Stillbirth and Miscarriage
Miscarriage is a widely used term for early pregnancy loss and is common. It is estimated that up to a quarter of all pregnancies end with the loss of the baby through miscarriage.
Stillbirth is the death of a baby in utero, prior to or during birth from the 20th week of pregnancy onwards or 400 gram birthweight. The baby is born "still", showing no signs of life. Around 1 in 130 women reaching 20 weeks of pregnancy will have a stillborn baby.
" It seems like a wisp of time that you were here. Places ache inside as I silently mourn."
The loss of a baby at any stage in pregnancy can have a profound impact on parents. Often parents describe a bonding or attachment to their baby very early in pregnancy, or even prior to conception. When the baby dies, many parents feel the loss of the hopes, plans and dreams they had for their future.
To feel sad, empty and bewildered at this time is normal and understandable. If you have experienced a miscarriage or stillbirth you may feel that others do not acknowledge your loss and that you are alone in your grief. The information below is written from the collective experiences of many women and their families who have experienced miscarriage or stillbirth.
Reasons for Miscarriage/Stillbirth
It is very rare for miscarriage or stillbirth to occur because of something you have or have not done, although many parents may feel guilty and still feel this is the case. For the majority of women the cause of miscarriage will never be known, even after extensive testing. Many parents have expressed feelings of frustation and helplessness when a cause cannot be found. The cause of death is unknown in nearly a third of stillborn babies.
When a Miscarriage/Stillbirth Occurs
When a pregnancy threatens to miscarry there is often very little the mother, father or health professionals can do to alter the outcome. This can be a time of considerable uncertainty and anxiety for many women and their partners as they wait, hoping the symptoms will go away and that their baby is still alive and growing. Feelings such as fear, guilt and sadness may be intense as parents search for explanations for the onset of symptoms.
"I feel so numb, I couldn't believe it was happening to me."
Waiting for a miscarriage that is inevitable or to deliver a stillborn child can be lonely and confusing. It can be difficult knowing that you are carrying your baby who has died while trying to anticipate and prepare yourself for the completion of your miscarriage/birth.
If the baby dies during labour or if the parents were unaware of the babies death before delivery, the joy of birth can rapidly turn to a feeling of devastation and loss.
There are many ways to create memories of your baby. Parents often describe that creating lasting memories of their baby is an acknowledgement of the reality of their baby's brief life.
For parents who experience early miscarriage there may not be any physical evidence of the baby. When miscarriage occurs later in pregnancy or when a baby is stillborn, parents may have the opportunity to see and touch their baby.
It is for the parents to decide about having contact and spending time with their child and it is common for parents to change their minds about these things. Most parents don't regret spending time with their baby. It is such a brief time to have an opportunity to spend time with him or her.
Some ways parents have created memories of their baby include:
- Naming their baby
- Conducting a ceremony of significance or funeral for their baby
- Planting a shrub or tree in memory of their baby, perhaps one that flowers around the time of the expected birth date or another significant day
- Keeping a journal or diary to write about their baby, the hopes and dreams they had and the things they would have done together
- Writing poetry about their baby and about their own experience of loss
- Drawing the image they have of their baby, or having an artist professionally draw their baby from a description
- Collecting any early ultrasound pictures, medical reports and papers, arm band, their babies hair, etc. from their hospital admission
- Sending cards or writing to family and friends letting them know what has happened
- Choosing a piece of jewellery, e.g. A locket on a chain, a bracelet, a birthstone or ring engraved with their baby's name or initials
- Choosing a special painting, book or ornament to place in their home in memory of their baby
- Placing a memorial to their baby in the personal notices section of the newspaper
- Creating a birth, name giving or memorial certificate which can be displayed at home or kept in an album with other mementos
- Prepare a family tree including the baby
- Hold a memorial service or blessing - a year, or even 20 or 30 years later
- Design a memorial to place on the baby's grave or in another special place
- Enter the baby's name in a hospital book of remembrance
- Make a cross-stitch birth sampler, a photo frame, a memory box or a ceramic tile
- Adopt a star
- Give gifts to other children during the year in honour of the baby
For many parents, photographing and/or taking video footage of their baby can be a very special way of remembering him or her. Photographing feet, hands or ears showing the perfect parts of the baby can allow for lovely memories, particularly if the baby has some imperfections. It may be important that the whole family is included in photos of the baby, rather than only the mother with the baby or the baby on his or her own. Many parents and families speak proudly of the photos they have of themselves and their baby, especially those where despite the tragedy and sadness, they managed to smile and feel proud as parents. A professional photographer may be able to come to the hospital or home to take photos.
Video footage can be taken in the hospital, at home and at the funeral. At a later time it can be set to music or the parents may like to narrate the film.
Autopsy or post-mortem are terms that describe the same procedure - a surgical examination of a body after death, which is conducted by a qualified pathologist to determine the cause of death or to find out more about factors that might have contributed to the death. Regulations about autopsy differ throughout the world, but parents usually have to give written consent for an autopsy to be conducted on their stillborn baby's body.
A pathological examination, similiar to an autopsy, of a miscarried baby may also provide valuable information aobut your baby and your future pregnancies.
Feelings and Reactions
Many parents describe a range of responses, including disbelief, anger, sadness, guilt, heartache and overwhelming confusion. Life may suddenly seem to be "out of control".
Your grief may be combined with feelings of anger and bitterness. The unfairness of losing a much wanted baby can be traumatic in early pregnancy as at full term. You may feel a sense of betrayal of your body which you trusted to cope easily with your pregnancy. When a pregnancy is unplanned and initially unwanted and a miscarriage occurs, the mother may feel that somehow her feelings of rejection towards the baby have caused the loss. This too, is a natural emotional reaction, and eventually such feelings of guilt will be put into perspective.
Physical reactions such as changes in appetite, sleeping difficulties, a general feeling of being unwell, fatigue and difficulty in concentrating may also be experienced. There are all parts fo grief and bereavement and are normal responses to loss.
There may be times when you withdraw your interest in everything around you. This is a part of normal grieving. It may take weeks or even months before you feel able to return to daily activities. Give yourself time to recover both emotionally and physically. As far as possible, maintain a proper diet and get adequate sleep.
Future events such as your expected due date of delivery, the anniversary of your miscarriage or stillbirth, another pregnancy, Christmas and significant family occasions may be difficult for you. Being aware of this ahead of time may be helpful.
"I will never forget hearing the words "I can't seem to find the heartbeat" after what seem like hours of trying to find that strong, thumping sound, we had to accept that our baby had died silently and unnoticed. It was so difficult to understand when we had just spent a couple of hours shopping for baby clothes."
Couples you have experienced a miscarriage or stillbirth feel isolated and lonely, particularly when others around them are having babies. It can be painful to see pregnant women at work or at the shopping centre, and you may find you avoid holding other peoples babies.
You may feel alone in your grief, particularly if other people did not even know you were pregnant. They will not realise what has happened and you may feel awkward and too vulnerable to tell them now. Those women without a partner to support them may also experience difficulties in having their emotional and physical needs met.
"I feel empty like there's a big hole inside me."
It is important to have someone with whom you can share your thoughts and feelings at this time. Understanding family members or close friends may provide valuable support. Nevertheless, there may be occasions when you feel particularly alone and support from others may be helpful.
As individuals, many parents describe that their thoughts and reactions during bereavement are often different to those of their partner. It can be difficult for partners to maintain effective communication in their relationship while they are experiencing feelings of guilt and sadness. This is particularly so when one partner seems to be "getting on with life" and the other is continuing to express sadness. It can seem that one has forgotten and doesn't care about the miscarriage or stillbirth while the other is not "coping well".
Try to talk openly about your own feelings and needs with your partner. Listening to each other's different needs and expectations may be helpful in understanding your partners' grief. Just as sadness does not mean that you are "not coping" "getting on with life" does not mean that a person doesn't care. You may be just experiencing grief differently. Often your partner cannot be expected to meet all of your needs and it may be helpful to have others to talk to.
"As a father sometimes I feel so helpless, I have learned to cope with this pain in my way, sometimes that means going for a long run where I get the head space to really think about my son".
If you have other children that may be affected by your miscarriage or stillbirth, their reactions to the loss of your baby will be individual. They will be influenced by age, personality and the parental, cultural and religious influences present in their upbringing.
Children react to the stress they feel themselves and to what they see happening around them. Young children may become unusually clingy, easily upset and distressed. Older children may be aggressive, disruptive or unusually quiet. These are common grief reactions in children. Following a miscarriage or stillbirth, your own feelings of grief, sadness, hurt and confusion amy make it difficult for you to provide the comfort and explanations that your children may need. Talk to your children honestly about your baby and how you feel. Provide explanations of what has happened suited to their age, ability to understand and your family beliefs. It is better to give short, simple, accurate explanations frequently rather than lengthy talks. Their questions will help you to understand their specific concerns. Answer honestly, even if the answer is "I don't know".
Who Can I Talk To?
Sometimes it helps to talk to someone who has also experienced a miscarriage or stillbirth. SIDS and Kids Western Australia offers telephone peer support and groups with people who have suffered the loss of their own child, as well as professional grief counselling for individuals, couples and families. Counselling can be face-to-face, by telephone or via email. Please call 9474 3544 for more information or to book an appointment.
How Others Can Help
Family and friends are often deeply distressed when someone close to them experiences a miscarriage or stillbirth. They may feel helpless and powerless and wonder what they can possibly do to make the family "feel better". It is often distressing for family and friends that the people closest to them are going through an experience that no one has any control over or can prevent.
"I feel the need to talk to people about my baby and not have them say, it was 'only a miscarriage' or 'it's for the best'."
To help a family member or friend who has suffered a miscarriage or stillbirth often 'I just don't know what to say' is the most helpful thing anyone can say. Other suggestions are:
- If the baby was named talk of him or her by name
- Reading this and other websites and books or pamplets to learn about miscarriage, stillbirths and bereavement
- Make or buy something in memory of the baby. Display it in your home, or give it to the parents
- Offer to assist with creating memories of the baby
- Offer practical help including housework, cooking, child care etc.
- Be available to listen to the parents, often to the same details over and over
- Be sensitive to the sometimes unpredictable behaviour of bereaved parents
- Understand that sometimes parents will want to be alone
- Offer to accompany the parents as a support person to a support group meeting or on a follow-up visit to their health care provider
Following late miscarriage or stillbirth your breasts may produce milk. Women cannot control the hormones that stimulate the breasts to fill with milk. Full breasts may leak following an embrace, hearing the cry of a baby or even after thinking of your baby.
"My body began making milk for the baby I had lost. I couldn't believe it was happening to me."
The breasts can be very sensitive to touch and be painful and uncomfortable. Breast milk can be suppressed by avoiding stimulation of the breasts and wearing a firm bra both day and night. Painful breasts are often relieved by taking warm showers, cold compresses and using pillows for support.
Production of milk is distressing for some mothers and comforting for others. Some women feel that their milk is the last link they have to their baby.
Planning another Pregnancy
For most women, a miscarriage or stillbirth is a chance occurrence and the next pregnancy is very likely to proceed to full term.
Following miscarriage or stillbirth some parents are keen to become pregnant again as soon as possible. Others feel the need to wait for some time. Sometimes, partners have differing views about subsquent pregnancy, causing strain on their relationship. Also, planning future pregnancies may involve medical and/or genetic investigations and counselling.
You may need to consider the results of post-mortem, pathology or genetic investigations when contemplating another pregnancy. Apart from medical and physical considerations, there is no correct or appropriate period of time to wait before trying again. Your doctor or clinic medical staff may suggest how long to wait before resuming sexual activity and before attempting to become pregnant again. You should discuss your individual needs with them.
SIDS and Kids WA offers:
Bereavement Support Telepone Service 1800 686 780
Professional Counselling (08) 9474 3544
Support Groups (08) 9474 3544
Perinatal Loss Service WA
The Perinatal Loss Service WA provides coordinated, comprehensive and continuing multidisciplinary clinical and supportive care to families that have experienced perinatal or pregnancy loss.
Contact Women and Newborn Health Service WA (08) 9340 2128 for more information.
Genetic Services of WA
Provides information, counselling and support for individuals, couples and families following the diagnosis of a genetic condition in a familiy member or when an abnormality is found in an unborn baby.
Phone (08) 9340 1525 or email email@example.com for more information.
Websites with resources, support and information
A Heartbreaking Choice
Genea - Miscarriage Management
Genetic Support Council of Western Australia
SIDS and Kids WA do not endorse the contents of external websites.