When The Worst Happens: A Guide To Pregnancy And Infant Loss

In recognition of Pregnancy and Infant Loss Awareness Month, psychologist Dr. Hannah Cassedy offers guidance for grieving families.

infant-loss

The sad fact is that 10-25% of all clinically recognized pregnancies end in miscarriage, usually within the first trimester. Stillbirth, which is fetal death at 20 weeks or later, occurs in one out of every 100 pregnancies. And almost six out of every 1,000 live births end in infant death before the first birthday, leaving families with what is often unprecedented grief.

During pregnancy, some parents learn of severe complications that will result in pregnancy loss or infant death. Depending on the circumstances, some may choose to terminate pregnancies that are not compatible with life. Others may choose to carry the pregnancy to delivery while preparing for a stillbirth or infant loss. These are terribly difficult choices for families to make, and there’s no rulebook on how to navigate them. However, resources and support are available; families in these situations don’t have to go through it alone. Below are some general guidelines for families facing the loss of a late pregnancy or an infant.

Attachment:

If you’re anticipating that your pregnancy will end in stillbirth or infant loss, you might have conflicted feelings about whether or not you want to form an emotional attachment to your baby. Many parents in this situation fear that if they become attached, their grief will be unbearable after the loss. They don’t want to grieve someone that they loved, so they try not to love at all. This is understandable. However, to put my scientist hat on for a second, research shows that parents who lose children actually have a harder time with grief if they did not attach to their child. In my clinical experience, I see the same thing.

No one wants to grieve the loss of a child. But you can make it slightly easier on yourself by loving that baby with all your might; by cherishing your time together either in the womb or in your arms; by commemorating that child’s presence in your life and in your family’s; and by honoring the memory of him or her with photographs, mementos, and memorials. These things of course will not bring your baby back, but they will help you remember him or her with love and compassion.

In the Hospital:

If you give birth to a baby who has died late in pregnancy or soon after delivery, you will likely have the opportunity to hold and spend time with them for many hours in the hospital. The hospital staff might offer you resources, such as pastoral care, complementary photographers if you’d like to have professional photos of your child, and funeral home services that are equipped to handle the unique circumstances of your loss. Feel free to pick and choose which resources to use. Although it’s an intensely personal decision, professional photographs can be an invaluable way to cherish your baby, so this is one that I’d encourage you to consider if it’s at all of interest. It can also be meaningful to hold your baby, sing lullabies, dress him or her in a special outfit, and spend time together as a small family. Some may consider these choices morbid, but they can help you build cherished memories of your child and aid in the grieving process.

In addition to the resources that your hospital might offer, there are also many national and local nonprofits that can offer free support, such as volunteer photographers, online and in-person support groups, and memorial events.

Mementos:

Although grief looks different for everyone, mementos – physical objects that commemorate your baby – can be hugely powerful in helping the grieving process. There are many different ways to create mementos, but some ideas are:

  • Memory boxes with objects from the pregnancy and hospital, such as sonograms, appointment cards, hospital bracelets, and footprints or handprints
  • Photo albums with pictures of your pregnancy, delivery, and baby
  • Living memorials such as a planted flowerbed or tree in your baby’s memory, with or without his or her ashes integrated into the soil
  • A small area of your house with candles, pictures, and objects that remind you of your baby, such as a stuffed animal or dried flowers that you received after the delivery

There are also professional services available that can create mementos out of objects you provide, such as jewelry made from flowers you received, or a teddy bear or quilt out of your baby’s clothing. Whatever form your mementos take, this is an opportunity to create something unique to your baby and meaningful to you. The goal here is to give you something tangible to hold onto – something to help you carry your baby’s memory with you.

Lactation:

Some mothers are surprised to learn that their breastmilk might come in after delivery, even if the baby does not survive. Some find this to be an upsetting reminder of the loss, whereas others cherish the milk as a reminder of their child. Neither response is right or wrong; what’s important here is to honor your own experience. You might consider consulting with a lactation specialist for advice about how to keep your milk ducts from clogging as your body learns to decrease milk production. If you’re interested in pumping and donating your breastmilk to a baby in need, you could consider a service such as Human Milk Banking Association of North America. Again, there is no right response here. Do what works for you.

Informing Others:

Some families struggle with how to tell their friends and neighbors about their loss. If you don’t want to have that conversation yourself, you don’t have to. You could designate a trusted friend or relative to inform people in your community on your behalf. You could also consider mailing a printed birth and death announcement, if that would be fitting for you. Simply sharing your baby’s name, birth date, and death date with others can feel cathartic for some, and it can help reduce the isolation you might be feeling. But there is no right way to go about this. Share as much or as little as feels appropriate to you.

Anniversaries:

Although everyone’s experience is different, it is worth anticipating that the anniversaries of your baby’s birth and death might be difficult days, weeks, or months for you. Although they’re not pleasant feelings, sadness, grief, and sorrow are testaments to the love you have for your baby. Those feelings are normal and natural, so don’t be afraid to feel them.

Also remember that you don’t need to feel them alone. Anniversaries are good times to reach out to your support system for help. Cherish your mementos, photos, and memories. Consider participating in a memorial service or walk for families who have experienced similar losses. Call upon your community, or use this opportunity to create a community in your baby’s honor.

When the holidays roll around, it might feel good to incorporate your baby into your family traditions in some way. Does he or she have a special Christmas tree ornament? Can you say a prayer in your baby’s memory during the High Holidays? Or what about simply looking for a bright star, like your baby, on New Year’s Eve? Even if your child’s life was short, he or she can still hold a place in your heart and in your family.

 

Dr. Hannah Cassedy is a Dallas-based clinical psychologist who works with perinatal mental health, including the effects of pregnancy and infant loss on parents.