Supporting Mothers After Complicated Birth And Loss

As midwives, we hope to give our clients empowered birth experiences – births where they have been enabled to make informed decisions; where their hopes, wishes and desires are respected within the bounds of ensuring safety. When couples are viewed and treated as essential members of the birth team and thus have their opinions, ideas and desires honoured in the birth process, families have positive and beautiful birth experiences, even when birth doesn’t go 100% according to plan.

Sadly, though, when loss occurs within pregnancy or shortly after birth, many of these families are not afforded this right. The result is that an already highly traumatic situation has added trauma because decisions are made for these couples. At the very time that these families need time, information, support and most importantly of all, to be given a voice to say what they need in this time of trauma, many care providers do the exact opposite.

Instead of time, they rush the births; instead of providing information and listening to the couple, they tell the couple what needs to be done and how. Instead of creating a safe space where these couples can voice their needs, the care provider decides for them based on what they think the couple needs. This all ADDS trauma.

As midwives, how can you support your families who face pregnancy loss, stillbirth or infancy death shortly after birth in a way that reduces trauma and minimises their regrets? Here are a few guidelines:

• Acknowledge the depth of their loss and their baby as a baby – no matter the gestational age. Sadly, our country currently does not recognise babies born before 26 weeks as babies – they are viewed as medical waste. For these parents, this was their daughter or son, a child they longed for and were planning for. They had hopes and dreams for this baby. Often society does not acknowledge their loss. We hear this by the words uttered to these families such as, ‘At least you know you can fall pregnant’, ‘Be grateful that you did not get to know your baby and then lose them; that would have been worse’, or, ‘You can have another baby’. These words are meant for comfort but in fact only minimise the parents’ feelings, invalidate their loss and isolate them.
• Encourage them to name their baby. Again, no matter the gestational age, encourage the parents to name their baby. A name is an acknowledgement that this person existed!
• Listen to the parents, give them information and space to make decisions that they feel are best for them and their grieving and healing journey. Validate their emotions! Reassure them that you will guide and support them; they are not alone.
• Draw up a birth plan. If they are still going to birth their baby, let them make decisions regarding the birth, their meeting and saying goodbye to their baby. Include in the birth plan the following: *
  • Do they want to see Baby?
  • Do they want to hold Baby?
  • Do they want to have family/siblings view Baby?
  • Is there a special blanket/outfit that they would like baby wrapped or clothed in?
  • Do they or a sibling want to give a gift to Baby? If so, do they want that gift to go with Baby to the funeral home or to have it returned to them as part of the memory box?
  • Do they want to write baby a letter?
  • Do they want photos, footprints, handprints, or moulds made?
  • Is there a religious ceremony that they would like to have performed?
• Be sure to refer the couple for ongoing support.

By giving these families the opportunity to make decisions around their birth, meeting their baby and saying goodbye in the way they need to, we can minimise the trauma and thus still give them empowered births. These births can still be beautiful and meaningful in among the sadness, heartbreak and grief. Empowering our families in this way helps them grieve and heal.

Author: Samala Kriedemann

Samala Kriedeman is a mother of four and the owner and heart of Mama Nurture, Qualified Social Worker, Certified Birth & Bereavement Doula and HypnoBirthing Practitioner.