The Loss of Your Baby

The loss of your baby 179 16 (www.sands.org.uk) Sands (www.sands.org.uk) with can put you in touch other parents who have had a late miscarriage, stillbirth or also have neonatal death. They an online community at www. sands.community/login and a parents’ telephone helpline on 0808 164 3332. Miscarriage Association The (www.miscarriageassociation. org.uk) can give you information with other and put you in touch parents who have experienced can call their a miscarriage. You helpline on 01924 200 799. Some women may have to cope with cope to may have Some women stillbirth pregnancy, ectopic miscarriage, after death (death shortly or neonatal some of why explains birth). This chapter these things may happen.

The lossThe of your baby

offer support and information. support and offer run by are often These bereaved parents. It can be very helpful to talk to another parent who has been through a similar experience. following organisations The may help: Ectopic Pregnancy The (www.ectopic.org.uk) Trust support and information offers for parents who have had an have They ectopic pregnancy. 2653 a helpline on 020 7733 with and can put you in touch other people who have had an ectopic pregnancy.

There are also a number of There voluntary organisations that Talk to the people close to you Talk about and to your how you feel, doctor or health visitor midwife, about what has happened and Sometimes it is easier to why. talk to someone who is not a family member or friend, such as the health professionals mentioned above. If your baby dies during pregnancy or shortly after birth, you will need both information has a Trust and support. Each bereavement coordinator and who can bereavement midwife support you and also put you people and with other in touch organisations who can help you. More information can also website be found on your Trust for ‘bereavement by searching support’. Help and support 16 important to give yourself time to grieve. An ectopic pregnancy involves abdominal surgery or treatment with powerful medicines. It may affect your chances of becoming pregnant again.

It may be helpful to talk to your doctor to discuss the possible Ectopic pregnancy increase the risk. The warning causes and whether your signs start soon after a missed chances of conceiving a baby After fertilisation, the egg should period. have been affected. move down into the uterus to develop. Sometimes it gets These are: Miscarriage stuck in the fallopian tube and begins to grow there. This • severe pain on one side, low If a pregnancy ends before is called an ectopic or tubal down in the abdomen; the 24th week, it is known as pregnancy. Rarely, the egg can a miscarriage. Miscarriages become stuck elsewhere, such • vaginal bleeding or a brown are quite common in the first as the ovary or the cervix. The watery discharge; three months of pregnancy. fertilised egg cannot develop At least one in six confirmed • pain in your shoulders; properly and your health may be pregnancies end this way. Many at serious risk if the pregnancy • feeling dizzy or faint; early miscarriages (before 14 continues. The egg has to be weeks) happen because there removed. This can be done • pain when you have a bowel is something wrong with the through an operation or with movement. development of the baby. There medicines. can be other causes, such If you have any of these as hormone or blood-clotting symptoms and you might be problems. A later miscarriage pregnant – even if you have not may be due to an infection, had a positive pregnancy test problems in the placenta, or the – you should see your doctor cervix being weak and opening immediately. too early in the pregnancy.

Some women have no obvious A miscarriage in the first few signs or symptoms at all and weeks may start like a period, an ectopic pregnancy may with spotting or bleeding and sometimes be mistaken for mild cramps or backache. The Ectopic pregnancy can be irritable bowel syndrome, food pain and bleeding may get worse caused by damage in the poisoning or even appendicitis. and there can be heavy bleeding, fallopian tube, possibly as a blood clots and quite severe result of an infection. Previous Afterwards cramping pains. With a later abdominal surgery and previous You almost certainly will feel a miscarriage, you may go through ectopic pregnancy can also strong sense of loss and it is an early labour. If you bleed

180 The loss of your baby 181 16 anyone close to you, especially anyone close to has happened if the miscarriage You later in your pregnancy. distressed, shocked, may feel may or just numb. You angry, wondering whether guilty, feel your miscarriage was caused by is anything you did or did not do. It important to know that, whatever the cause, miscarriage is never anyone’s fault. If a miscarriage is going to happen, there is very little that anyone can do to stop it. Some people find having something to remember their baby by helps. In an early loss, this may be a copy of a scan picture. If you have a late miscarriage, you may be able to see and hold your baby might also be able if you wish. You to take photographs, footprints and handprints as a keepsake. Some parents a hospitals offer certificate to commemorate their is done because there This baby. is no formal registration of a baby who dies before 24 weeks of pregnancy. Try to talk about your feelings Try with your partner and those might also close to you. You want to contact the Miscarriage Association or SANDS (see page 179). gently widened and the and the gently widened are of your uterus contents by suction. removed If your Induced labour. baby dies after about 14 go into weeks, you may If this doesn’t happen, labour. tablets you will be offered Although that start labour. prefer some women would labour, not to go through than for you this is safer an operation to remove the be cared for will You baby. and supported throughout the labour of and the birth your baby. Both women and men find it difficult to come to terms with a miscarriage at any stage. You a sense will almost certainly feel will need time to of loss. You grieve over the lost baby just as you would over the death of • Afterwards One early miscarriage is unlikely of having your chances to affect a baby in the future. If you have three or more early miscarriages you should be referred in a row, to a specialist for further investigations. However, sometimes no clear cause can be found. You may be Medicine. You tablets or pessaries offered to start the process of miscarriage. Operation. If you have been pregnant for less than 14 weeks, your doctor may advise an operation called an ERPC (evacuation of retained products of conception). It is done under cervix is anaesthetic. The • • Sometimes to it is preferable wait and let the miscarriage but there are happen naturally, three ways of actively managing a miscarriage: Treatment for miscarriage Treatment Some that their women find out baby has died only when they have a routine scan. If they have had no pain or bleeding, this can come as a terrible shock, especially if the scan shows that the baby died days or weeks called is sometimes before. This a missed or silent miscarriage. or begin to have pains at any to have pains at or begin you should pregnancy, stage of your GPcontact You midwife. or local contact your could also unit. If you are early pregnancy seven weeks more than six or be referred pregnant, you may scan to see if for an ultrasound heartbeat and is your baby has a Sometimes developing normally. by itself and the bleeding stops will carry on your pregnancy quite normally. It is devastating to experience a stillbirth or neonatal death.

You and your partner are likely to experience a range of emotions that come and go unpredictably. These can include disbelief, anger, guilt and grief. Some women think they can hear their baby crying, and it is not uncommon for mothers to think that they can still feel their baby kicking inside. The grief is usually most intense in the early months after the loss. Some Stillbirth and neonatal Sometimes a baby dies in the parents find helpful to create death uterus (an intra-uterine death or memories of their baby, for IUD) but labour does not start In the UK around 3,000 babies example they may see and hold spontaneously. If this happens, are stillborn every year. This their baby and give their baby a you will be given medicines to means that the pregnancy has name. You may want to have a induce the labour. This is the lasted for 24 weeks or more and photograph of your baby and to safest way of delivering the the baby is dead when it is born. keep some mementos, such as a baby. It also means that you and About 1,300 babies also die lock of hair, hand and footprints your partner can see and hold shortly after birth. or the baby’s shawl. All this the baby at birth if you want to. can help you and your family to Following a stillbirth or in the topic specific confidential remember your baby as a real event of a baby dying in the enquiries. This work, which person and may, in time, help first month of life, a form called is jointly funded by the UK you to live with your loss. You a perinatal death notification Departments of Heath, brings may also find it helpful to talk to (PDN) is completed by a health together the information and your GP, community midwife or professional. Information is learning associated with every health visitor or to other parents collected about mothers and stillbirth and neonatal death who have lost a baby. SANDS babies from pregnancy through and develops recommendations can put you in touch with other to birth and the early newborn to improve the care provided parents who can offer support period. The form, which is to women, babies and families and information (see page 179). anonymised (it contains during pregnancy, childbirth and no information that could the newborn period. Post-mortems identify individuals), is then One of the first questions sent to a national surveillance Further information on the work you are likely to ask is why programme which is run by a of MBRRACE-UK/NIMACH your baby died. A post- consortium called MBRRACE- can be obtained by contacting mortem examination can help UK. MBRRACE-UK conducts the NIMACH office on to provide some answers, a national perinatal mortality 028 9536 3481 or at although sometimes no clear surveillance programme and pha.site/mbrrace-uk cause is found. A post-mortem

182 available, you will be offered an Multiple births appointment with a consultant The loss of one baby from who can explain the results to a multiple pregnancy is very you and also what these might difficult for any parent. Grieving mean for a future pregnancy. for the baby who has died may, however, provide other while caring for and celebrating information that could be helpful For those parents who choose the life of the surviving baby for future pregnancies and may to have a post-mortem on brings very mixed and complex rule out certain causes. If it is their baby, this will be carried emotions. Often the surviving 16 thought that a post-mortem out in Alderhay Women’s and

baby is premature and in a T he loss of your baby could be helpful, a senior doctor Children’s Trust. neonatal unit, causing additional or midwife will discuss this with concern. For further information you and explain the possible For those parents who choose and support, contact Twins Trust benefits. not to have a post-mortem, (www.twinstrust.org). Staff in the other tests including genetic neonatal unit will support you If you decide to have a full or testing and testing your through this difficult time. partial post-mortem, you will be placenta may provide important asked to sign a consent form. answers as to why your baby When the post-mortem report is died.

Saying goodbye to your baby chaplain will be able to help you. Alternatively, you may prefer to contact someone from your own A funeral or some other way of saying goodbye can religious community, the Miscarriage Association or be a very important part of coping with your loss, SANDS about the kind of funeral you want. You do however early it happens. not have to attend the funeral if you don’t want to.

If your baby dies before 24 weeks, your midwife Many hospitals arrange a regular service of will provide you with information and the hospital remembrance for all babies who die in pregnancy, may offer to arrange for a cremation or burial, at birth or in infancy. Again, you can choose to possibly together with other babies who have died attend if you wish. in pregnancy. If you prefer to take your baby home or to make your own arrangements, you can do that. Many parents are surprised at how much and how You may need some form of certification from the long they grieve after losing a baby. Friends and hospital and they should provide helpful information acquaintances often don’t know what to say or and contacts. The Miscarriage Association and how to offer support, and they may expect you to SANDS (see page 179) can provide further support get back to ‘normal’ long before that is possible. and information. You may find it helpful to contact SANDS or the Miscarriage Association so that you can If your baby dies after 24 weeks, you will need talk to people who have been through similar to register your baby’s birth (even if they were experiences and who can offer you support and stillborn) with the Registrar of Births, Deaths and information. You should be entitled to maternity Marriages. The hospital will offer to arrange a leave if your baby is stillborn or dies after 24 funeral, burial or cremation free of charge, or you weeks. may choose to organise this yourself. The hospital

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