Loss and Meaning

April 28, 2018

I started writing pieces of this down a bit over a week ago, sitting alone in a calm hospital cafeteria of an out of town. My wife was waiting on her dinner in her room, and I was slowly and distantly chewing on my dinner.

At this point it had been 28 hours after learning my unborn child no longer had a heartbeat.

Our Story

The day before started off so jovial. I met a new employee at work and mentioned that I had 2 kids and my third on the way. I told her, in fact, I’d be going to find out the sex of the baby that afternoon. Evidently our newer doctor’s office favors anatomy scans after 20 weeks, so this was actually fairly late for us compared to our last two girls.

At the appointment we got taken back nearly a half hour late and by this time were very anxious to find out if our baby was a girl or boy. The sonograph tech got everything set up, pressed the device against my wife’s belly, and there was our baby — so much bigger than our last sonogram 8 weeks prior! The images were a bit off, which I guess is normal if the bladder is full. After about a minute the tech asked my wife to empty her bladder. My wife and I laughed hard and she complied. As my wife went into the restroom, the tech mentioned she’d be back in a minute and left the room. My wife came back out shortly after, we joked around a bit more, and then after about 5 minutes started to get impatient and frustrated.

We assumed that she started chatting with someone or took a smoke break. I peeked out into the hall and could hear her talking to someone. Then my wife wondered aloud from behind me something we hadn’t considered, “I wonder if something’s wrong…”

The tech came back down the hall and was bringing a nurse or someone with her — I can’t remember who she was at this point. When they came into the room she introduced herself and I cut her short asking if something was wrong. The next time she opened her mouth she broke us.

She told us the baby had no heartbeat.

My wife started bawling and I don’t remember anything else she told us until I asked her to check again and held out hope that they were wrong. They scanned for quite a while. I could see my baby there on the screen — arms, legs, head, and ribs. But there was no familiar fluttering between those ribs or blood flowing. We were told we had to leave for Pittsburgh immediately to “evaluate our options for delivering” the baby. I made the out of town hospital check yet again and they got three doctors to confirm before I wholly accepted what had happened. That acceptance finally brought some tears for me.

Our baby. Our hopes. Our dreams. Gone.

Your Story

I intended to keep this largely private, and most details I will. However I want to make some of this public because this sort of thing happens far more often than I realized, and nothing can prepare you for the pain, sadness, and hopelessness in that moment and days to follow learning your child is stillborn. That being said, knowing what to face going in may help lessen the repeated blows as they tell you what to expect and remind you what decisions you have to make. My third child never got to see the world and leave their own mark, so I want to ensure that their short life makes some positive impact to honor them.

Hearing the News

Nothing I can say hear will lessen the hit. It fucking sucks and it will always hurt, even when it’s just a memory. I can tell you that you and your partner are not alone. Many people learn they’ve had a miscarriage or a stillborn and will understand the pain you’re feeling. A surprising number of people you already know may have experienced it and you’ve never known. I’m fortunate (as fortunate as this sort of thing can be) in that I’ve known several people who have experienced this. Talking through it with my oldest and dearest friend, and hearing his experience, helped me greatly — I hope that you too have someone close. Some people keep this close to the chest and haven’t told you before they suffered this sort of loss; however, they may choose to open up to you in order to help you through the process.

There are also many organizations and support groups both online and in person that you can reach out to and communicate with. These can be just as invaluable as someone in your personal network. You may even make some lifelong friends out of this experience.

However you choose to do this, I cannot encourage you enough to not handle this alone. It may feel like all you want to do, but bottling up your emotions may prolong your grieving and pain. Please, please, talk to someone about what you’re going through. At bare minimum, please communicate openly with your partner.

Your Partner

This section is targeted primarily to men who are suffering a loss with their partner, because I am highly under qualified to discuss this from the perspective of a woman.

This time is insanely hard for both you and your partner. Our instinct seems to be to protect our partner, but when you both suffer the loss it’s important to accept that at some point you need to grieve as well. For me, along with the need to protect my wife, I didn’t feel justified in grieving nearly as hard as she did — she carried the baby inside her for 20 weeks. They were never apart, she would always talk to the baby, everything about her was changed in some way by the baby, and even after death, the baby was still there. I can’t fathom how hard this was on my wife and I’ve been with her every step of the way. From numerous accounts, articles, friends, and from my wife herself, I was reminded that I’m experiencing the loss as well and it’s okay and healthy to acknowledge it.

For the first several hours I was rather stoic and blank, trying my hardest to comfort my wife and only trying to drive the process forward as we had to make decisions, arrangements, and communication throughout the day. In one of the hospital rooms my wife waiting for scans my wife and I were trying to research how we could try to break the news to our daughters that this happened, and I saw something mentioning that as the father I shouldn’t be afraid to show my emotions, and not doing so may signal to my wife that I don’t care.

I immediately asked my wife if I’ve come off as indifferent throughout the day, not wanting to add to her pain if it was the case. My wife and I have been married for nearly 6 years and together for over 15, so she assured me that she knew I cared and knows how I get when situations go sideways. She did, however, affirm that I can’t bottle my emotions up and that she’s not that only one that suffered a loss. She told me to let myself grieve an not only be focused on her. When I finally shed some tears after another interaction with the doctors, she was there for me as I was for her — holding me tightly. It made her feel a bit better knowing that she could help comfort me in the situation.

Telling Others

Adding to the pain of the situation is the fact that people may know you were expecting a baby, but don’t know the baby is gone. This information is yours, but unfortunately if people aren’t informed you’ll be hearing the questions “How are along are you?”, “When is the baby due?”, “Is it a boy or girl” and reliving it every time. We handled it by informing those closest to us and letting them spread the news. For neighbors and friends I make sure I’m the one they run into first so that I can give them the heads up so my wife doesn’t get put into the situation.

Outside of word-of-mouth, you may choose to notify multiple people at once via Facebook or similar social networks (we opted not to). Or you may personally want to tell people case-by-case. Do what feels right to you. And this brings us to the hardest ones to tell.

Telling Your Children

Along with actually hearing the news about the death, telling our kids was the hardest part. We agonized over how to tell them. Read countless articles online, and I read some of the books on grief they gave us while my wife napped. There are so many recommendations from different folk, but one theme seems to be consistent: don’t sugar coat it or use confusing terms because they will tend to take it literally. Things like “we lost the baby”, “the baby is asleep and can’t wake up”, “the baby went to heaven”, or similar phreases imply impermanent states. Most sources said to tell them and use real words, but don’t disclose more than what they ask.

For us, our girls are 5 and almost 3. When we got home from the hospital we told them the baby wasn’t strong enough to be born and had died. I’m not going to go into details of reactions, but they understood what happened and largely handled the news well. Children are insanely resilient.

Now, one thing I could never find was to how to tell children where the baby physically went. I was panicking about this part because I didn’t know how to answer it. I’m still unsure how they’ll react when we get the urn next week, and how we’ll explain it. At the moment I think I’m going to explain that when babies die and aren’t able to be born, they turn them into ash since their body can’t survive. The answer to this will also greatly depend on how you handle the next part.

Another thing I’ve read is to not shield them too much as they may come to resent being left out. They suffered a loss too (assuming you told them or were far enough to notice), and need to be able to grieve. If you do a memorial of any sort, let them be involved. Let them make something for the baby if that’s how they want to express themselves. It may seem hard, but it seems to really help.

Warning: These next sections have details that are not easy to read and may be upsetting. Either stop now or be ready to proceed.

How to Deliver

As if mothers haven’t been through enough, they still need to get the baby and placenta out. I’m not going to tell you how we chose to handle it, because it’s important that you and your partner handle it either the way you want, or the way your health care provider tells you is medically safest. I am not qualified to give recommendations.

There are different options based on your situation. I can tell you they seem very reluctant to perform a C-Section because despite it being performed commonly, it’s a risky surgery that is often done for the sake of the safety of the baby. Since the baby is no longer alive, they don’t want to risk the mother. So that leaves two more common options.

Vaginal Delivery

A standard vaginal delivery is one of the options they’ll present as long as there are no blocking risks. They’ll certainly offer an epidural and other things to make the mother as comfortable as possible, but like any other option this is not an easy process. If you’d like a chance to hold your child before they are taken away, this is the most realistic option. Some people aren’t sure whether they’d like to. Think hard on it and discuss it with your partner. Decide whether this option is right for you and if the risks are worth it. This next part is a bit gruesome, but I want you to be aware of it in case your provider does not give you the warning. Make sure the sonography tech tells you an estimate on how far along the baby was when it passed way. The placenta doesn’t necessarily know the baby passed away right away, so delivering a stillborn that passed away a day ago vs one that passed away a couple weeks prior can be very different experiences. I know that’s not giving pleasant imagery, and the thoughts of it were horrifying when the hospital listed possibilities to us, but it’s important to know.

They will likely offer to try to get you hand prints and foot prints for a memory box.

D & E

This method is common for babies that pass away prior to 20 weeks, high-risk pregnancies, or women who have had prior C-sections. In this procedure, it is highly unlikely that you’ll be able to hold your child because they “evacuate the pregnancy”, implying that they will almost always need to remove everything from the uterus in pieces. This procedure is also extremely unpleasant to hear and imagine, but they will tell you it is the safest for the mother. While it is a short procedure (I think they said less than a half hour), it can take as long as labor and delivery because they need to dilate the cervix to 2–3cm over about a day and secure an operating room for the procedure.

They will still offer you a memory box with handprints and footprints, and will try hard to make it possible, but they caveat it with the fact that it may not be possible to get the prints due to the way the procedure is done.

Autopsy

This part is at least as hard to stomach as the decision on delivery. Often times the doctors have no idea why the baby passed away. They will take blood from the mother and tissue from the pregnancy to do some testing, but those are still not as conclusive as an autopsy. An autopsy will allow them to try to see what may have happened in two different ways. They can do an external autopsy, in which they will not harm the body (from what I can remember, I recommend searching the web to confirm or asking your physician), but will take samples that they can test further. This yields more information, but is still not as informative as an internal autopsy. This is exactly what you think it is, more or less like what you’ve seen on TV. They will cut into the body and examine each organ in ways I don’t want to think about too much. It’s hard to picture, but this is your best chance at finding out what happened to your baby.

If you’re planning on having another baby, this kind of information can be helpful to understand your chances of it happening again or what you can do to prevent it (if anything). It can also be helpful in knowing if there is anything hereditary that you need to be concerned about with your existing or future children. The autopsy also helps research in discovering why some of these things happen, and what people and doctors can do to prevent them in the future.

You need to choose what is right for you. It’s a hard choice with tradeoffs, and there’s no getting around it.

Disposal

I’m sorry, that term sounds insensitive, but it is unfortunately the term that will be used. From what I’ve read and what doctors told us (within Pennsylvania at least), babies in the womb for less than 20 weeks have to be disposed of by the hospital per regulation. From what I understand, the remains will be cremated, but it will be done with others remain and buried together at a cemetery. Evidently babies will be buried in a specified area at many cemeteries. There will be no grave to visit in this situation. Above 20 weeks you can choose to allow the hospital to dispose of the remains or you can dispose of it. For fairly obvious reasons, if they perform a D & E they will only allow you to have the remains cremated to avoid further trauma. If you have a vaginal delivery you can decide whether to have a burial or cremation (which you can choose to inter later).

You’ll need select a funeral home to handle the remains. They will continually ask you if you’ve decided on one — be sure to research and find one that will work with you for your needs. Many will offer a heavy discount for stillborns and deceased infants. The one we dealt with were incredibly kind, worked with us, and gave us a deep discount. Usually the hospital will send in a social worker to help you find a funeral home and tell you ones they partner with or are known to offer discounts. If you need help affording the costs, there are organizations like Emma’s Footprints that are available to help you.

Conclusion

I sincerely hope you never have to deal with this sort of loss. Losing a baby is hard no matter whether it’s an early miscarriage, half way through, or any further along. It’s an odd feeling grieving a child you’ve never seen, but that child is yours no matter what. You had hopes and dreams for that baby. You’ve undoubtedly pictured what life would be like, what their life would be like as they got older. You’ve thought about how he or she would play with their siblings as they grew up together. Take the time you need to mourn your loss the way you need to. The choices aren’t easy, especially given the pain you’ll be in, but those decisions stay with you. Think as carefully as you can and do what you think will be right for you and your family. My child had its life cut short, but I’m hoping this article written based on that short life and death will help you and others understand what is to come.

I wish you all the best, and remember — you are not alone.