When Melissa Giroux, a registered nurse from St. Albert, Alta., went into labour on June 19, 2008, she was excited about having her baby girl placed in her arms. After all, her 40 weeks and five days of pregnancy had been textbook. No bleeding. No ultrasound problems. No high blood pressure. But everything took a sharp U-turn when Melissa and her husband headed to the labour and delivery floor.
“When they tried to find a heart rate, there wasn’t one,” she says. “We were totally unprepared. Stunned.” The couple’s baby – they named her Ellianna – is one of more than 2,000 babies who die in the womb each year in Canada, after at least 20 weeks of pregnancy. Some babies die due to a lethal combination of factors such as low amniotic fluid or a knot in the umbilical cord, while other stillbirths are caused by birth defects, placental problems, poor fetal growth, infections, or a mother’s chronic health conditions. Whatever the cause, stillbirth often blindsides parents who have been busily reading pregnancy books and decorating the nursery. Unlike a century ago, when stillbirths and infant mortality rates were much higher, in today’s highly medical environment, the death of a baby is particularly shocking. It goes against all of the messages pregnant mothers receive about delivering happy, healthy babies after nine months.
Self-blame and grieving
Inevitably, grieving parents feel enormous culpability for the death of their child. “Logically I know it’s not my fault, but emotionally I blame myself. I wonder what I could have done differently,” says Tannis Brissett of Ajax, Ont., who lost her son, Malachi, on May 19, 2009, only a couple of weeks before her due date. Her story is similar to Melissa’s in that she had no idea her baby was in trouble, (his umbilical cord was wrapped around his neck at birth). All was fine until she woke up one Saturday morning and realized he wasn’t moving. So she did what all the baby books instructed: she drank some juice and rested on her side. An hour later, and still not feeling any movement, she headed to the hospital and got the awful news. Her son was gone.
Grief is dark, shocking and visceral. And that’s a huge problem for couples dealing with their feelings after a stillbirth, says Audrey Stringer, a bereavement counsellor from Sarnia, Ont., and author of Get Over It: Surviving Grief to Live Again. Family and friends’ uncomfortable reactions only compound the problem.
“People will say, ‘Oh, you’re young. You can have more children,’ but this talk minimizes what the parent is feeling,” she says. “The stillbirth is also incredibly hard on a couple’s relationship since each parent often grieves in different ways. The mother might go numb and not want to talk about her extreme feelings of loss, pain and even anger. The father might try to work though his grief by spending long hours at work.”
Helping the whole family
Tannis says she has to be careful not to take out her sadness on her husband. “Sometimes I resent the fact that my husband can get up and go to work and function,” she says, even though, at the same time, she realizes how important it is that he’s coping differently since they have a three-year-old boy who still needs attention. And what if there are other kids in the family? What should a parent say to them after the death of a tiny sibling?
Stringer says to tell them what happened and not to be afraid to show your emotions. Some families create little books about the baby brother or sister they never knew. Others plant trees or take time each month or year to memorialize the baby. Rituals are important.
But it’s the early days after a family experiences a stillbirth that are usually the most difficult. Mothers struggle, not only with their milk coming in and with the typical afterbirth hormonal swings, but with their grief. Some fall into a deep depression. If depression is extreme, they must seek help from their healthcare professional or a grief counsellor.
A year on, Melissa says Ellianna will always remain a member of her family, one of her children. “As awful as this experience was, it showed us how much love and support we have,” she says. That came in handy when Melissa and her husband were expecting the next time. Happily, their son, Evan, was born in June 2009.
An encouraging overview
The incidence of stillbirths has decreased over the past couple of decades due to medical advances.
- An incompatibility between the blood groups of the mother and her baby used to be a major cause of stillbirth, but now can be prevented.
- The treatment of high-risk conditions such as high blood pressure and diabetes has improved in recent years.
- High-risk mothers, including mothers who have had a previous stillbirth, can be closely monitored during pregnancy and life-saving treatment often can be given.
- A baby can sometimes be delivered prematurely when a problem is identified.
- Mothers can track the number of fetal kicks felt during the second half of pregnancy. If the kick count decreases or stops, the doctor may arrange for an ultrasound, the baby’s heart rate may be monitored, and steps can be taken if there is a problem.
- Mothers can refrain from smoking, drinking alcohol, or using street drugs, because these all increase chances of having a stillbirth.
How to help
You find out your friend, co-worker, sister or even an acquaintance has experienced a stillbirth. What do you do? What can you say? Here’s a list of DOs and DON’Ts:
- DO say, “I’m sorry for your loss,” then, if appropriate, give the grieving parent a hug.
- DO offer to help around the house, watch the children for an afternoon or go grocery-shopping.
- DO say little, but listen, listen, listen.
- DO be patient. Recovery takes time.
- DON'T avoid the parents who are mourning. They need you.
- DON'T say, “You can have other children.”
- DON'T say, “There must have been something wrong with the baby, so it’s just as well.”
- DON'T try to fix things.