The Responding to Pregnancy Loss Service.

Pam Wakefield,
Masters in Therapeutic Arts Practice.
Therapy Stream.
Workplace practicum, using a Private Practice, in collaboration with Amanda Scott Art Therapy.

The ‘Responding to Pregnancy Loss’ service was conceived and implemented as part of my MIECAT final year workplace practicum. I have long wanted to offer a support service to women who have experienced pregnancy loss and intend to provide such a service in the future.

There is on-going research which suggests that women who experience pregnancy loss are receiving considerable support from a variety of on-line communities. ‘Responding to Pregnancy Loss’ is such a service. It invites people who have experienced any type of pregnancy loss to share their experience(s) via a secure website and to receive from me in return an Intersubjective response (ISR). An ISR is a MIECAT procedure, which is given by a MIECAT companion, formed in any modality, in responsive resonance to the material of the other (The MIECAT Institute Inc, 2016, p. 11). I anticipated that these ISRs would be small pieces of art, perhaps a painting, a collage or a poem.

Before launching the service, I made some art of my own which felt like a good place to begin. I produced a variety of pieces using clay, paint and collage. Eventually I made a multimodal piece which was loosely based on an ultrasound image, something I know well from my current work as an obstetric sonographer. (I scan pregnant mums and produce diagnostic images of their babies). I offered a few variations of this image to my supervision group, asking for their feedback. This proved really helpful in moving me on to a final piece. The final image became the printed postcard which is used to advertise the service.

The day the printed cards arrived I remember standing speechless as I held one my hands. I just kept looking at it, amazed to see my own art in print. I felt like I was standing on the edge of possibility. The back of the postcard gives a brief introduction to the service and directs people to a webpage hosted by my practicum’s workplace supervisor, Amanda Scott (MTAP, AThR).

This webpage ( gives the details of my service, tries to answer some of the frequently asked questions and offers some background information about me. One of my first challenges in writing the content for the webpage was trying to find the right words with which to describe what I was offering, using non-MIECAT language. I had to try to explain the nature of an ISR and why I thought that they might have some value for people who experience a pregnancy loss. A specific problem in early pregnancy loss, that I see, is the lack of any tangible evidence of the existence of the baby. Generally, when someone dies they leave behind clothing, jewellery and photographs as well as many memories held in the minds of others. When a baby dies in early pregnancy, often the only thing that remains are the expectations and dreams of the parents. There are no photographs, no clothes, no toys; there is nothing physical to hold on to. There are not even any memories of time spent together.

I hoped that by making art as a direct result of being with someone’s experience of loss, I could provide something tangible and offer a way to witness the existence of the baby by attending to the story of their short life. I also hoped that by offering the service as a web-based resource, people would be able to access the website reasonably easily, privately, and in a way and at a time that suited them. The website also offers anonymity for those to whom this is important. A further advantage of an online site is that it offers the opportunity for people to write in any way they wish. This might be through a carefully thought out process of typing and editing, or by a spontaneous stream of consciousness. Participants were encouraged to write whatever felt right to them, a few lines or many pages.

Finally, all the preparatory work, the art making and the wordsmithing was done. The webpage was completed and ‘live’, the postcards were out in the world. Now all I had to do was wait … Would there be any responses? The waiting did give me time to consider and then to make peace with the possibility that nothing would happen, that no-one would use the service. Then came the day that I received an e-mail from Amanda Scott, telling me that there was a submission on the website. As I read her e-mail I was delighted and filled with excitement. And then seconds later I experienced total panic. I realised that this was not the best state to be in when I read the submission. I wanted to be calm and receptive, so I waited for an hour before I opened the attachment. Despite my preparations, I found myself crying as I read that first submission, I was quite overwhelmed with emotion. What on earth I had done? How could I have put myself in this position because I didn’t know how I could possibly be of any help.

Thankfully some internal instinct for self-care kicked in and I closed the computer and reached for my journal. After a long walk things seemed easier as I remembered that all I really had to do was to respond. Later, when I came to the submission again, I was able to stay with it and allow myself to begin to connect with the experience without becoming overwhelmed. I noted some keywords, words which “somehow rose to the surface… feels significant… stands out” (The MIECAT Institute Inc, 2016, p, 8) and jotted down my initial responses. The following day, I read the submission again and realised that I still felt unsure. Yet despite this lack of clarity I began spontaneously collecting together a variety of items. The collection eventually resolved itself into an idea from which the final ISR emerged. Several submissions later I now have a much better, clearer understanding of my process.

When I first read a submission, I know I need time and solitude to simply read the words and honour the uniqueness of the experience. I expect to have an immediate and possibly an emotional reaction to what I read but I know that this state will pass quite quickly and beyond that is a space where I can just be with the experience for as long as I need. I will re-read the submission noting keywords or associations or images that come to mind. And then I take time to reflect, sometimes for many days, until something emerges with which I can work to form my ISR.

In making the ISRs I have found myself walking along the beach collecting shells, feathers and sea-glass. Sitting for hours sewing a tiny blue hat and blanket to re-purpose a small clay sculpture that I bought a year ago. I have been absorbed in the process of painting and collaging the representations. And I have discovered that forming an ISR is engrossing, time consuming, sometimes frustrating and quite wonderful. There have been surprising moments of content arising within the process (content in process), particularly as I struggled to make some of the 3-Dimensional representations. Even finding myself making multimodal 3D responses has been a surprise because my usual materials of choice would be paint or collage. Producing 3D representations also led to a realisation that I was going to have take photographs of the pieces in order to be able to send them on to the participants. Suddenly I needed to learn how to use the SLR camera, I had to wait for good light to a take suitable photograph and then remember how to use my photoprinter.

Finally, with the photograph printed I was done. No I wasn’t. The printed photograph alone seemed unexpectedly inadequate, it didn’t capture the fullness of the representation. What to do? I reflected for a while and found myself wanting to present the photograph in some way and to offer an explanation as to why a photograph had become necessary. I made a small hand-torn card, printed out a short note of explanation and glued this onto the front of the card, slipping the photograph inside. I fully expected that my ISR was now finished but no, it still wasn’t done. Something was missing but what was it? As I sat holding the card and feeling confused, my eyes went to the original 3D form and I suddenly had the answer. Cutting off some small pieces of the cloth that I had used in the 3D representation, I placed these onto the card. Breathing out in relief, I finally had a sense of completion. I hand stitched the fabric pieces onto the card. Now the recipient would have both a photograph of their 3D ISR and a piece of that original form.

All that remained now was to package the ISR and send it off. Yet even this simple process turned out to be a little more complicated. I started to wonder what the participants experience of physically receiving an ISR in the post would be like. I had to somehow offer the ISR gently and with this in mind I added another layer to the ISR. I felt that to unwrap the ISR might allow the process of opening and receiving to be more deliberate and perhaps slow it down. So I carefully wrapped the card containing the ISR in coloured tissue paper and sealed it with a piece of decorative tape. This multi-layered package was then placed into a rigid cardboard envelope, addressed and finally posted. At the postbox I pause for a moment before dropping the envelope in. I hesitate to let it go. I’ve spent a long time making this unique piece and now I must to say goodbye to it.

I wonder if the package will reach its destination safely and undamaged. I hope that the ISR might land well with the participant and I consider what might happen if it does not. My fingers decide let go and there is a gentle thump as the parcel slides down into the box. Gone. It’s on it’s way. I am left in the unknown.

Thankfully, after my time at MIECAT, the unknown is not quite such a scary place to be anymore.

My grateful thanks must go to Amanda Woodford (MA ECAT, AThR) for first suggesting the ISR service. To Amanda Scott (MTAP, AThR) for doing an amazing job as my placement workplace supervisor and for generously offering me a space on her professional website. To Kevin Jeynes (MA ECAT), my MIECAT supervisor and the members of my supervision group. To the wonderful individuals and their families who allowed me to use their ISRs in this written piece, you know who you are. And of course, to all those incredible people who were brave enough to use the ‘Responding to Pregnancy Loss’ service.

The MIECAT Institute Inc (2016). Approach to arts based inquiry. Glossary. [Class handout]. The MIECAT Institute Inc, Melbourne.


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