Lessons in Grief: Public Health and Healing in Community

When we learn about loss in public health, it is often as an abstraction. We read and talk about the millions of people affected by poor health care systems, but they remain faceless statistics, their emotions and stories out of reach. In spring 2024, hoping to bridge this gap in my work in reproductive and maternal health care, I began meeting with a Boston, Massachusetts–based support group for parents who have lost their children during pregnancy or infancy. At their biweekly sessions, attendees discuss what to do with old maternity clothes, or ask how to handle questions from well-meaning coworkers and family. There is no cost to join, attendance commitment, or strict timeline. It is simply a space for those in grief to gather.

I first visited the group to share community-based resources for postpartum depression and miscarriage recovery as part of a local reproductive health outreach program. But my paltry pamphlets and rehearsed speech felt hollow in a room filled with such raw, honest mourning, and I left that initial meeting believing I had done little to help. Instead of stepping away, though, I asked to attend the next session, wanting to better understand the group’s health care experiences. Over the following months, my ideas about effective public health and the meaning of community-building transformed.

In the United States, maternal and reproductive health care has long been riddled with fault lines. Most advocates know the studies well enough to recite their grim findings: the US pregnancy-related mortality rate is double the average of other high-income countries and has worsened over the past two decades.^1,2 Over 80% of these deaths are preventable.³ Our country’s infant mortality rate also surpasses that of other high-income nations, with stark disparities for babies born to Black and American Indian/Alaska Native parents.² These poor health outcomes stem from entrenched socioeconomic inequities, including unequal access to prenatal and postpartum services.⁴

It is easy to become numb to these figures, to repeat them without really knowing what they mean. Studies of patients’ experiences offer only piecemeal insight into a system that doles out care and neglect along familiar lines. We know, for example, that one in five women report mistreatment while receiving maternity care, and that Black, Hispanic, and uninsured patients are more likely to experience threats of withholding treatment from providers.^5,6 However, these studies do not account for what comes after—the grief, solitude, and, in some cases, recovery that follows maternal morbidity, miscarriage, or infant loss. The limited available research describes this process as one of intense isolation, where feelings of inadequacy and stigma shadow recovering patients.⁷ Support groups, including the one I attended, provide a rare space for this grief to find voice and witness. In fact, one reason I continued returning to the group was to understand how people can forge hope and community amid such profound pain.

Through those meetings, I learned that numbers alone can obscure the firsthand experiences that make public health problems—and their potential solutions—concrete. Only when I moved beyond the data did I truly hear the stories of people like Alice, a Black woman who said her nurses dismissed her cries of stabbing spasms during labor. Another Black woman recalled how her physician insisted she repeatedly rate her pain on a scale of 1 to 10, as if he “didn’t believe me the first time.” I discovered that some group participants dislike being labeled as “patients” and prefer to be called “parents.” (“I still feel like a mother, even if my son was only with me for a few hours,” one woman told me.) Many had not dismantled their babies’ cribs. These stories opened my eyes but also left me, as a young student unable to relate to these experiences, feeling like an imposter. This sense of inadequacy only grew as I tried to update the resource pamphlets I had brought to the group. My attempts to incorporate what I had learned felt shallow. For all my research and advocacy, I could not restore what these parents had lost.

Then, a few weeks later, I met the founder of the support group: a White, male ob-gyn without children, who had connected several former patients after they shared how isolated they felt in their sadness. “It’s easy to feel helpless when the problem seems so overwhelming, especially if you haven’t personally experienced it,” he told me. “I couldn’t begin to comprehend those parents’ grief, let alone offer a straightforward solution. But I found that listening to people’s stories is a good start.” I realized that I was clinging to the same mindset I had when I first joined the support group, trying to fit existing answers into the problem instead of truly considering what the parents had shared with me over many meetings: their beliefs, hopes, and visions for the future.

In public health interventions, health care facilitators are seen as the “knowledge holders” because of their professional status, and, by extension, are believed to hold the greatest power. Yet, as Ogunwole and Starks write,⁸ the most meaningful connections form when we, as public health advocates, step back from this title and trust others as the true “knowers” of their own experiences. Ultimately, forging a community depends less on what we know and more on our willingness to learn—to recognize what we do not, and perhaps can never, fully understand, and to act with that humility.

Adopting this framework, I set aside my pamphlets and worked with the support group to organize a maternity clothes drive, offering the parents an opportunity to donate tangible reminders of their bereavement while connecting them with local families in need. “It’s a way to give purpose to our pain,” one group member said. As we packed up the remaining items at the end of the drive, Alice announced that she and her husband planned to apply for adoption next year. The group responded with hugs and cheers of genuine celebration, the kind grounded in a shared understanding of loss and belief in the possibility of healing. Moments like those embody the true work of public health: not just delivering resources or care, but walking alongside people in their darkest times and helping them find light again. In these spaces, we build community.