Friday 22 September 2017

The grief associated with stillbirth and miscarriage is now recognised

Internationally, 2.7 million babies worldwide are stillborn annually. Photo: Getty Images
Internationally, 2.7 million babies worldwide are stillborn annually. Photo: Getty Images

Most women desire children and even at a young age, we harbour fantasies of motherhood. Girls enjoy playing with their dolls - they cradle them like babies and enjoy dressing them up.

Fast forward to adulthood and the childhood dreams turn to brooding and day dreams.

The young woman ruminates about motherhood and may even experience a physical yearning for a child. She day dreams of holding her baby, walking with a buggy and even imagines the child's facial appearance.

The drive for motherhood is powerful indeed and so it should be, as it is vitally necessary to propagate the human species if humanity is to survive.

When the positive pregnancy test is returned, the plans for the baby kick in with force. The bedroom is made ready, names are discussed and clothes are bought.

The American ritual of the 'baby shower' is now becoming fashionable in Ireland and well-meaning grannies and grandaunts begin knitting. Scans of the baby are circulated to friends and the baby increasingly becomes the focus for the family and beyond.

Imagine that tragedy strikes and the expectant mother miscarries - especially but not exclusively - if this is late in the pregnancy or she has a stillbirth.

Stillbirth is defined as the death of a baby at or after 28 weeks' gestation, although some definitions put it at or after 20 weeks and others at or after 24 weeks.

Before 20 weeks, such a loss is referred to as a miscarriage or a spontaneous abortion. Since 1995, it has been possible to register a stillborn baby (born after 24 weeks and weighing 500g or more).

Registering the death may not seem controversial, but prior to the 1995 Stillborn Registration Act, the absence of recognition of the baby caused parents much anguish. In Ireland, one in every 200 births it stillborn, making it more common than many people realise.

Internationally, 2.7 million babies worldwide are stillborn annually. Only in recent years has the grief associated with miscarriage and stillbirth been fully appreciated.

The grief can be present for many years, but because the baby is 'gone', does not mean it is forgotten.

I have treated a number of women who mourned their babies even 20 years after the loss.

Meanwhile, they had given birth to other children, lived happy lives and had much that was positive in their families - but the void was still present in their inner secret sanctum.

Every pregnancy is accompanied by images, aspirations and plans, yet these are crushed when a baby dies, even before any have the possibility of realisation.

Mental pictures of which side of the family the baby might resemble, the daydreams of the baby walking, talking and going to school come to a sudden and terrifyingly unexpected end.

The grief experienced is for the baby, for the dreams that had surrounded that baby and for the future that will now never be realised.

Well-meaning friends may try and offer consolation by saying that the grieving mother is young enough to have more children or that she is lucky to have those already born to her. Comments such as these disenfranchises her grief.

The grief of fathers is still not fully appreciated and many suffer in silence.

The loss of a baby through miscarriage or stillbirth may have a profound effect on the relationship as mother and father grieve separately and differently.

For example, recent research (Burden et al 2016 BMC Pregnancy and Childbirth) shows that fathers often deal with loss in these circumstances by avoidance or substance misuse.

Sexual feelings are also different between mothers and fathers and they behave differently during subsequent pregnancies, with mothers expressing greater fear and uncertainty.

Despite the devastating, life-changing event of the loss of a baby in pregnancy, particularly as it advances, the above study shows that well supported couples develop resilience and new life-enriching life skills.

In Ireland, A Little Lifetime Foundation is one such organisation that assists parents who have lost a baby in pregnancy.

Those affected by the loss of a baby during this time may find this wonderful organisation of assistance.

You do not need to face it alone.

* For more information, see alittlelifetime.ie, miscarriage.ie, feileacain.ie.

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