Helping families through the grief and loss of stillbirth
Friday 25 October 2019
Losing a baby to stillbirth can be a profoundly heartbreaking experience. Every parent hopes their child will arrive safely into the world, nurturing dreams for their little one that stretch far beyond their due date. Every day in Australia, six families face the reality of their child arriving stillborn, and a lifetime of memories are instead created in just a few precious moments.
Family, friends and healthcare providers can all support parents as they grieve the death of a child. Midwives are one of the key healthcare providers who can offer support to mums and dads and help them to make memories that can be cherished a lifetime.
We spoke with Susan, Midwifery Unit Manager, and Louise, Clinical Bereavement Midwife, from the Centre for Advanced Prenatal Care at Royal Brisbane and Women’s Hospital about what stillbirth is and why it can happen, support services available to parents who experience stillbirth, and what you can do to support someone you know who has experienced stillbirth.
Stillbirth rates and causes
Stillbirth, the birth of a baby without signs of life after 20 weeks’ gestation, affects around 2,200 Australian families every year.
The causes and risk factors associated with stillbirth include:
- Haemorrhage (blood loss)
- Congenital anomalies (the baby’s body or functional systems have not developed normally)
- Maternal health conditions such as diabetes, high blood pressure, and kidney disease.
But in around 25 per cent of cases, the cause of death remains unexplained.
As part of their work, midwives and other birth professionals care for families experiencing stillbirth. For midwives like Susan and Louise, providing care during this incredibly difficult time is a part of their role that they deeply value.
“Helping people at one of the darkest times of their life is really rewarding,” said Susan. “Enabling them to parent, because a lot of them don’t feel like parents, but just to reinforce that they are. They’ve had a baby and it is their child and will be forever.”
Making memories with baby
One of the ways that Susan and Louise support parents following the death of their baby is by helping them make memories with their baby. This can help mums and dads in the initial stages of loss and throughout the grieving process.
“If we can make a difference in a family's life in such a vulnerable situation, I think that is paramount,” said Louise. “We can give them memories to take home – something to cherish.”
With the help of generous donations from organisations like Precious Wings, Harrisons Little Wings, Bears of Hope, Angel Gowns and Treasured Babies, midwives help parents to capture special memories with their child.
“We receive beautiful memory boxes that are made and donated by parents who have been in a similar situation,” said Louise. “It’s a foundation box with little seedlings to grow in the garden, photo frames, candles to light for remembrance, and then we build on that with their memories.”
Teddy bears and baby clothes can hold special memories for the child’s parents and siblings.
“You might give one teddy bear to the baby and the parents have one, or a sibling. And then when it comes time to say the final goodbye you might swap them, so that the baby gets the one that smells of the parents and the parents get the one that smells of the baby,” said Susan. “It’s the same with clothing – we might say, ‘If you want, we can swap baby out of those clothes and you can keep those to put in your box or take home.”
Susan and Louise help parents to know what is available in their situation, and then the parents choose what is right for them. Mementos can include a memory book, locks of hair, arm bands, cot cards, the tape that was used to measure the baby, and prints or casts of hands and feet. Midwives can also connect parents with photographers who can capture precious family time.
“It’s about making sure that the parents know everything, they know all their options for memory creation, they know what's available depending on the size of the baby, the gestation, what they might look like,” said Louise. “Just being very open and making sure that they've got knowledge so that they make the decisions that they want to make.”
Midwives often assist mums and dads to hold, bath, cuddle and dress their baby, giving them a positive experience of parenting.
“Some families spend a lot of time with the baby, and some families don't. Being totally guided by what they want to do is a really good rule of thumb,” said Susan.
“One of my biggest wishes is to give people the option of taking the baby home. It’s possible, it’s allowed, and it’s reasonably straightforward to organise,” said Susan. This gives families an opportunity to create memories and say their final goodbyes in the home.
When a child is lost to stillbirth, the initial stages can often feel like a blur. The support of a midwife can help parents to capture special moments and recognise the everlasting impact that their beautiful baby has had on their lives.
Services for parents coping with stillbirth
If you have experienced stillbirth, it’s important to know that grief is a normal, natural response to loss. It can feel overwhelming, but know that grief changes with time; it won’t always be this way. Allow time to grieve and heal. Seek support wherever you need it, including from your healthcare team.
“Sometimes parents heal in different ways and community supports can be very beneficial. Some parents might think ‘I’ve got lots of family around me, I should go to them’, but someone external can often offer the best kind of support,” said Louise.
Your healthcare team is there to support you through the grieving process. They can also help you connect with support services like Red Nose Grief and Loss (1300 308 307) and Sands (1300 072 637). These organisations provide 24-hour phone support and resources for those coping with pregnancy and infant loss.
More information is available on memory making, health considerations and medical support for parents who have experienced stillbirth.
Supporting bereaved families
It can be difficult to know how to help or what to say to loved ones when they are grieving the loss of their baby. Listening is often the best support you can give.
“If the parents want to talk about the baby, don't try and change the subject,” said Susan. “If you want to say something about the baby, say it, because they like hearing the baby’s name; they don't get to use the baby’s name very often over time.
When they want to talk about the baby don't shy away from the subject; engage with them.”
Sadly, there is still stigma around stillbirth, which can greatly impact parents and intensify their sense of loss and isolation. You can help break down the stigma of stillbirth by letting grieving parents know that you are there for them. Focus on being genuine and caring and less on having the perfect words to say. Refer to resources like SANDS’ Words Matter fact sheet for tips on talking with families who have lost a baby.
You may also be able to support grieving parents in practical ways like doing groceries, caring for the family pet, and dropping off meals.
“Parents often go into a state where even eating and self-care can sort of go out the window, because they're in this blur. Having family to be able to drop meals off, phone each day, check in, come for a walk… sometimes getting out of the house and just having fresh air can really help clear the head,” said Louise. “It’s about the practical aspects as well as the emotional support.”
A parent's grief may not always be visible, but that doesn’t mean it’s not there. As time goes on, continue to offer support, and honour significant days like birthdays and awareness days like Pregnancy and Infant Loss Day (15 October).
“Over the weeks other people move on, but the parents don't necessarily move on that quickly. Sometimes they do move on or give the appearance that they've moved on. But keep offering that help,” said Susan.
Support groups are available for bereaved mums, dads, grandparents, siblings, and extended family members. Speak with your GP or a health professional to find out more.
Reducing the risk of stillbirth
It’s important to know that not all stillbirths are preventable. Parents can do everything in their power to bring their baby safely into the world, yet sometimes it doesn’t go according to plan.
However, there are certain things that mums can do to monitor their growing baby and give them the best possible chance of safe arrival. Getting to know the pattern of your baby’s movements is vital.
“Movements is something we talk to women about a lot,” said Louise. “Changing movements is a definite sign that they need to come in to a hospital. Most babies’ movements will change before they pass.
Coming and engaging in antenatal care means that you're able to have discussions and get more help from health providers with movements.”
Susan encourages mums to act immediately if they notice their baby’s movements have decreased, stopped, or if they are worried for any other reason.
“If you're at all concerned about the baby’s movements, phone the hospital. We'd rather you phoned every day for 12 weeks than be sitting worrying at home thinking, ‘Should I phone or should I not phone?’ If you're worried about the movements, phone,” said Susan.
From 28 weeks of pregnancy, mums are encouraged to go to sleep on their side.
“Your heaviest sleep is in that initial phase, so go to sleep on your side, and if you wake up on your back, roll over,” said Louise.
It’s normal to change position as you sleep, and if you wake up on your back, it’s ok – just roll onto your side again. The most important thing is it start every nap or sleep lying on your side.
With the support of their healthcare team and loved ones, mums are also encouraged to stop smoking during pregnancy, regularly attend check-ups to measure baby’s growth and to talk about the time of birth.
These five recommendations are a part of the Safer Baby Bundle, which is an evidence-based approach to reducing the rate of preventable stillbirth in Australia.
For more information and support regarding stillbirth, visit:
Thank you to Susan, Louise, and Metro North Hospital and Health Service for providing an insight into your work.