As the trees and flowers begin to bud and the green grass pops up everywhere, some of you may struggle with this season of a resurgence as it can feel as if life is moving on. Your grieving heart may still feel blanketed with the dark days of winter. Spring is often called the season of hope, and some of you may be unable to find any hopeful moments. You may not feel any excitement in the change of season. Others of you are possibly thankful the winter months are ending, and the change of seasons can feel like a new beginning. Perhaps you feel a glimmer of hope and have a newfound energy.
This time of year, it can be helpful to begin planning a vacation for the summer. As the days become warmer and longer, taking a day trip in a relaxing environment close to home can be rejuvenating and refreshing to the soul. You may find it peaceful and healing to your spirit to begin planning a special garden in memory of your baby. Even something as simple as a short daily walk around your neighbourhood is a nice way to take a break from the daily routine. However you are feeling, and whatever you decide to do in the coming warmer months, take time to do what you need to do to nourish your body and spirit. Be present to where you need to be, and feel what you need to feel. And know that you are not alone.
Share provides free information and grief support to those who have experienced an early pregnancy loss, stillbirth or infant death. Below you will find clear explanations of each type of loss as well as some answers to common questions about the grief process. Information packets are available upon request.
What is an Early Pregnancy Loss?
Medically, an early pregnancy loss is defined as any loss before 20 weeks gestation, with most of these losses occurring before the thirteenth week. The death of a baby before the thirteenth week is called a first-trimester loss and most commonly occurs because of a problem with the development of the baby or placenta. Many people consider losses early in the second-trimester stillbirths since often labour needs to be induced so the baby can be delivered.
Types of Early Pregnancy Loss:
A threatened miscarriage means you have symptoms of a miscarriage, such as bleeding and/or cramping, but no miscarriage has occurred, and your cervix is closed. This does not mean you will definitely lose the baby, as half of all women who have these symptoms go on to deliver full-term babies.
An inevitable miscarriage means you have symptoms such as bleeding and cramping, but you may also pass some tissue. An examination shows that your cervix is open, and this indicates that you will probably miscarry.
An incomplete miscarriage may occur if you experience severe cramping and bleeding. This suggests that there could be small parts of the placenta and/or baby still in your uterus. You may require hospitalization and a D & C (dilation and curettage) if this happens. During a D & C, the doctor will dilate your cervix and remove the tissue, baby, and blood lining your uterus. This procedure will either be done in a hospital under general anaesthesia or in your doctor’s office with local anaesthesia.
A missed miscarriage is the discovery through ultrasound that your baby has died, but you have no symptoms of a miscarriage. You may eventually miscarry on your own, require a D & C, or be given a prescription that will cause you to miscarry. You may also be sent home to wait for a natural miscarriage with no intervention.
A blighted ovum is a common cause of early pregnancy loss. This means a placenta developed and produced the pregnancy hormones, but due to an abnormality with the fertilized egg, the fetus did not develop or failed earlier than the first six weeks. On ultrasound, there is only evidence of a gestational sac. Your body may have reabsorbed the baby early in pregnancy. If a natural miscarriage does not happen, you may need a D & C or other medical treatment.
An ectopic or tubal pregnancy occurs when, instead of attaching to your uterus, the fertilized egg attaches itself to a fallopian tube or some other place inside your abdomen. Usually, the first sign of an ectopic pregnancy is severe pain in the abdomen, with or without bleeding. If you have an ectopic or tubal pregnancy, your doctor may give you a drug called Methotrexate to dissolve the pregnancy. However, you may require surgery.
A chemical pregnancy is another special type of early pregnancy loss. Sometimes, because of infertility issues, a woman is closely monitored from the time of ovulation. HCG levels may rise, indicating conception has occurred, and then drop off, meaning the pregnancy was not viable. This may all happen before a menstrual period is even missed.
What is a stillbirth?
A stillbirth is the delivery of a baby who has died and is greater than 20 weeks gestation. In about half of all stillbirths, a cause for the baby’s death can be discovered after evaluating the baby. It is possible for the baby to have birth defects or problems with the placenta or umbilical cord. Another cause can be found in maternal circumstances such as an illness or recreational drug use. Unfortunately, for many stillbirths, the cause for the baby’s death can remain undetermined. Stillbirth cannot be predicted, nor can we predict whom it will affect.
What is a neonatal loss?
A neonatal loss is the death of a baby who was born alive and died shortly after birth. The baby may have lived for a few days, a few hours or only minutes. The baby may have died for a variety of reasons, including prematurity, infection, defects of major organs or chromosomal abnormalities. The baby’s life-threatening condition may or may not have been detectable before birth. The grief process may be impacted by the gestation of the pregnancy, and when problems were detected.
Whether you are parents who learned before or after birth, that your baby may die, the initial feelings you experience are very similar. You now have to go from the highs of awaiting a precious baby, to the lows of deep grief. Your emotions and feelings may be constantly changing with the circumstances of your loss.
Questions about Grief
For many families, the instant you knew you were pregnant, your life changed forever. Whether you were feeling joy or apprehension, this new baby was an important part of your future. The feelings you have after the death of a baby can be overwhelming and intense, as the death of a baby at any stage is a very real loss. You will not only begin a journey of recovering physically but also emotionally and spiritually.
The following are frequently asked questions of bereaved parents, family, and friends. They have been provided as a source of some of the questions you may have, and also to realize the normalcy of all the emotions and fears you may experience during your grief journey.
I feel like I am sad all the time. Is this normal?
Experiencing the death of a baby can be shocking, and the many emotions you have may be overwhelming. The intense feelings of your grief will not last forever; there will come a time when the heartache is less painful. It is important for you to know that what you are feeling is normal for you. Give yourself permission to grieve. Intense feelings associated with grief can last up to 2 years, but not all that time is spent in deep grief. Incorporating your loss into daily life takes patience and time.
Is it normal to feel like I am going crazy?
Grief can be tiring and overwhelming… There are so many emotions associated with grief. It is very unlikely that you will experience grief in stages or as steps. You might experience a range of emotions at different times, or re-experience an emotion you have already felt. There is no right or wrong way to move through your feelings.
You may feel…
- Overwhelming Shock
- Low Self-Esteem
- Loss of Control
- Guilt and/or Self-Blame
- Sadness and/or Depression
- Physically symptoms related to Hormonal Changes
Finding ways to express your grief and finding support can help you feel less “crazy.” When a baby dies, so many expectations and hopes were shattered, and now you are finding ways to put the pieces of life back together when some of them don’t fit anymore. For some bereaved parents, attending support meetings and connecting with other bereaved parents helps lessen the feelings of loneliness or “craziness.”
Is it normal to feel so tired? How can I feel better?
Your health and wellness are important to positive grieving. Your doctor will give you specific directions for your physical aftercare. Taking care of your physical health is just as important as taking care of your emotional and spiritual health. You may experience mood swings, fatigue, insomnia, inability to concentrate or irritability. Your energy levels may not be consistent, as well as your appetite. Eating a balanced diet, drinking plenty of water, and maintaining a regular rest routine is important. There are many support resources out there to help you find some comfort. Sometimes a good friend with great listening skills will help, as well as support groups, or online organizations. You may also feel a need for spiritual bonds during this time. Contact clergy or simply set aside time for reflection or relaxation. Some people enjoy reading and writing, or journaling your experience could be part of their healing process.
It seems like my spouse isn’t grieving for our baby. Why are we so different?
The death of a baby can be difficult for both parents. It is important to give yourself permission to grieve the way you need to grieve and to allow the same for your spouse. You and your partner may have similar feelings, yet you may feel miles apart. You may even have difficulty understanding how your partner is grieving even though you both lost this baby. As much as some people would like one, there is not a step-by-step process for grieving. Everyone grieves differently. Some people are quiet in their grief, choosing solitary activities. Others may be more expressive in how they show grief and maybe more assertive in grieving, such as sharing openly, crying, or sharing and making memories. For the quiet griever, they may be perceived as cold and irritable, or even depressed. Your partner may wonder why you don’t feel the same emotions at the same time. You may need to take a long walk alone, while your partner may need to be held and hear that you are sad too. It is normal to question your spouse, or for your spouse to question where you are in your grief. People want to know that they are all right and that you are too. Finding ways to express to your partner how you grieve or what you need to get through the death of your baby is invaluable to your relationship.
I am just too sad to be intimate with my partner. Will I ever feel better?
It is sometimes difficult to bear the weight of several strong emotions at the same time. Everyone is different when it comes to being intimate again with his or her partner. Your doctor will give you direction on your healthcare and guidelines for sexual intercourse. He or she may permit intimacy with your spouse, but you may not be ready. You may have fears of how it may feel, future pregnancy, or allowing yourself to feel good. Being hesitant is normal, but giving yourself permission to love and be loved is important, whether intercourse is involved or not. It is important to communicate with your spouse your fears or feelings as to why it’s just not comfortable yet. It is normal also to have the same feelings after having intercourse. You may cry or want to be alone. These more intense feelings you may have will lessen with time. Listen to your body and your heart to decide what is right for you.
Nobody seems to understand that I am still grieving, what can I do?
It is difficult for someone who has never lost a baby to comprehend what you are going through. Some people may not know what to say to you or understand the intimate relationship you and your baby already had since they were not able to experience the same tangible bond while you were pregnant. The best way to deal with others when you are grieving is, to be honest, and tell people what you need. Some bereaved parents have found it helpful to write notes or letters to the family or friends explaining their circumstances surrounding their loss and what they needed from them. Sometimes people can be surprised at the depth of your feelings. Even if others are having a difficult time understanding your loss, allow yourself time to remember and honour your precious baby.
How do I cope with other people? How will my coworkers understand when I go back to work?
Even for someone who has experienced the loss of a baby, your experience is different and unique. Many times they don’t know what to say and don’t understand you lost a part of you, including the future you were planning together. They may say things they feel are comforting, but make you angry. Most people are not trying to be insensitive to you; they just don’t truly understand the impact the death of your baby had on you. The best way to communicate with your friends, family, and coworkers when you are grieving is to be honest and specific in what you need. If you are not a verbal person, write a note telling them how you feel, what you have been through, or how you need to be supported. Depending on the relationships you have built, going back to work may be difficult. It is normal to have feelings of confusion, crying, having difficult days, or having trouble concentrating. Grief can make a normal day of work unbearable. Do your best to find appropriate ways to communicate your needs as a grieving parent and coworker/friend. As you continue grieving and remembering your baby, days will begin to fall into a new normal pattern.
Why does the death of my grandchild hurt so much?
A grandparent’s grief can be a complicated journey. Your grief is twofold. Not only are you mourning the loss of your grandchild, but you have also lost a part of your son or daughter that will never be the same. Many grandparents feel a sense of helplessness because they are unable to prevent the anguish their own child feels. Life may now seem more fragile and unfair than ever. These feelings may be frustrating, but they are completely normal for grandparents and family to feel as they, too, experience the loss of this baby.
I don’t know what to do or say. How can I support my son or daughter?
Sometimes there is just nothing to say. Just be quiet, be with them, hold their hand, touch their shoulder, or give them a hug. If you can’t find the right words way, “I’m sorry,” or “I just don’t know what to say.” Avoid clichés like “Thank goodness you are young, you can have more children,” or “God wouldn’t give you more than you can handle.” What may seem comforting to you may be very hurtful to them.
Check up on your son or daughter. Be specific in your offer to help. Perhaps offer to run errands, provide food, or do laundry. After a few weeks, people generally don’t stop by as often. Parents need a reminder that they are not alone.
One misconception is that the shorter the baby’s life, the easier the grief process. The opposite is true. Chances are your child is grieving not only the loss of his or her baby but their pregnancy or hopes and dreams for the future. Acknowledge the baby by using his or her name. This shows you value the short life of your grandchild.
Avoid giving advice. There are no rules that define how one should feel or how soon one will return to the norms of daily life. Your child needs to be heard without feeling judged or receiving unwanted advice. Grief can make people more sensitive and vulnerable.
It is very difficult to watch your own child grieve, and after some time you may wonder why they have not gotten better. The parents of a baby that dies need more time to grieve, as the average intense grieving period could be up to 24 months. Parents will go through ups and downs during this time, but allowing them time and being patient will help them grieve.
Remember special dates or holidays. Parents, and grandparents, may be saddened by special events or dates like birthdays, due dates, delivery dates, Mother’s or Fathers’ Day, because it is a reminder that their baby is not here. Acknowledge how difficult these days maybe without the baby, and ask how they are doing. Showing your recognition with hugs, cards, gifts, or special remembrances also helps to create special mementoes.
How do I talk to my son or daughter about the future?
The future is best held in the hands and hearts of your son or daughter. Allow them to share their thoughts on future pregnancies or children without pressure or prodding. Even though you may have good intentions, encouraging or implying that parents should have more children may make the parents feel as though you are minimizing their loss. When the time is right, your son or daughter will share with you their plans, and it will be all right to share your emotions. Just remember, whether or not there are more children in the future for your son or daughter, it is important to remember and honour your grandchild that died.
How can I support my grieving child(ren)?
Children want to share their experience of grief with adults. Your child’s love for the baby may be very special, and it will be unique as to how much they were included during the pregnancy/birth. Open-ended questions can help you talk and listen to what your child feels. You can ask, “How does that make you feel?” or “What would you like to do for the baby?”
Children need honesty, not deception when it comes to sharing sad news. Generally, children find ways to cope with grief. It is important to refrain from using clichés, half-truths, and fairy tales that may not explain the mystery of death. Remember that children think literally. Using phrases like “we lost the baby, “ the baby is sleeping with God,” “the baby went on a long trip,” or “the baby is watching over you now” can be confusing because of the literal meaning of the phrases. Use an honest explanation like, “The baby died. That means her heart stopped beating and her body doesn’t work anymore. She is not with us like she used to, but we will always remember and love her very much.” explains literally what happened. Use simple and honest explanations.
Allow your child to ask questions. Younger children tend to need to repeat the same question again and again. Each time you repeat the answer or story honestly, you are allowing your child to understand it more deeply. Because you too are grieving, this may be a frustrating process. Do your best to be patient and open, as children learn how to cope from your sincere feelings, actions and responses to their questions.
How will I know if my child needs more help than I can give?
Children, just as you, will grieve and heal over time. Additional help can come from extended family, close friends, teachers, counsellors, social workers, therapists, etc. You may want to seek professional counselling if you have any serious concerns, or if your child…
- Pretends nothing happened
- Develops a fear of school or school work dramatically declines
- Threatens suicide
- Frequently panics or shows excessive anxiety
- Physically assaults other people or is cruel to animals
- Behaves poorly with family members
- Becomes involved in drugs or alcohol
- Begins committing seriously social delinquent acts
- Is unwilling or unable to socialize with other children
I’ve never experienced the loss of a baby. What am I supposed to do to make my friends feel better?
No matter what you say or do, there is nothing that will make your friends “feel better.” Fortunately, there are some ideas that will help you be a part of their experience and will help them through their grief.
If you don’t know what to say, don’t say anything. Sometimes just being with them or offering a hug is enough. It’s all right not to know what to say. Say, “I’m sorry this happened,” or “This is so awful, I don’t know what to say.”
Respond to your friends’ grief just as if one another member of their family had died. Send flowers, sympathy cards, share special remembrances, make a phone call, make or bring dinner. Even though this baby’s life was short, your friends lost their hopes and future too.
It’s been a couple of months. Why aren’t my friends over the loss of their baby?
The death of a baby is very sad and life-altering. The intense grieving can take up to 24 months, not all of them spent in deep sadness. The best thing for you to do is help them through their grief. Ask sincerely, “How are you?” and be ready to listen. Sometimes parents can verbalize what they need from you, so you will know what you can do or say to comfort them.
Do your best to acknowledge the baby that has died by using his or her name. This will show you value the short life of their baby and that he or she is not forgotten.
Grieving parents may be saddened at certain times of the year or by special events, like birthdays, due dates, delivery dates, Mother’s or Father’s Day because they are reminded that their baby is not here. Your friends need your support and acknowledgement during these days.
After a while, people stop calling or dropping by, which can be a lonely time because they may feel that people have forgotten their baby. Make a call or write them a note to let them know you care.