warner (25:04)

there there is the emotional grief, right, that that we all recognize. But then there is

There's the embodied grief, right? Like all the sensations, all of all of the things that we experience, you know, mind, body and spirit, and also the relational aspect of it. So, I think emotionally,

A parent is grieving their baby, but they may, you know, as we talked about, they are grieving an imagined future, and they may imagine bringing that baby home, right? We're talking about holidays, birthdays, siblings, you know, all all kinds of things. So when we say someone lost a pregnancy, sometimes I feel like that language doesn't

capture the magnitude of what was actually lost. And then there is the so there's that piece, right? And then there's the embodied layer. And this is something I've have become particularly interested through my work. because pregnancy loss doesn't happen outside of the body, right? Somebody may be grieving while

simultaneously recovering from childbirth or medical procedure, So depending on where you're at just you know, gestationally, right? You know, how far you have been in your pregnancy, your milk may come in, right? And the hormones are still changing, there may be stitches or, you know, a C section incision, right? You may still look pregnant. I mean

our bodies still are are recovering from that. And so the body is still behaving as though there is a baby to take care of, even though there is no no baby

Megan (26:53)

And even with that I wanna st I mean I've

people have talked about looking pregnant and people saying, congratulations, when you've just lost your child. Like and they're like,

Dr. Solimar Santiago-Warner (27:03)

Yes.

Megan (27:05)

I can't stop my day to explain it to them. So they just have to that compounds, yeah.

Dr. Solimar Santiago-Warner (27:12)

Exactly.

They have to cut they have to swallow that. They have to

Megan (27:16)

Yeah.

Dr. Solimar Santiago-Warner (27:16)

just like, you know, s probably smile through and say thank you. And I mean that is such a a crazy contradiction. Or listen, you know, sometimes we can't control our emotions and other times it's like we burst out crying.

or maybe lash out, you know, because we've been holding so much in, right? And like no one else is aware of what's going on.

the other thing I want to talk about is the the relational layer, right? because laws can change relationships, on so many levels, partners.

may grieve very differently. friends may disappear because they don't know what to say, what to do.

Family members may want, you know, someone to move forward before they they're ready. and you know, so sometimes there are secondary losses that happen around the primary loss. And so when we understand these types of layers, you know, we start to understand why grief after pregnancy or infant loss is just so complex.

Pauline (28:29)

as humans, right, we're we're drawn to community. We want to find people who are like us. We like having people

who have shared experiences. And one of the most common places that that happens is is like around parenting and pregnancy. And so very often the pregnant person has friends who are also pregnant at the same time, or we're we're expecting babies

at the same time.

And then when one person doesn't bring home that baby, now that that connection that you had changes.

Dr. Solimar Santiago-Warner (29:04)

Absolutely. You know, and I think about too how in a typical postpartum, period in a postpartum body, in many cultures we have rituals, right, to support, a birthing person, mommy, and and baby. And there's all these things, right, to help, the body recover. We have like warm soups and like, you know, we have all these people taking.

Taking

care of them. But when it comes to someone who experienced a loss, that doesn't really exist. Not at least in in our part of the world. It doesn't really

Megan (29:42)

Yeah.

Dr. Solimar Santiago-Warner (29:42)

exist, right? And so I always think about like what would that look like if we had the same type of care and support, for a woman that has gone through postpartum.

with an expected outcome versus you know someone who experienced a loss and how what would that look like and I wonder how would that can you know aid in someone's bereavement process as they continue

Pauline (30:16)

So we've talked a lot about the person who gave birth and especially because of embodied work, right? What happens to the pregnant body after the baby is gone? But before we end, there's often more parents or more people involved, right? So what about the person who didn't carry the baby or the generations or the siblings?

Do they experience that loss?

Dr. Solimar Santiago-Warner (30:44)

Of course they do. They definitely do. I'll start with the partners or that person that that is with, you know, with that birthing person. grief is very physical.

period right we can get into the nitty gritty of like the neurobiology of it and I go over that stuff with my patients by the way because I want them to understand that this is not coming this is not happening out of nowhere like

Megan (31:12)

Right, there's nothing wrong

with them. It's like this is what yeah.

Dr. Solimar Santiago-Warner (31:14)

Right. I mean

the the body is responding. Their body is doing what it needs to do to respond to this like extreme, you know, level of of stress and and and overwhelmness So with the partners, they're going through their own grieving process, right? They're they are experiencing physical things Again, headaches, tensions, you know, different parts of the body, the brain fog, all of these.

things they can be experiencing. With the partners, in particular, what's really hard is they may have witnessed everything, right? They were they were probably with you know right there listening to everything and

They're not allowed to say anything when we are talking to families. I know in the hospital setting, we're talking with the primary patient,

Pauline (32:04)

They feel like they're

not allowed to say anything. They are allowed to speak.

Dr. Solimar Santiago-Warner (32:07)

Right, right.

So

yeah, and that's the other thing. But even with that, I mean the body language of the providers gives us this message of like, yeah, you know, this you're not allowed, you know. And so

Pauline (32:19)

Right, my attention is here.

Dr. Solimar Santiago-Warner (32:21)

right. And so that's why the partners they don't know what to do be you know, like in that physical space because it's like they're getting a lot of nonverbal communication of like, you know, this is an experience of of the patient.

But no one is asking them how are they feeling? How are they doing? How are they holding up? what is coming up for them? Nobody's asking them, you know, like a year later, like, what does this season of life mean for you? And how is that

Megan (32:49)

Yeah.

Dr. Solimar Santiago-Warner (32:49)

showing up for you? there's no checkup.

Pauline (32:51)

Right. There's no check up five days later.

Megan (32:55)

Yeah, are you having nightmares?

Or do you have flashbacks? Yeah, there's not yeah.

Dr. Solimar Santiago-Warner (32:58)

Yeah,

and even at work, I mean we that's a whole nother topic bereavement policies and all of that.

Megan (33:04)

trust me, I could get on a soapbox about this. It makes me so angry, but

Dr. Solimar Santiago-Warner (33:09)

But you know, we

Pauline (33:09)

We're making progress in New York State.

Dr. Solimar Santiago-Warner (33:11)

we are, we sure are.

Megan (33:12)

It's true, it's true.

Dr. Solimar Santiago-Warner (33:13)

And we still have a long way to go. But even with the birthing person, right, there's a lot of issues with that with the partners. I mean, they rarely get anything. no one is really checking up on them, right? What

Megan (33:26)

Yeah.

Dr. Solimar Santiago-Warner (33:26)

I do know

Pauline (33:27)

No, there's no postpartum visit.

Dr. Solimar Santiago-Warner (33:28)

there isn't, period.

Pauline (33:30)

Period.

Dr. Solimar Santiago-Warner (33:30)

And so that is really hard. And what I what we notice is that we start to see

I don't want to say delay because it's like it's been happening. The the

Megan (33:42)

Mm.

Dr. Solimar Santiago-Warner (33:42)

the grieving process has been happening since the beginning, but the manifestations of that it really comes out later but then people the everybody else has forgotten about it so they're like wait what is going on like why is this person acting certain

in way and so we have to include the partners in these conversations and we need to have better postpartum care that is more family centered when it comes to the to these type of experiences whoever that family is because many people have chosen family families that identify in

That are from the LGBTQ communities, they're even more stigmatized and more silenced, because there's so many stigmas, about how as a society we think about family planning and all of that. And so those biases, they come up, you know, not necessarily directly, but they come up in the way that we provide care at the bedside,

Megan (34:47)

Yeah.

Dr. Solimar Santiago-Warner (34:48)

after.

Afterwards. So, we have to pay attention to all of these things, and we need to have a more family-centered care when we're taking care of our families.

Megan (34:58)

the name of our podcast is What No Mom Told You. I know this is a big ask, but thinking about loved ones supporting other people who have experienced loss.

What is one thing that you wish loved ones would know when it comes to supporting people who've experienced pregnancy or and or infant loss?

Dr. Solimar Santiago-Warner (35:24)

The most important thing is showing up for that person, you don't have to really say anything. But a simple hey just thinking of you and your baby goes a long way.

If that person shares with you the name of their baby, ask if it's okay and you can just you you know you use that baby's name.

Megan (35:43)

Use the name, yeah.

Dr. Solimar Santiago-Warner (35:44)

Use the name, use the name. don't ask that question. Let me know if you need anything that actually puts the burden on the grieving family. I suggest

let's say you're going to the supermarket. Hey, I'm going to the supermarket. I'm gonna pick up a couple of things. do you want something? Or I'm gonna I'm gonna bring some tea or something over, honestly, if if I could just like throw it out there. there are some people that are like I have to do something, right?

Megan (36:10)

Mm.

Dr. Solimar Santiago-Warner (36:11)

Okay, why don't you get them like a gift card to like a cleaning person?

Megan (36:15)

Yep. Laundry. Yeah.

Dr. Solimar Santiago-Warner (36:17)

Laundry, some you know, because it becomes so messy, right? It's so disoriented, especially those several weeks afterwards. and depending where people are at,

People need these practical things

Pauline (36:27)

practical support.

Dr. Solimar Santiago-Warner (36:29)

Yeah, they need those practical support, but they may not have the mental capacity at the time to really ask for that. So be like one step ahead.

Pauline (36:37)

Just offer.

Dr. Solimar Santiago-Warner (36:38)

and if somebody wants to talk, listen. You don't have to give an opinion or

Megan (36:43)

Yeah.

Dr. Solimar Santiago-Warner (36:44)

or tell them to look at the bright side of things. Just listen.

Pauline (36:47)

Yeah. You don't have to have the answers.

Megan (36:49)

Yeah.

Dr. Solimar Santiago-Warner (36:50)

Not at all.

Pauline (36:50)

'Cause there are there aren't any.

Megan (36:52)

there are always those people in a friend group who are like the first to plan a bachelor party or to organize, you know, XYZ. If you're that friend, you are the person in charge then of organizing the support following a loss

Pauline (37:08)

That's it. Megan assigned it.

Megan (37:09)

Yeah, y that's your special skill set.

Pauline (37:12)

if you are listening and you are that

person, Megan just told you,

Megan (37:16)

That's your job. That's your job.

Dr. Solimar Santiago-Warner (37:16)

Yes, yep.

Pauline (37:16)

get yourself in order.

Megan (37:18)

You get on the you organize the mule train. It's, you know, rides to the doctor's offices. It's gas you know walk the dog, laundry, yeah.

Dr. Solimar Santiago-Warner (37:25)

Mm-hmm. Yes. Yeah.

Pauline (37:26)

Walk the dog.

Dr. Solimar Santiago-Warner (37:30)

But even a simple and I have to say because I've done this not only with my patients but also my very close loved ones.

I would just call or send them a message and saying, you don't have to answer. I'm just letting you know that I'm thinking of you. And

Megan (37:46)

Yeah.

Dr. Solimar Santiago-Warner (37:46)

some of them they'll respond back because they're like, yes, and others they they don't, and that is fine too. But all of them have said to me that that simple text message.

I'm just saying hi, I'm thinking of you, like meant the world to them. So if there's anything that you can do, I would say do that.

Pauline (38:06)

Yeah, I love that. Thank you so much for sharing all of your insights with us and getting us thinking about what that experience is like for people. and all of the ways that we can support because it is really common. And if you're listening, you've either been through it or you know somebody who has. And we all need the tools of how to help. So thank you.

Megan (38:33)

Thank you.

Dr. Solimar Santiago-Warner (38:33)

Thank you for having me.

Pauline (38:34)

thank you for being here. And if you're listening and you enjoyed this conversation, well, there's more where that came from. We'll see you next time.

Megan (38:42)

Bye.