Third Trimester Loss, Full Term Loss, Stillbirth

The most unbelievable occurrence has happened. You have reached the very end of your pregnancy and with little or no warning, your baby has died in utero.

Utter Disbelief

There are no words to describe your feelings or the impact of this event. Devastation, disbelief, sadness beyond words.

Searching for Answers

When a loss occurs at this stage everyone wants answers. Sometimes there are explanations of what happened, but not always. The most common situations are problems with the umbilical cord – it may have knotted cutting off blood and nutrient supply to the baby, or the cord may have wound itself around the baby’s neck causing him/her to choke. There are other known situations – the baby may have had a seizure in utero and died. The placenta may have detached itself from the uterus (placenta abruption) and this can cause either immediate death or severe problems leading to the death. And as is the case for some, there is no known cause.

Another cause of fetal death may be related to the health of the mother. Certain syndromes such as HELLP (preeclampsia, hypertension), may cause the baby to die and the mother’s health to be jeopardized. Primary concern is usually placed on the health of the mother unless there are other extreme circumstances in which case your family will need to make decisions.

Autopsy is an Option for Some

Many people choose to do an autopsy at this stage in order to get more information since that will help with “closure” and a better understanding of what took place. Others, for personal or religious reasons choose not to do an autopsy and find peace in knowing that the baby goes to his/her resting place “undisturbed.”

Experiences with the Baby

When you have a stillbirth baby, in this day and age, you are always given the option to see, hold or even wash and dress the baby. Pictures are always taken. This is written at a time when most hospitals and birthing centers have become aware of the importance of offering this to the grieving family. There may be exceptions – and if you were an exception, advocacy should be advanced wherever you delivered in order that others will not be treated as you were.

You will need to decide whether you wish to spend time with the baby and with whom you wish to share this experience. Some couples reserve this experience to be just between themselves and their baby. Others invite family members, even siblings – depending on their age – and close friends to join in this somber event.

You will not be thinking straight at this point so whatever you decide to do, it is the right thing for you at that moment.

In some hospital settings, opportunities to see the baby again may be offered hours later or even the next day. Sometimes bereaved families may leave the hospital without seeing the baby and return through the intervention of the social worker or Labor & Delivery team to see the baby a day or days later. Do not feel awkward requesting this even though it may feel strange to you. If it feels like you need to do this then make sure you follow your instinct.

Burial/Memorial/Cremation Plans

It is the rare situation these days that a family is not responsible for the disposition of the baby following a stillbirth. Years ago the hospital staff would whisk the baby away without giving the grieving mother and family a chance to ever see or hold the baby, and there would never be a discussion about the event again. Where these babies are buried is a mystery to these families; there is no record, no pictures nor any other memento (before the onset of ultrasound imaging). Doctors would give no information to the families and women were advised to get pregnant again as fast as possible in order to forget what happened.

Deciding where to bury or whether to cremate your baby may take a few days for you to figure out. Hopefully you are dealing with a hospital that will not pressure you and will offer guidance to make an informed decision. You may want to consult with family members or even clergy so that you make the choice that is right for you and your family. Many cemeteries have sections set aside for babies and the cost is relatively low compared to buying a regular plot. Often these sections have standard memorial plaques that you can personalize for your baby. It can be comforting for families to know that their baby will be in a section with other babies. Some families may have a family plot where you can bury your baby, or you may decide to purchase a family plot where you know you and other family members will be buried alongside your baby.

Cremation

Cremation is a legitimate option for many families. This choice allows you to keep the ashes in an urn at home, or to bury the ashes in a special place. Some people choose to disperse the ashes in a holy or otherwise meaningful location.

For additional details about burial, cremation, and memorial service ideas please read the section on 2nd trimester loss.

The Aftermath – Returning to an Empty House

Returning to an empty house – perhaps one where the nursery was already set up – empty-handed, without holding your baby is one of the hardest experiences to get through. Sometimes well meaning family and friends may have taken apart the nursery in order to spare you any reminders. This may be a comfort for some – to not have any physical reminders in your home. Others find some peace of mind spending time in what would have been the baby’s room – a time to gather your thoughts and spill your tears.

Whatever is going on in your home space it is natural for you to be dealing with a deep sense of loss and sadness and a feeling of a physical void. Not only is this natural, it is also expected. You should not feel that you have to hide your feelings from people – this is a serious and tragic loss.

Reactions of Others

Many of your family members and friends will “get it”, but don’t be surprised by those who don’t. You may feel angry and hurt by those who don’t get it and that can be dealt with at a later time. For now, embrace those who understand and offer their support.

Understand and Express Your Needs

It is not uncommon for the grieving mother to feel like she cannot be alone. Your partner may not be able to take extra time off from work, but make sure you make your needs known not only to your partner, but also to family and friends who can create a rotation so that you are not alone. Do not be afraid to ask for what you need. This may feel foreign to you to ask for this help – but you should do it even if it feels awkward. People who offer to help, do so because they really want to.

At the other end of the spectrum it is also not uncommon to feel like you want to be alone (or just with your partner) and you may feel burdened by everyone’s desire to help or be around. This is another example of a time when it’s important to make your true needs known.

The New You

This will undoubtedly be a you that you have not known before. Of course you are the same person deep down, but you are dealing with a new reality and not one that you have had the opportunity to ever rehearse for. You have permission to be that new you: the new you who asks for things at times, turns things or people away at other times, cries uncontrollably, and/or feels enormous anger.

Your Work Place

Many work places now give maternity leave for those who have experienced a full-term loss. If your work place does not and you need more time, you can ask the hospital social worker, or a counselor you are seeing to intervene and help explain to your HR department the nature and depth of your loss so that you can have more time off from work. Some people prefer to return to work soon so that they don’t have to be at home without their baby. Whatever you decide is the right decision for you.

Coping With Your Feelings

The crying; the anger, the fears, the sleeplessness, the hurt – these are all natural feelings and reactions and are to be expected. It is important to keep in mind some parameters: nutrition, sleep, and safety. It is vital that you make sure you eat, and if nothing else, at least drink and keep yourself hydrated. Sleep is also crucial for your physical and mental well-being. If you need aids to help you sleep that is absolutely fine and you should ask your doctor to suggest an over-the-counter sleep aid, or to give you a prescription for one.

Getting Support

Most people who suffer a pregnancy or infant loss find that they need some kind of support to help them through this difficult and unexpected tragedy. Support may come from family or friends, from professionals or peers. One thing is certain, it is tough to go it alone. It is hard to ask for, and seek help. And in our society there is a stigma attached to getting help. People feel it’s a sign of weakness to seek help and support – but the truth is, it’s a sign of strength to seek the help that you need. Getting support is an indication that you are taking care of yourself and your needs. In order to move on and heal, it is important to take care of yourself. Seeking support should be a priority. Support groups are venues that allow you to be with others who have experienced the same thing. People in support groups need you as much as you need them. For some, individual counseling may be a more comfortable environment. In general it is best to look for support from a source that is non-judgmental and unconditionally supportive. You deserve it!