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Challenge: Pregnancy and Infant Loss

What do I say? Expert advice on helping friends and family cope with the loss of a baby

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The death of a baby is so terrible, so unthinkable, and sadly, so common it’s surprising that we don’t have better ways of dealing with it. Once a person unfastens the tender subject of miscarriage, stillbirth, or neonatal death (death in the first 28 days of life) it is often surprising to learn that more women have been affected by baby loss than have not. It can be an intimately personal, solitary thing, but that doesn’t mean it should be ignored. Sometimes a parent can feel very alone while grieving a baby, and often the people around her or him don’t know what to say or do to offer support. Some may think that ignoring the death will help, or otherwise try to shield the parent from grief. But the grief is constantly present, and needs to be acknowledged and experienced for a parent to be truly comforted.

We often say we can’t imagine what a person must be going through when they lose a child, but I think it’s more accurate to say that we can imagine, and the image is so heartbreaking we may feel we have to shut it out. But regardless of whether the death is an early, mid, or late term loss, or after a child is born, the grief is real and the healing process is different for each person. And it is important for those of us who are friends or relatives feeling at a loss for words or paralyzed by inaction to find ways to support that grief and healing.

Grief is Grief

Melinda Olson, founder of the Earth Mama Angel Baby line of natural and organic products for pregnancy and baby care, created the Healing Hearts Baby Loss Comfort line of products and web site as a resource for when mothers need emotional and physical comfort after the loss of a baby. She created these products, which include a uterine tonic postpartum tea, and tea to help reduce breast milk, to address very normal physical concerns. “Women who have lost a child are also postpartum women,” says Olson. “And they need a lot of the same things that other postpartum women do – like salves and herbal baths. But they also need support for their broken hearts.”

Olson says her web site was created to offer advice for friends and families on how to help loved ones who have lost a baby. But Olson says it is important to let women support each other through the grieving process. “When you lose a loved one, like a parent, your friends bring food, ask you what you need. But when you lose a child, it’s often silent or your friends have trouble knowing what to say.”

Though she has never lost a child, Olson adds, “I have come close enough to losing a child to look it right in the face, and I have never been the same since that day. Death and loss are difficult no matter who has died, and the common elements of grieving carry through whether you’ve lost a parent, a friend or a child. The grief felt from losing a baby is not smaller because the baby is smaller. The empty place felt from a baby’s death is never going to be filled. It’s a pain that will never completely heal or be relieved by subsequent pregnancies. But there are grief tools to help comfort the healing process. There is no timetable for healing, nor does it go in a straight line. People don’t lose a baby, cry and be finished. Everyone has to grieve at their own pace, and in their own way.”

Debra R. Howe, Program Coordinator for First Candle’s National SIDS & Infant Death Program Support Center agrees, “Don’t give the parents a prescribed time to grieve, continue to ask about the baby. It is counterintuitive, we think the parents don’t want to remember, but they do.”

Lori Logan, M.S., C.G.C., Olivia Hess, M.S., C.G.C. and Teresa Tiberg, M.S., the genetic counseling team at Desert Perinatal Associates counsel, “Healing takes time and the love of family members and friends. Continue to be supportive in the weeks and months to come.”

Babies Shouldn’t Die

Miscarriage or the death of a baby is especially devastating “because we have an idea of the order of life,” says Ms. Howe. “When a baby dies it throws that belief to the wind. It becomes chaos. We believe that only old people die. No parent ever expects to bury a child, no matter how old they are. It’s not just the loss; it’s the loss of a belief. Babies shouldn’t die.”

The Desert Perinatal Associates team adds, “The loss of a baby at any stage is a loss of hopes and dreams, and bonding is bonding, whether it occurs earlier or later in pregnancy. One woman might grieve a six-week pregnancy loss deeply, while another may have been ambivalent about being pregnant, and have mixed feelings of loss and relief. Do not discount early losses, however! These are often “unsupported losses” meaning that many people may not have known of the pregnancy, and may never have seen a pregnant appearing belly.”

Depending where a woman is in her pregnancy she can also be experiencing physical symptoms along with the classic stages of grief. Women who lose a child during the last trimester can undergo postpartum symptoms. “Your friend may have hormonal fluctuations, and even milk production. Ask if they have discussed these issues with their doctor, help is available,” advises the DPA team. Physical comfort for aching breasts, bleeding and cramps is important, says Ms. Olson. “Women who have lost a baby are medically postpartum women too, because they go through the same physical symptoms pregnant and postpartum women experience. Their hearts and empty arms ache from loss, but their bodies need healing and comfort too.”

Grieving a baby can be a very lonely thing, but it’s important to acknowledge and support that the parents, grandparents, and other family members are going through a very real, personal loss. Simply acknowledging the death can be a very comforting, powerful action. “We just don’t do grief well anymore,” Ms. Howe says. “A century ago when there was a death, regardless how well you knew the family, you were able to identify what family had a loss and the community would meet that family’s needs. Whether it was meals or taking care of children or just sitting with the family. There were outside signs, people would wear black, there might be a flag over their door. But today we find that grief can be a very lonely and painful experience, you can be working with someone or pass them on the street and never know they have suffered a loss.”

Ms. Howe encourages us to remember single parents, people who don’t have family or extended family, and fathers. “When fathers return back to work, the question is usually, “How’s your wife?” as if the loss was not shared. They can feel in some way they have let their family down, that they could not protect their babies. You can say, “How are you doing since your baby died?” They may cry but you shouldn’t be worried about reminding people, they don’t forget. But the concern is that other people forget.”

Tools for Healing

Ms. Olson believes that grief is often very isolating and having a space to openly acknowledge the heartache is a good first step. “The forum on our site was created so that women can talk to other women who truly can say they understand how to speak to the sorrow. Seeing evidence that many people understand what you are going through can help with the feelings of isolation and loneliness.”

As people who want to support our friends through their loss, speaking up is very important. “We should never avoid the issue because we don’t know what to say,” says Ms. Howe, “the families notice, and it’s very hurtful. You just have to acknowledge it somehow, whatever is appropriate. It’s different in different settings and for different relationships.”

But how do we know what to say? Ms. Howe suggests that there is no one right thing to say, but there are a lot of things not to say. “I think a lot of times, out of our own discomfort, we say things that are canned responses, and those things can be particularly hurtful. For example, “god never gives us more than we can bear,” “there’s a reason for everything,” or “god needed another angel.” We say these things because we don’t know what to say, but deep down we know that they are not comforting things. Honestly? The best response could be a touch, a hug, being present and being with them in that moment without saying anything.”

The Workout Family team also suggests not waiting for the parents to ask for your presence or your help. “Be comfortable with silence and with their tears. Be an empathetic listener. Listening is more important than talking! Be accepting of the parents’ feelings of anger. What has happened to them is unfair.”

Details are Important

Another seemingly hard but helpful way to comfort someone is to call the baby by name. “Hearing their baby’s name mentioned tells them that regardless of how short their baby’s life was, it made an impact.” Ms. Howe says. “Remember the baby’s birthday, and the anniversary, or the angel date, of the death. After the funeral people have a tendency to slack off the caring, but they should continue to acknowledge the baby and the death. People say “I don’t want to make them cry” or “I don’t want to remind them” but there isn’t a day that goes by that they don’t cry, and they will never forget, but having people remember that they had a baby, parents find that very comforting.” The DPA team also suggests offers of housecleaning and laundry, or mowing the lawn, babysitting or taking your friend to her follow-up doctor appointments.

If you can’t be there to support the family, you can always send a card that says, “I am sorry about the loss of your baby. I am thinking of you.” Send a gift of a remembrance candle or cards for takeout restaurants so parents don’t have to think about dinner. Ms. Howe advises us to remember the dates, “and when the family is ready, you may be able to suggest a way to memorialize the baby, plan a walk, or have a birthday party.” And the DPA team reminds us, “Remember the due date, if it was a pregnancy loss. Send a card or flowers. Don’t forget fathers. They are grieving deeply too.”

Finally, give the family time. “Be OK with silence,” says the DPA team. “It is more comforting than phrases that try to fix the situation. Continue to be supportive in the weeks and months to come. Healing takes time and the love of family members and friends.”

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