Helping When The Least Expected Happens |
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Helping When The Least Expected Happens |
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John and Lisa were thrilled about this pregnancy.
It was their first and had been problem-free. In the
eighth month, everything was almost ready. Lisa’s
bag was packed, names were chosen, the baby’s room
was painted, and John was nearly done refinishing the
cradle his mother had used to rock him as a baby. A few
days before their next prenatal visit, Lisa noticed that
the baby had not moved for some time. She thought that
the baby must be resting. The next day Lisa still did not
feel the baby move. John and Lisa tried to tell
themselves that everything was probably alright, but they
sensed that something was wrong. They went to the
doctor’s office. The doctor could not find the
baby’s heartbeat and ultrasound confirmed what they
had feared. Their baby was dead. John and Lisa were expecting a healthy, perfect baby. Suddenly expectations, hopes, and dreams had been cruely shattered. Their precious baby was stillborn. The cradle is empty. What happened? Why them? How can you help? |
What Is Stillbirth? |
Stillbirth and miscarriage both define a
pregnancy loss. Stillbirth is the death of a baby after
the 20th week of pregnancy but prior to delivery. Most
often it is detected while the baby is in the
mother’s uterus, sometimes not until labor is
underway. Miscarriage (sometimes called
spontaneous abortion) is a loss that occurs before
the 20th week of pregnancy. There is a great sense of disappointment and loss whenever parents suffer the death of their baby, whether it be an early pregnancy loss, a late pregnancy loss, or a loss occurring sometime after birth. Stillbirth and miscarriage are separately defined, not because one is an easier or more difficult loss with which to deal, but because they differ in many ways. Stillbirth and miscarriage have different causes, need different evaluations, and differ medically and in the ways that parents and families can best be helped. |
Why Should You Know About Stillbirth? |
Stillbirth is common. It may affect anyone. There is
no way to predict when stillbirth will happen or who will
experience it. Stillbirth occurs in families of all
races, religions, and income levels. Each year in the
United States about 25,000 babies, or 68 babies every
day, are born still. This is about 1 stillbirth in every
115 births. Something as common as this will, at some
point, directly or indirectly touch the lives of many
people. A friend, a relative, or you, yourself, may
experience stillbirth. |
Why Do Stillbirths Happen? |
One of the most common questions following a
stillbirth is, "Why did my baby die?" Answering
this question is not always easy or possible. Extensive
and careful examination of the baby and placenta is
needed following delivery. This includes an internal
autopsy and several other studies. Often these
evaluations will provide helpful information and
eventually bring peace of mind. With extensive
evaluation, a cause for stillbirth can be identified in
40%-50% of all stillbirths. Even when a cause is not
specifically identified, at least potential high risks
for recurrence may be ruled out. Parents who experience
stillbirth will be asked to consider extensive
evaluations for their baby. Many will want everything
done to try to discover why their baby died. Others may
think that such assessment violates their baby. The
decision should be theirs. They will need to choose what
is best for them. |
Types Of Causes Of Stillbirth |
Information about cause can be very important for
parents and families. It may help parents in planning
future pregnancies by providing insight to the frequently
asked question, "Will stillbirth happen again?"
The information may also help parents and families to
deal emotionally with their loss. Knowledge, in general,
can be empowering, and it may provide a sense of comfort
by helping to alleviate uncertainty or guilt. Identifiable causes of stillbirth generally fall into one of three different categories: birth defects in the baby, problems with the placenta or umbilical cord, or maternal illnesses or conditions which may sometimes affect pregnancy. • Birth defects are common but often overlooked causes for stillbirth. About one-fourth of babies who are stillborn have one or more birth defects that are responsible for their death. • The placenta and umbilical cord are the baby’s "lifeline" for oxygen and nutrients. Problems in either one may completely cut off or severely interfere with the needed flow of blood, oxygen, and nutrients to the baby. Although commonly pointed to as the likely cause for the death of a baby, problems with the placenta or umbilical cord actually account for only a moderate number of stillbirths. • Although uncommon, maternal conditions may be responsible for stillbirth. Certain illnesses in the mother, such as diabetes or hypertension, and their treatments, sometimes cause stillbirths. An increased risk for stillbirth is also associated with the use of certain recreational drugs, particularly cocaine. In addition, there are many other rare causes of stillbirth. Stillbirths are usually not caused by something parents or family members did or did not do. |
If Stillbirth Happens Once Will It Happen Again? |
Extensive evaluation of the baby and placenta may
help determine the chance that stillbirth could happen
again. On average, there is approximately a 3% chance for
stillbirth to recur in a next pregnancy—or
approximately a 97% chance that a future pregnancy would not
end in stillbirth. Finding a specific cause may imply a
much higher or lower risk than this average one. In
almost all circumstances, healthy pregnancies are
possible. |
Some Common Responses To Stillbirth |
In the natural course of life events, babies are
least of all expected to die. The loss of a baby through
stillbirth can be overwhelming and devastating for
parents as well as for family members and friends.
Although such feelings are surprising to some, the
stillbirth of a baby is a great loss, as great as that of
an older child or any loved one. When stillbirth occurs, parents who were anxiously awaiting a baby suddenly are not. It is natural for them to grieve deeply for the baby who has died and for the hopes, dreams, and wishes that will never be; hopes, dreams, and wishes that, for parents, are real long before the birth of their baby. They may feel a strong sense of sadness, or anger, or bitterness at the unfairness of this tragedy. There is usually nothing anyone did to cause, or could have done to prevent, a stillbirth. Yet, parents especially may feel guilt and blame themselves for the death of their baby. Parents may also experience feelings of loneliness and longing, helplessness, or, because of the intensity of their emotions, confusion. These emotions are real and a normal part of grieving. Grieving is a process of making meaning out of the loss and of life without their baby. Grieving is not easy. It is long, unpredictable, and requires a lot of energy. Parents and family members need time to grieve since grieving is necessary to work through pain toward healing. |
What Can You Do To Help? |
Naturally, there is an urge to ease parents’
sorrow. Realistically, there is nothing anyone can say or
do to take away their pain. You can provide love,
hope, understanding, and the same support you would offer
to anyone who has experienced the death of a loved one. • Ignoring the subject does not make it go away nor does it make parents feel less pain. Acknowledge the stillborn baby. Most parents and family members need to talk about the death and about their baby. Use the baby’s name or refer to "the baby" and let parents know that you are willing and interested in hearing about their experience if they wish to share it with you. • Acknowledge and validate the grief parents and family members may feel following stillbirth. Help them by allowing and encouraging them to express their feelings and concerns. • Don’t be silent just because finding the "right" words to say is sometimes difficult. A simple "I’ve been thinking about you," "I’m sorry", or "I’m here if you would like to talk" can be comforting and reassuring. • Sometimes presence is more powerful than words. Be there to provide a shoulder to lean on or a hand to hold. Be there to listen. • Let parents make their own decisions. Encourage them to do what is best for them and support them in whatever they choose. Your patience, love, and understanding are important immediately following the stillbirth and are also needed as time passes. Grieving takes time. Parents and family members will not be "done thinking about the baby" after a month or even a year. Their baby will never be forgotten. Continual love and support will help parents to work through their tragedy and cope with this painful experience. You can make a difference. |
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This educational pamphlet was written by Patricia L. Leh, M.S., Catherine A. Reiser, M.S., and Richard M. Pauli, M.D., Ph.D. as part of the continuing education activities of the Wisconsin Stillbirth Service Program. WiSSP is dedicated to serving families who experience the tragedy of stillbirth and the professionals who care for them–in Wisconsin and throughout the world. Wisconsin Stillbirth Service Program Production of this pamphlet was made possible by funding from the Perinatal Foundation. Portions of WiSSP activities have been supported by Maternal and Child Health Funds from the State of Wisconsin. Order form for a printed version of this pamphlet. |
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