Kathy Donaghy talks to bereavement experts who give some advice on dealing with the sensitive subject of loss
Acknowledging the loss
While you may feel at sea and unsure of what to say, it's likely that whatever support you can offer will be valued greatly. Bereavement support midwife at the National Maternity Hospital (NMH), in Dublin, Brenda Casey, says simply acknowledging the loss is hugely important. And in the case of miscarriage, she urges against correlating that loss with the gestation period or how many weeks pregnant the woman was. "Once the loss is acknowledged, you have to fine tune your listening skills and follow the lead of the mum or dad. It's not something that can be fixed - it's all about support," says Brenda. Marie Cregan, one of the founding members of Féileacáin, the stillbirth and neonatal death association of Ireland, points out that when a baby has died it's one of the worst things that will ever happen a family and acknowledging this is important. "It's a significant trauma and it's going to be with them for a long time," says Mary.
It's good to talk
When miscarriage and still birth occurs, often society's attitude is not to talk about it for fear that it's too upsetting. But not talking about it is often very hurtful to those affected and only compounds society's fear of speaking about through miscarriage or still birth. According to Tracy Donegan - midwife and founder of the Gentlebirth app - the language we use is important when faced with the news that someone close to us has experienced the death of a baby. "We must remember that the parents didn't 'lose' a pregnancy; nobody is lost. In the eyes of the parents their baby has died and no matter how much we want to fix it, we can't. Some suggestions of what to say are 'I am so sorry', 'I am here for you' and 'I don't know what to say.'
According to the Miscarriage Association of Ireland, you don't have to say anything to a friend who has experienced a miscarriage - just being there is important. The association says that many women need to talk over and over about their experience of miscarriage and fear that people will tire of the repetition. It advises the friends of a woman who has had a miscarriage to allow her to express her feelings even if you differ from their opinions and allow them to talk openly about the baby they have lost as often as they need to.
Don't impose your own judgements
Realising that everyone's experience is unique is very important when trying to reach out to a friend who has suffered a miscarriage or stillbirth. According to Brenda Casey, bereavement support midwife at the National Maternity Hospital in Dublin, people impose their own judgements on how someone should react all the time. She says if someone is quite religious they might say something like 'You have an angel in heaven' and while this is a comfort to some, it is most unhelpful to another. She advises people to fine tune their listening skills and take their lead from what the mum or dad is saying without offering judgement. "Don't impose your own judgement on that person or your own beliefs. It's all about honing in on the wants and needs of the person," says Brenda. Mary Cregan of Féileacáin says even if you have been through the same experience yourself, you don't ever know how someone feels.
People may mean well but when a woman has experienced a stillbirth or miscarriage, hearing the words "it was just not meant to be" are extremely unhelpful. Platitudes may make a woman feeling angry and upset at what has happened even angrier. According to the Miscarriage Association of Ireland, never say "You can try for another child" or "You're young yet, you have plenty of time".
Send a card, email or text
If you can't talk to the person because you are afraid of upsetting her or intruding, you could send a card, email or text message. Britain's Miscarriage Association says that women who have experienced miscarriage can feel extremely isolated and one of the most important things you can do is be there. However the association highlights that if you're pregnant yourself, you might worry that your friend or relative would be upset to see you. The association suggests sending a message asking if your friend would be OK to see you.
Don't forget Dads
Brenda Casey from the National Maternity Hospital says that it's important not to forget fathers in all of this. She says it's important to remember they are grieving too. "Men tend to say that if their partner is OK, then he's OK. But again it's all down to the individual - everybody's road is so different," she says.
Remember other family members
Other children in the family may not know what has happened but they do know their parents are upset and they may act out in various ways to get attention. Brenda Casey from the National Maternity Hospital says if there are children, a friend could offer to take them to and from school or help with child minding. "Having a supportive friend who can help out is very beneficial," she says. Mary Cregan of Féileacain says people must acknowledge the loss for the other children in a family because the baby was the sibling they were expecting.
Help out with housework
Taking on some jobs around the house for a friend or cooking a meal will be greatly appreciated. Mum of four Siobhán O'Neill White experienced two miscarriages and says she remembers how much she appreciated the casseroles and other dinners cooked by her own mum and mother-in-law afterwards.
"I think another really helpful thing to do is offer to help around the house. For example bring a pile of laundry home for the person. If they have other children, offer to take them out for a while or you can offer to babysit for a while so the couple can have some time alone together. Even if they just go for a walk or to a movie, it will be nice for them to get some time together," says Siobhán.
There's no time limit
Often we put our own prescribed time limit on how long it will take someone to recover from a miscarriage or stillbirth. But experts agree that this is different for everyone. Brenda Casey of the NMH says that in the past it was expected that people went through the various stages of grief. However she says new research has vastly enhanced our understanding of how we grieve. "It's not something you 'get over'," she says. Casey says new research into what is called the "dual process of grief" shows we oscillate between immersing ourselves in our grief and restoration oriented coping where we get to a point where we are getting on with things. However there are times when the pendulum swings back and we plunge headlong back into grief. Casey says one woman described this to her as being "ambushed" by her grief. "The winding road goes on forever and you are never the same person again," she says.
Remember it's about them, not you
Even if you have suffered a miscarriage or a still birth yourself, remember try not to make the conversation about you. Each person is unique and so too is their experience of grief. The American Pregnancy Organisation points out that support is not about giving advice, it's about listening. While it says some identification may be helpful, keep it to a minimum.
Don't try to "fix it"
According to Brenda Casey of the NHM, as a society we are very uncomfortable with talking about death and even more so when it comes to talking about a baby's death. She says people try to say something that will fix things when this is impossible. Rather than rush in with this attitude, she advises people to be open and ask "Is there something I can do to support you? or just ask "Would you like to talk about it?.
Reassure the grieving person that their feelings and reactions are normal and necessary for healing. Remember that specific dates or events as the anniversary of the loss or the expected due date, may trigger an emotional response. Britain's Miscarriage Association says it's perfectly normal for a woman to feel shocked and confused, numb, angry, jealous, guilty, empty and lonely, panicky and out of control and unable to cope with everyday life. It's ok to feel any of these things and the best thing you can do for someone who is feeling any of these things and struggling with it is remind them it's OK.
Remember trigger points in the future
Mary Cregan of Féileacáin says the loss of a baby will be felt forever. She says for parents who have lost a baby there are, what she calls, the hidden anniversaries of the heart; dates like a due date or first Christmas that can hit families really hard. "Give them time. If they want to talk about the baby, talk. You are not upsetting them - they are upset already. Don't expect them to be OK. Mother's Day can be horrible because they are still mothers," says Mary.
Give a little gift
Depending on the relationship, bringing flowers or even sending a beautiful card can be helpful. Two years ago US based psychologist and writer Dr Jessica Zucker launched a line of pregnancy loss cards to help console and offer support after she experienced a miscarriage at 16 weeks. While there are no cards in the Irish market place that speak about some of the most challenging times that can occur in your life, a card with heart-felt sentiments written inside can mean a lot.
For further information you can contact the Miscarriage Association of Ireland at (01) 8735702 or at www.miscarriage.ie
Also see feileacain.ie for more information
Anne Marie Gillooley shares the heartbreaking story of the loss of her son Max and the attempts to rebuild the lives of herself and her husband while keeping their son's memory alive
Exactly one year ago today, 19 weeks into a much-longed-for second pregnancy, I learned that the baby that I was carrying had died. Pretty much the first thing I did as soon as I found out was google 'late miscarriage'.
I didn't see Coronation Street last Wednesday. It is too soon for me to watch anything that even remotely resembles my own experience. In the popular soap, Michelle Connor, played by Kym Marsh, went into labour at 23 weeks, her waters breaking at her baby shower in true soap style. She was rushed to hospital and delivered her baby to his inevitable death, in a maternity ward surrounded by the sound of crying newborns.