Navigating Stillbirth

Written with insight and direction from two mothers and dear friends who have experienced stillbirth, Heather (son, Luke) and Amanda (son, Theo); who work every day to honor their son’s lives and help other families navigate these unforeseen losses.

Photo of Amanda and Theo, taken by the amazing birth, bereavement, and family photographer, Melissa Helmick.

“Stillbirth” is a phrase parents are too afraid to entertain, let alone research. Because of this fear, the realities of a stillbirth pregnancy, delivery, and postpartum, are commonly unknown. Stillbirth isn’t something as easy on the heart to Google as “breast feeding options” or a list of the most convenient strollers; However, for 1 in 160 pregnancies, this outcome is a reality parents must be prepared to navigate, for their own sake. When boarding an airplane, and embarking on a flight, the pilot makes all passengers aware of emergency protocols: this does not make the event of an emergency a likelihood, but it equips the passenger to navigate one, were it to occur. In the same way, this article’s intent is not to exacerbate fear, but to equip new parents that in the worst-case scenario, they would be able to navigate emergency protocols as smoothly as possible, and in a manner honoring to their child. 

In this article, I hope to better prepare and equip parents for the possibility of a stillbirth, and more importantly, to create awareness regarding the resources and options available to maximize the moments with their sweet baby. This is also an important read for birth workers who have not yet walked through a stillbirth with their clients, so they can know the options available to the bereaved parents and feel equipped to show up for their clients fully despite the nature of the birth.

We will be exploring labor/delivery, postpartum, as well as touching on the impact stillbirth has on spousal and family relationships.

Labor/delivery; the process of giving birth to your child, and the options available.

Parents will often be given two options for delivery: a vaginal delivery or a cesarean. In the moment, it surprises many parents that they’d be expected to vaginally deliver their stillborn. While neither option is right or wrong, one of the benefits of vaginal delivery is a lowered risk of complications during future deliveries, as well as the bonding experience with baby that a vaginal birth can provide. Post birth, there is a flood of hormones, that some parents report helps with the immediate emotional and physical pain, allowing for heightened bonding between them and their baby. It is also important to consider what you can handle and remember that a vaginal birth means an induction of labor, which will likely be a much longer delivery then a cesarean birth.

Often parents who choose vaginal delivery may decide to experience labor in different ways than originally planned. Some mothers may choose an epidural, while others may choose heavier medication. There may be benefits to your future grief process in choosing to be aware and alert during the birthing experience; but in this unique scenario, it is important to balance what your body and emotions can handle with what you may regret missing in the future. Once again, there is no right or wrong way to choose to experience this process.

During a stillbirth, it is also important to remember any necessary items you may need at the hospital. In these situations, many parents struggle with presence of mind. Reverting to a hospital check list may help. You will likely need to include some additional items for the circumstances, such as any medication your partner may need- especially anxiety medication, if they believe they may need help with the intensity of the situation; or a special outfit to put baby in for photos and cuddling (sometimes a preemie outfit is best suited if baby is preterm). This outfit will become an important keep-sake later. Some parents bring books, stuffed animals, or something they’d like their baby’s hand prints in. One parent brought their journal so they’d have a page with their son’s footprint, and others bring baby books.

Postpartum; immediate hours after birth, end of life planning, and extended postpartum.

Memory making is an important component of a stillborn birth, and many hospitals offer hand molds/prints/cut locks of hair, etc., Some parents like to read special books to their baby, or give them their first bath, cloth them, swaddle them. These are all things the hospital will allow you to do. You may want to hold onto any swaddle or delivery blankets as well. It is absolutely okay if later you decide you don’t want them, but it will be nice to have the choice available. 

Often, parents are allowed an unlimited amount of time with baby, and most hospitals provide cooling cots to enable extended time for the family- parents can even spend the night with their newborn, and many do. There is no deadline to leave the hospital, and you do not need to be rushed through making memories that will last a lifetime. 

Many hospitals provide a photography session via a volunteer organization. If for any reason, these photographers are not available, stillborn local facebook groups, or local doulas, will likely be able to put you in contact with grief photographers who donate their services. These photos are often priceless during the grieving process, and throughout life. Parents who have them, cherish them deeply. You can always take photos with your baby, but if you aren’t sure you can handle it or aren’t even sure you even want photos of your baby, you can always have the photographer take the photos in a different room and keep them on a hard drive for a later date if you change your mind and want to look at them.

Often in the hospital, a social worker will be available to help parents process end of life planning. There are resources for how to lay your baby to rest and/or offer memorial services to them if you wish to do so. The social worker will walk you through the processes that need to happen. Many funeral homes will donate their services to grieving parents, and there is often a list of local options. End of life planning while freshly postpartum can be overwhelming, but it is not something that needs to be navigated alone.

Parents in this instance will also be provided options for how to part with baby, whether they want to settle them into their travel arrangements or allow the nurses to. A lesser known, and sometimes available option is for the parents to transport their baby themselves, in their car. Some parents may prefer this, to extend time with their child, and to minimize interference from outside parties.

While you are experiencing an unnatural postpartum, you will still experience the after-effects of birth. This means breast pumps and healing supplies will still be required, but there is always the option to have a friend or family member deliver these items to you. You may also want to have a family member or friend go home ahead of you to put away anything that may be upsetting when you arrive- one family wanted their baby’s stuff to be put around their house after the delivery, while another had their doula go ahead and pack everything away. There is no right or wrong way to process. 

While your brain will know something is clearly not right, your body will begin to produce milk almost immediately after birth. Many loss parents are caught off guard by this. Pumping or hand-expressing some milk will likely be necessary to avoid engorgement and mastitis. Some parents prefer to donate their milk, and some prefer to freeze their milk to use at a later time in keep-sake jewelry. There is no wrong way to pump, or to process pumping, as it can be an emotionally heavy experience post loss. One mother I knew would look at a photo of her newborn to help milk flow while she pumped, while another just cried during it. Both were healing in their own ways. You can also ask your doctor, midwife, or lactation consultant the fastest ways to diminish your milk supply if you have no interest in continuing milk expression. Some of the most popular ways are frozen cabbage leaves and taking decongestants but talk to your medical care provider about the most up to date recommendations that work with other medications you are on.

Some mothers also experience something called “empty arms syndrome”. This is where your body longs for a baby to hold after the birth. The bodies physical responses to postpartum can add a layer of distress onto the bereavement process. Some mothers find holding something their baby touched is important to them, while other mothers get things like the molly bear, which is a stuffed animal weighted to the size of their baby at birth. Having something tangle to let your body grieve, alongside the emotional grief, can be an important part of the healing process.

Family/Spousal relationships and support.

Stillbirth impacts all areas of life, including family. Some couples may choose to keep their time with their child more private, while others enjoy sharing their baby with extended family. One stillbirth family had their extended family visit in the delivery room for a few moments. Family members were allowed to hold baby, read them a book, pray over, or sing to them before leaving so the parents could spend time alone with their child. Another couple had their parents meet the baby in a separate room, arranged by the nurses, as they did not want visitors.

Once again, there is no right or wrong decision, so long as you consider how you may feel moving forward. How you choose to include family in the birthing/postpartum process is highly personal and dependent on your familial relationships, but there can be great comfort in discussing sweet features of baby or having family in photos with baby.

Postpartum is an emotionally heavy season to navigate in a marriage, and postpartum and mourning is another thing altogether. While it is difficult, it is not impossible. Many marriages discover new depths and intimacies during this season. One couple described the mourning period as a “second honeymoon of sorts” where the individuals came to know one another in a deeper way through their loss. Often times, however, as both spouses approach mourning uniquely, there will be relational difficulty. This is normal, and often couple-grief counseling or therapy is encouraged as you navigate not only grief, but one another’s grappling with grief. If you can’t afford professional therapy, many churches provide counseling for members, as well as nonmembers; or even reaching out to other couples who have experienced loss can be helpful.

For many new stillbirth parents, they can feel out of place with the “normal” new parent community. There are so many stillbirth communities that can provide a surprising amount of relief to parents. These are available on all platforms- Facebook, Instagram, zoom meetings, or in-person groups. Many parents discover these groups provide a place of community during an isolating time, and a guide path to navigating their new “normal”.

If you’re experiencing an unexpected end to your pregnancy, it is important to know there are resources and options available. You can have time with your baby, build memories to look back on, and experience help with the difficulty of end-of-life planning. You can maximize the sweet moments. While this potential is a worst-case scenario, we hope you end this article knowing that, in that worst case scenario, you will experience support, and the ability to cherish your time with your baby in the manner of your choosing. You will receive community and love in the seasons following.

This is not an article any doula wants to write, or a situation we wish for parents to encounter. But as doulas, our goal is always for the families in our care to be informed and prepared to even navigate seemingly impossible scenarios. We personally desire for you to be prepared to navigate a stillbirth, as well as help you be prepared to navigate your resources and options. Consider this article the pilots’ instructions, or a life preserver on a cruise boat: something we hope you never have to use, as you enjoy the joys of your parenting experience, but something to keep you safe in the case that you do.