Coping with Grief After Stillbirth

The death of an unborn baby is classified as stillbirth after the 20th week of pregnancy, or when the child weighs more than 400 grams. The baby may have died before being born, or during labour. According to the Stillbirth Foundation, one in 135 births in Australia will be a stillborn baby.

Stillbirth is legally different from a miscarriage.

Registering the birth

After a stillbirth it is a legal requirement to register your baby’s birth and death. This does not apply in the case of a miscarriage.

You should speak to the doctors and healthcare professionals caring for you about the specific legal requirements in your situation. Generally, in Australia, a birth and death must be registered when the baby has been stillborn, after the 20th week of pregnancy. If the length of pregnancy is not known, it will be recorded as a stillbirth, and therefore need registering, if the baby weighs more than 400 grams.

Making memories

After a stillbirth, usually hospital staff will talk to you about your wishes, including whether you want a post-mortem or other medical tests. During this time you may be able to hold your baby, take photos, a lock of hair, or any other kind of keepsake for remembrance. You may decide to name your baby, or you may choose not to.

The choices you make at this time are very personal and there are no right or wrong answers. Do not be afraid to ask for time alone with your baby.

Planning a funeral

The hospital staff will also talk to you about funeral options. They may be able to arrange a simple funeral service with burial or cremation, or you may wish to organise the service yourself via a funeral director.

Funeral directors are often trained or experienced in meeting the needs of parents bereaved by stillbirth. You will be able to discuss all the arrangements with them. Let the hospital staff know as soon as possible that you would like to arrange the funeral with a funeral director of your choosing.

You do not have to have a full funeral service for your baby, but many couples choose to have one as a way of saying goodbye. Like any funeral, it can help you and those around you begin to understand and cope with the loss.

Grief after stillbirth

By definition, stillbirth happens late in the pregnancy. This means that the baby has to be delivered, usually in hospital. The act of giving birth to a stillborn baby can be extremely upsetting and, as such, the mother will require the best support, compassion and understanding possible. Likewise, partners will often already have a great amount of love for their child and can grieve intensely following the stillbirth.

If you are recovering after a stillbirth, it can be difficult to talk about your emotions. Much the same as miscarriage, the loss of unborn babies is rarely discussed in our society. The result is that the people around you - friends, family, even your partner - may be unsure how to best support and care for you. If you feel pressurised by others to return to work or ‘get over it’, try to remember that your grief is real and necessary, and it is not wrong for you to mourn the loss of your baby. It will take time and people should respect that.

Grief is unique for each person and can involve a mixture of different intense emotions. There is no ‘normal’ way to feel after a stillbirth, although some of the following reactions are reported by many bereaved parents:

• Longing for your child. You may feel as though your miss your child and all the wonderful things you had planned for them.
• Jealousy of other families. You may find it difficult to be around friends or family members with children, especially those with young babies.
• Guilt or shame. Even if your doctor has reassured you that the stillbirth was not your fault, you may feel guilty and ashamed that you couldn’t prevent it.
• Anger at the world, God, doctors or your partner. Anger is a common emotion when grieving, as you try to understand who or what is responsible for the loss of your baby.

If you are struggling with grief, you may wish to seek support and advice from a bereavement counselling organisation.

Physical effects

All types of grief can have a physical impact on the bereaved, such as exhaustion, sleeplessness or loss of appetite. Stillbirth can have a particularly significant impact, however, because the mother has gone through the physical trauma of giving birth.

Women often experience bleeding and after-pains similar to menstrual cramps in the days and weeks following a stillbirth. As with any kind of birth, the woman’s hormone levels will be rapidly changing as her body adjusts from being pregnant to not being pregnant. This can lead to mood swings, making grieving particularly painful.

One of the other side effects is that the mother may start producing milk, which can be physically uncomfortable and emotionally distressing. Doctors may be able to prescribe medication to stop the milk from being produced.

It is extremely important for women recovering from stillbirth to look after themselves physically. This can be difficult when also coping with the emotional challenges of stillbirth, so extra practical support such as cooking and doing household chores can be invaluable from friends and family.

Doctors will usually schedule a follow-up appointment a few weeks after the mother leaves hospital to check any lingering physical symptoms. This can also be a time to discuss the possibility of future pregnancies.

Pregnancy after stillbirth

After a stillbirth, you might decide to try for another pregnancy. Some couples find that they are eager to become pregnant again, others are more hesitant. Some may decide to not try again at all. It is important to discuss your feelings as a couple, and bear in mind that your partner may feel differently from you. You may also find that your feelings change as you adjust to the loss of your baby.

If you do plan for another pregnancy, it is vital to talk to your doctor about any medical problems. They should be able to discuss any complications that may have caused the stillbirth and help you decide if pregnancy is right for you. Be aware that the doctor may advise you to wait a certain number of weeks before having sex again, as the mother will need to physically recover.

Sometimes couples are told that they are unlikely to become pregnant again. For people who have planned and longed for a family, this can be devastating news and lead to increased feelings of grief and depression. It is important to fully discuss your options with both your doctor and your partner, and seek support from a relevant organisation such as Sands.

Moving towards healing

After a stillbirth you may feel as though you will never be okay again. It is true that you will always love your child and a part of you will always be grieving. This does not mean, however, that you cannot find ways to get through each day and discover things that bring you some happiness.

Healing after a stillbirth is a long process and you should not pressure yourself to ‘get over it’ or pretend to be okay. You may find that the following allow you to cope better from day-to-day as you grieve for your loss:

• Find a way to express your emotions. It is vital that you recognise what you are feeling and find a way to express it. You may not feel ready to confront your feelings for a while, but eventually you might try writing a diary, talking to a friend or your partner, or joining a support group.
• Find a keepsake for your child. It may be helpful to find ways of remembering your child in your daily life and honouring the love you feel for them. Don’t feel pressured to throw out all their toys and possessions. You may want to keep a blanket or cuddly toy as a way of acknowledging their importance to you.
• Communicate with your partner. Losing a child does not mean your relationship is over. Though the grief may make things difficult, your bond may actually strengthen as you learn to support and comfort one another. Consider couple’s therapy if you are struggling to understand each other’s needs.
• Look after your health. Stillbirth can have significant physical effects and grief can also affect your health. You may experience a loss of appetite or sleeplessness, but try to eat well and regularly, and see a doctor if these symptoms continue.

If you are coping with stillbirth, contact a bereavement support organisation for further advice and information.