What seems like an unbelievable occurrence is that your baby dies after he or she is born.

Sometimes you may be prepared for a problem if your delivery was very premature or if your baby was born with certain conditions.

A full-term gestation is 40 weeks. Babies born at 23 weeks gestation and above can now survive delivery and can often survive after extended stays in the NICU (neonatal intensive care unit). Medical technology is now so advanced that doctors help babies live at 23-25 weeks gestation. It is important to know that babies delivered this early will initially most likely have a multitude of issues. You should speak to your physician and do your own research to learn more, but a few common problems at this early gestational age are: lung development, eye development and brain development. Babies born prematurely are prone to bleeds in the brain especially up to about 32 weeks gestation. There is so much that can be done nowadays to offset future problems but it is not fail-safe and the earlier the gestational age, the higher chance of future issues including the question of survival during the first few weeks of life.

It seems unfathomable to think that your baby may die after birth but this does occur.

Causes of death of new-born babies can be attributed to issues that have arisen with the pregnant mother’s conditions. Placenta abruption is a condition in which the placenta detaches itself from the fetus. There are other situations that may occur with the placenta that can jeopardize the baby’s health and survival.

High blood pressure in the pregnancy mother can lead to what’s called the HELLP syndrome and can cause an early delivery. This condition may cause the pregnant woman to be very sick and it is absolutely imperative that the baby be delivered to save her life. Some babies survive this delivery, but not all do. Listeria and other bacteria may be other causes of premature births and these situations often lead to newborn infant death.

There are myriad conditions some genetically-linked, others that are unpredictable natural occurrences that may result in severe illness in your newborn and ultimate death. Heart conditions that may be revealed through high-level sonograms may prepare you and your family for the possibility of post-delivery complications. For some of these conditions procedures and surgeries that can be performed. Your baby may undergo surgery and not survive. A newborn swallowing meconium at the time of delivery is another factor that can be attributed to the death of a baby.

These are unthinkable situations but if you are reading this section, then it is likely that something to this effect has occurred to you or to someone whom you know.

NOTHING COMPENSATES FOR THE DEATH OF YOUR BABY

The one thing that women/couples report who have delivered a live baby is that you may get a more compassionate response from friends and family than those whose baby was not born alive. It feels to others that this is a more tangible loss since you held a live baby in your arms. As awful as it is to lose a newborn infant for some this makes the loss easier to manage since you had a some time with your baby. Of course it may not feel like bonding, but the truth is you had the experience of a live birth.

You may have the opportunity to prepare for your baby’s death. Knowing that s/he will die soon will give you time to think about who you would like to be present with you, if you want to hold your baby when s/he is dying and some other angles. You will undoubtedly have many questions for your baby’s physician about your baby’s condition, level of pain, dying process. There may not be exact answers for any of this. But one thing that I’ve heard over and over again, and personally witnessed, is that babies who are dying usually die peacefully without gasping for breath and writhing in pain. It can bring many women/couples comfort holding their babies while they die knowing that they are doing everything that is in their control for their baby and this final act of love is in their hands.

Hopefully you have had opportunities to take pictures with your baby when s/he was alive. In some cases this may not be true if his/her life was spent in an enclosed NICU incubator and you were not even able to hold your baby. Most hospitals will allow you to take pictures holding your baby after s/he has died if you wish. It is almost automatic now that hospitals take photos for you to take home. You will likely have footprints, can arrange for hand prints or even a hand plaster impression, locket of hair, clothing. All of these you can take home as part of your memory box.

The emotional pain is unimaginable.

What to Do

There are a multitude of tasks that you, your partner, or your family members are now faced with completing.

Autopsy

An autopsy is always offered. There are different levels of pathological investigation that can be done: from just an outside examination to a full-fledged autopsy. This again depends on your wishes. It is important to be aware that the results of this testing can take up to 10 weeks post delivery depending on the depth of the testing. You can usually get initial results within the first 2-3 weeks. It is very important that you find out from whom to get the results. Usually it’s from the neonatalogist but if you deliver at a hospital where your physician does not practice, or your baby was transferred to a different hospital you may need to request your results from the physician who took care of the baby.

Burial/Cremation Options

Making arrangements for burial is the most daunting task that must be handled.

1. Should you decide to bury your baby you will need to make your arrangements through a funeral home. There are many cemeteries that have sections set aside for babies. These sections have uniform markers that you can personalize with your baby’s name and birth/death date. You may also choose not to have a marker and still bury in the baby section.
2. Another burial option is to purchase a private plot where you can then put your own marker or stone. Funeral directors will be your most helpful resource for this information. Expenses for a burial can be kept to a minimum if you choose to do what’s called a direct burial – this means that the funeral home will pick up the baby’s body from the hospital and transfer it directly to the cemetery where you can have a grave-side service. In general funeral homes will usually greatly reduce their costs when it comes to burying babies.
3. It will not be unusual to have many people attend the funeral. Once people hear what has happened, they feel that attending the service/burial is a concrete way for them to show support. On the other hand, you may to decide that you want to keep this a private event for close family and friends.
4. Some families choose to have a wake. Since the baby was alive this is a decision that you may be faced with depending on your religious practices. Jewish families wonder if they sit shiva. According to Orthodox Jewish law shiva is sat when a baby is alive for 30 days or more. Some families consult their rabbi and decide to do a type of shiva that can be called something else. It is an important time to get as much support as you can and need.
5. If you have chosen to cremate, you can have the ashes in an urn, or you can decide to disperse the ashes in a favorite location. Some may choose to bury the ashes in your personal garden.

Memorial Options

1. You may choose to remember your baby in different ways: If you have buried your baby you can have a small stone placed at the grave or other memorial piece.
2. You may decide to do a memorial service for your baby. You can find appropriate poetry, musical selections, prayer material, etc. at your local library or on the Internet. If you do this at the funeral home there may be an additional fee involved.  Some families decide to have a service at a funeral home first before going to the cemetery. For cremation you can decide to have a small service at the crematory prior to the cremation.
3. Some people decide to plant a tree in their baby’s memory. This can be done at your home, in your yard, or at a special location that is meaningful to you and your family. Along a similar line, you may want to plant a garden in your baby’s memory.
4. Other memorial ideas include having a ceremony where you send a balloon (or bouquet of balloons – please make sure they are environmentally friendly!) up in your baby’s memory. You may want to include a letter to your baby, cremation ashes, or drawings from the baby’s siblings inside the balloon.

Physical Needs

As at other times of loss this is a time to allow people to take care of your needs, your food, your laundry, your contact with the outside world. Some people send out an announcement about the loss in order to inform all those you would have told about a live birth.

As discussed in the section on second and third trimester losses, the woman will be lactating as the body prepares for nursing the newborn. This is an extraordinarily painful physical reminder of what you are going through. Cold compresses and raw cabbage leaves will help alleviate the pain and reduce the flow of breast milk.

If you had a C-section it will take time to heal and to feel strong enough to get around on your own, to drive again, etc. There are myriad other physical reminders of the fact that you delivered a baby. It is all indescribably painful.

Emotional Needs

There is no comprehensive way to explain what your emotional needs will be during this time. It is not fair to list them or try to describe the enormity of your loss. There is no justice that can be done to put in words what you are feeling emotionally.

Facing the World

When you have delivered a baby who subsequently dies, you are related to differently in the “real” world. Undoubtedly you will be granted your full maternity leave – and if not, speak to your doctor who will be willing to contact your workplace and intervene on your behalf should you want more time. Not everyone finds it helpful to stay home for an extended period. What you choose to do is what’s right for you. And you may choose one thing and realize you need to do something else and it’s okay to change your mind. It is recommended that you make a plan to return part-time in the beginning with the understanding that you may need more time and you want to see how it feels to be back before committing to returning full time at work. Some women may have been on a leave prior to the delivery and/or have resigned from their jobs in anticipation of staying home with the baby. This can pose a challenge if you have no place of work to go back to. Some find it a welcome distraction to be out of the house.

Some women choose to go to a different supermarket, to switch their dry cleaner or their hair or nail salon in order to not have to face the barrage of questions at the outset. This is all okay!

Being Around Friends and Family Members with Babies and Children

This can be a painful reminder and a situation that you may want to avoid. Usually people find this to be the case, though there are others who find comfort in being with close friends with babies as it is confirming that “life goes on.” Only you will know what’s best for you. This may be the “new you,” and you may not recognize yourself and making your needs clearly known. You may have been the “caregiver” in the family, sensitive to everyone’s needs and not used to stating your own. This is the time to assert what is best for you without regard for how it makes others feel. YOU ARE OF PRIMARY IMPORTANCE!

How to Adjust

The sadness that you feel is very real and very deep. It is clear that this is a trans-formative experience in you and your partner’s life and the impact may be far- reaching. Acknowledging the impact, finding a voice to your sadness and being receptive to support are all paths to healing.

The Healing Journey

There is no predictable course of grief and the bereavement journey is not a straight line. It is a very personal experience. You probably feel that there is no one who can possibly understand what you are feeling and experiencing. In many ways this is true. Every single loss has its own identity and no one shares your same story and experience. But there are people who have had similar experiences who, like you, feel isolated from their world. Connecting to others who have had similar experiences can be comforting and help you with your personal healing. A support group is a place for you to find mutual support – by sharing your story and hearing others is a very healing experience. It is rare to find support group participants who do not find it to be the “right place” for them. Some people may have experienced other losses in their lives and may find that their reaction to an infant loss will be similar. They may be surprised at how much they are affected by this loss. It is a highly unusual and unexpected life event. Even if you’ve had loss in your life, losing a baby is different and you may find yourself surprised at how you are reacting. Individual counseling may be another place to find both support and a chance to talk about other losses and reactions in your life. Again, seeking help should be seen as a sign of strength.