If you’re reading this, you may have been through birth trauma, pregnancy loss, or baby loss. We’re very sorry that you’ve experienced something so difficult, and we want you to know that you’re not alone and that support is available.

We are a small team of psychological therapists and specialist midwives who offer compassionate, trauma-informed support for women and birthing people affected by loss or trauma, at any point in their fertility or maternity journey.

We’re also connected with other local support services and can gently help you find further support for you and your partner, if and when that feels right.

Either call us on 01234 290120 or email us with the form completed or questions around it at elft.bedlutonocean@nhs.net

• people who are pregnant and experiencing a fear of pregnancy or giving birth as a result of a previous pregnancy or baby loss or trauma (secondary tokophobia)

• people who have lost a pregnancy or a baby (up to 28 days after birth) and are experiencing prolonged or complex grief as a result of this experience

• people who are childless not by choice

• people who are experiencing trauma or PTSD as a result of their fertility journey, loss or birth experience.

• Individual Assessments:

  We meet with you to understand your current challenges and identify what kind of psychological or specialist midwifery support might help.

  
  

• Individual Formulations:

  This is a detailed look at your personal experiences and difficulties. It helps us understand the reasons behind what you're going through and guides us in choosing the best way to support you. It’s more of a shared story than a diagnosis.

  
  

• Low-Intensity Psychological Interventions:

  These are brief, focused sessions to offer you tools and strategies, to understand common difficulties such as trauma symptoms. They are usually offered as a course alongside other clients of Ocean, but can be offered individually if needed.

• Evidence-Based Psychological Therapies:

  This includes a variety of therapies like Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation & Reprocessing (EMDR), Compassion-Focused Therapy (CFT), or Prolonged Grief Disorder Treatment.  All are designed to meet your individual needs.

  
  

• Support for Partners:

  Some of the work we do may involve your partner as part of the overall support. We can also give information about services where partners can seek their own support, if needed.

  
  

  
  

Where possible, we will support with a “warm handover” to other services which can include a discussion with different services, completing a professional referral and sharing your assessment information (with your consent) to minimise the need to repeat yourself again and again.

bereavement midwife is a trained midwife who focuses specifically on supporting families when a baby dies during pregnancy, birth, or shortly after. They:

• Provide emotional support and counselling

• Help parents understand what’s happening medically

• Guide them through decisions (e.g. memory-making, funerals, follow-up care)

• Offer ongoing support after discharge

They’re often a consistent point of contact during a very difficult time

Emotional Wellbeing Midwives: provide individualised support to women and birthing people who are experiencing secondary tokophobia (severe fear of pregnancy/birth following previous experience of birth trauma or baby loss), on top of existing midwifery/obstetric care. This may include support with navigating the maternity system, answering concerns about pregnancy/labour/birth and/or trauma-informed birth planning.

Psychologists: we have qualified psychologists/psychological therapists and an assistant psychologist within OCEAN who provide psychologically-informed interventions for women and birthing people who are accessing OCEAN.

• Pregnancy loss

• Neonatal death (up to 28 days after birth)

• Birth trauma (which is not suitable for any other intervention)

• Severe fear of childbirth due to previous loss or trauma (secondary tokophobia)

This can be for a range of different reasons, including:

• We do not think that the type of treatment we offer would help to address your current needs.

o  For example, trauma therapy addresses symptoms of post-traumatic stress disorder; grief therapy for prolonged/complicated grief presentations

o   You may be looking for a different type of support e.g. support with raising a complaint, peer-based/befriending support or ad hoc support

• Now may not be the right time to be accessing further support.

o   Sometimes there can be a lot going on that may make it difficult to access planned care, for example due to multiple fertility/antenatal appointments, or there may be significant stressors occurring elsewhere in someone’s life, that make it difficult to commit to regular appointments needed as part of your planned care

o   The nature of therapy may not feel suitable at this time e.g. it requires regular commitment including time to practice information outside of sessions, it can increase distress and symptoms in the short-term

o   You are currently accessing psychological therapy elsewhere (within the NHS or privately) or you have very recently finished accessing therapy elsewhere

• It may be too soon for us to know whether psychological therapy would be helpful for you at this time.

o   It is common to experience a range of difficulties following a traumatic event, and these difficulties naturally resolve for the majority of people within 4-6 weeks without intervention

o   Grief is a universal and adaptive response following a loss, and we are not here to pathologise or interrupt the natural grieving process particularly within the first year after a loss

• Your needs may be better supported by other existing services.

o   In accordance with NICE guidance, we follow a ‘stepped-care approach’ and recommend the least intensive/restrictive treatment option in the first instance, and it may be that existing services may be more beneficial for you in the first instance

o   You may be experiencing factors that require support that we are not able to provide within OCEAN, for example, requiring the input of different professionals (such as psychiatry), support with mental health needs outside of OCEAN’s remit, or there is significant/acute risk.

Following your initial assessment with OCEAN, if we do not feel our support would best meet your needs we will discuss the reasons for this with you and consider the alternative options that may be helpful for you.

Where possible, we will support with a “warm handover” to other services which can include a discussion with different services, completing a professional referral and sharing your assessment information (with your consent) to minimise the need to repeat yourself again and again.

A: It could be one or more of the following;

• Previous loss in pregnancy

• Previous stillbirth

• Previous traumatic birth

• Inadequate pain relief during previous birth.

Q: How might it make you feel?

A: Any one or more of the following;

• Can’t stop thinking about my previous loss or trauma experience

• Frequent bad dreams or nightmares about it

• Extreme anxiety and fear when thinking about this pregnancy or birth

• Not wanting to think, talk or prepare for this pregnancy or birth

• Panic.

Q: Isn’t anxiety about birth normal?

A: To some extent, yes, it is. However, if you have had a difficult birth before or lost a pregnancy or baby, your fear may be extreme. It may make it very difficult to think about this next birth. This is called secondary tokophobia.

Growing around grief is a model created by grief counsellor Lois Tonkin. Tonkin came up with the model after speaking to a client about the death of their child. The woman told Tonkin that at first grief filled every part of her life. She drew a picture with a circle to represent her life and shading to indicate her grief. It was all consuming.

She had thought that as time went by the grief would shrink and become a much smaller part of her life. But what happened was different. The grief stayed just as big, but her life grew around it. There were times where she felt the grief as intensely as when her child first died. But there were other times where she felt she lived her life in the space outside the circle.

Why is the idea of  ‘growing around grief’ helpful?

This view of grief does not tell someone that their grief will go away in time. You will never be ‘over it’. It acknowledges that there will be some days where you feel grief as strongly as you did when the person first died. But there will also be days when you are able to move on with other parts of your life. Sometimes people feel guilty about this, as if it is disloyal to the person who has died. 

The ‘growing around grief’ model shows how we can still grieve the loss of our loved one while carrying on with our own lives. It shows that we can grow a new life which includes the loss.

Courtesy of Cruse https://www.cruse.org.uk/understanding-grief/effects-of-grief/growing-around-grief/

Integrated grief: this is quieter, adaptive form of grief. Whilst strong feelings of loss and sadness may surface in response to reminders e.g. anniversaries, on the whole grief is reshaped to fit into our lives. There is comprehension of the reality of the death and thoughts about this are accessible but not preoccupying. There is a reconnection with others and feelings of competence and wellbeing, where happiness seems possible.

Prolonged grief: also sometime called complex grief, is a prolonged period of at least a year in which feelings of acute grief remain dominant. Feelings of yearning, sorrow and disbelief remain dominant and may be complicated by secondary effects of anger, avoidance of reminders, depression and difficulties in relationships.

• Once your referral is accepted, you’ll be offered an appointment with a Wellbeing Midwife

• This is a chance to talk about:

  • Your current worries or distress in pregnancy

  • Your fertility and maternity history

  • Any past trauma or loss

  • Previous mental health experiences and support

• If this service isn’t the best fit, we’ll help you explore the next steps

2) Enhanced Midwifery Care

A personalised support plan based on your needs and goals

You may be offered:

• Appointments at key stages of pregnancy

• Support in appointments (e.g. with Obstetricians)

• Help to advocate for yourself and your baby

• Information to support your choices

• Links to other maternity services

• Visits to delivery suites or theatres

Birth preparation:

• Create a trauma-informed birth plan together

• Share your plan with your care team

Extra support options:

• Hypnobirthing (small online group via Teams, 4 sessions)

• G-TEP group (trauma support based on EMDR)

  • Helps reduce distress and re-experiencing symptoms

  • A Psychologist will contact you if this is suitable

3) Postnatal Care

• Follow-up support after your baby is born

• A small number of appointments based on your needs

• Support available for up to 8 weeks after birth

• May involve working with your Health Visitor or Perinatal care.

After this, your care will transition to your Health Visitor and GP

• Appointment with a Psychological Practitioner after your referral is accepted

• A space to explore:

  • Your current distress linked to your birth experience

  • Fertility and maternity history

  • Past trauma or loss

  • Previous mental health and support

• If this isn’t the right service, we’ll support you with next steps

2) Low Intensity Treatment

First stage of support (based on NICE guidance)

What to expect:

• Small online group (around 6 people)

• 4–6 sessions

• Focus on how past trauma affects you now

In the group:

• No pressure to share your trauma story

• Learn about common emotional responses after birth trauma

• Develop practical, evidence-based coping strategies

Additional notes:

• Individual sessions may be offered in exceptional cases

• Attending all sessions and practising skills between sessions will help you get the most from this stage

3) Review of Needs

• Follow-up with a Psychological Practitioner

• Reflect on:

  • How helpful and accessible the group was

  • What support you may need next

• May include further treatment or referral to other services

4) High Intensity Treatment

More in-depth, personalised support

• 1:1 sessions with a Psychological Practitioner

• Tailored to your needs and goals

• Developed together with your Psychologist

What to expect:

• Around 16–24 sessions

• Choice of in-person or online (Teams)pathway;

Re-experiencing: sudden and intense memories, images, or sensory experiences such as smells or body sensations. These are accompanied by strong emotions and can feel like you are back in the moment, and have a 'here and now' quality to them. Dreams and nightmares may also have the same quality. They can be difficult to distract or disengage from. Re-experiencing is different from remembering or rumination, which may bring up difficult emotions but more clearly feels like thinking about something which happened in the past.

Arousal: feeling jumpy or easily startled, or a sense of dread and that something bad may happen. This can include general feelings of anxiety, overwhelm or panic.

Avoidance: of reminders of the trauma. This might be places, conversations, objects, colours, or smells. It might lead to taking yourself away from activities, relationships, television, radio or social media. Avoidance can also be of memories and feelings that are associated with your trauma, and in more extreme forms may be disconnecting or dissociating from these things, and can lead to a confusion about whether your memories are reliable or if your trauma is real.

These symptoms are a natural, human response to experiencing something unexpected and overwhelming, where you or others around you felt unsafe. If you have responses from any of the categories above within the first 4-6 weeks following a birth trauma or traumatic loss, then please try not to worry. For many people, these symptoms will settle. Please look at the information in our self-help section about what you can do to support yourself or a loved one during this time.

PTSD is diagnosed where there are symptoms from each of these three areas that are having a prolonged and disruptive impact on wellbeing. If symptoms are not settling, or getting worse, and it has been at least 4-6 weeks since your birth or loss, then please get in touch with us to see if we can help.

• Appointment with a Psychological Practitioner after your referral is accepted

• A space to explore:

  • Your current distress related to your loss

  • Fertility and maternity history

  • Past trauma or loss experiences

  • Previous mental health and support

• If this isn’t the right service, we’ll guide you to next steps

2) Low Intensity Treatment

First stage of support (based on NICE guidance)

What to expect:

• Small online group (around 6 people)

• 4–6 sessions

• Focus on how your experience of loss is affecting you now

In the group:

• No expectation to talk about your loss

• Learn about common emotional responses after pregnancy or baby loss

• Develop practical, evidence-based coping strategies

Additional notes:

• Individual sessions may be offered in exceptional cases

• Attending all sessions and practising skills between sessions will help you get the most from this stage

3) Review of Needs

• Follow-up with a Psychological Practitioner

• Reflect on:

  • How helpful and accessible the group was

  • What support you may need next

• May include further treatment or referral to other services

  
  

  4) High Intensity Treatment

More in-depth, personalised support

• 1:1 sessions with a Psychological Practitioner

• Tailored to your needs and goals

• Developed together with your Psychologist

What to expect:

• Around 16–24 sessions

• Choice of in-person or online (Teams)

They provide specialist support and treatment for people with moderate to severe mental health difficulties during pregnancy or within the first 18mths after having a baby (called the ‘perinatal period’).

•They offer advice on medication to people with a history of severe mental illness who are considering trying to conceive

•They will provide an assessment of your needs and work with you to develop a plan of care during your pregnancy or to support you during the postnatal period. This plan may involve support from one or more of the different types of clinicians in the team, depending on your needs.

•They are a multi-disciplinary team, consisting of nurses, Occupational Therapists, Psychological therapists, nursery nurses, psychiatrists and social workers.

•They work closely with the Ocean service, and some people may receive support from both teams, depending on their needs.

There is an evidence-based technique that can help to reduce the impact your dreams and nightmares have on you. It requires a bit of imagination but is very easy to understand and use. Look at the information below and click on the links to learn more and give it a go.