The loss of your baby 16 16 Some women may have to cope with miscarriage, ectopic pregnancy, stillbirth T or neonatal death (death shortly after baby of your he loss birth). This chapter explains why some of these things may happen. Help and support offer support and information. The Miscarriage Association These are often run by (www.miscarriageassociation. If your baby dies during bereaved parents. It can be org.uk) can give you information pregnancy or shortly after birth, very helpful to talk to another and put you in touch with other you will need both information parent who has been through a parents who have experienced and support. Each Trust has a similar experience. a miscarriage. You can call their bereavement coordinator and helpline on 01924 200 799. bereavement midwife who can The following organisations support you and also put you may help: Sands (www.sands.org.uk) in touch with other people and can put you in touch with organisations who can help The Ectopic Pregnancy other parents who have had you. More information can also Trust (www.ectopic.org.uk) a late miscarriage, stillbirth or be found on your Trust website offers support and information neonatal death. They also have by searching for ‘bereavement for parents who have had an an online community at www. support’. ectopic pregnancy. They have sands.community/login and a a helpline on 020 7733 2653 parents’ telephone helpline on 0808 164 3332. Talk to the people close to you and can put you in touch with about how you feel, and to your other people who have had an midwife, doctor or health visitor ectopic pregnancy. about what has happened and why. Sometimes it is easier to talk to someone who is not a family member or friend, such as the health professionals mentioned above. There are also a number of voluntary organisations that 179 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 or begin to have pains at any gently widened and the stage of pregnancy, you should contents of your uterus are contact your GP or midwife. You removed by suction. could also contact your local early pregnancy unit. If you are • Induced labour. If your more than six or seven weeks baby dies after about 14 pregnant, you may be referred weeks, you may go into for an ultrasound scan to see if labour. If this doesn’t happen, your baby has a heartbeat and is you will be offered tablets 16 anyone close to you, especially developing normally. Sometimes that start labour. Although some women would prefer if the miscarriage has happened T the bleeding stops by itself and baby of your he loss later in your pregnancy. You your pregnancy will carry on not to go through labour, may feel shocked, distressed, quite normally. this is safer for you than an operation to remove the angry, or just numb. You may feel guilty, wondering whether Some women find out that their baby. You will be cared for your miscarriage was caused by baby has died only when they and supported throughout anything you did or did not do. It is have a routine scan. If they have the labour and the birth of important to know that, whatever had no pain or bleeding, this your baby. the cause, miscarriage is never can come as a terrible shock, anyone’s fault. If a miscarriage is especially if the scan shows that Afterwards going to happen, there is very little the baby died days or weeks One early miscarriage is unlikely that anyone can do to stop it. before. This is sometimes called to affect your chances of having a missed or silent miscarriage. a baby in the future. If you have Some people find having three or more early miscarriages something to remember their baby Treatment for miscarriage in a row, you should be referred by helps. In an early loss, this may to a specialist for further Sometimes it is preferable to be a copy of a scan picture. If you investigations. However, wait and let the miscarriage have a late miscarriage, you may sometimes no clear cause can happen naturally, but there are be able to see and hold your baby be found. three ways of actively managing if you wish. You might also be able a miscarriage: to take photographs, footprints Both women and men find it and handprints as a keepsake. • Medicine. You may be difficult to come to terms with Some hospitals offer parents a offered tablets or pessaries a miscarriage at any stage. You certificate to commemorate their to start the process of will almost certainly feel a sense baby. This is done because there miscarriage. of loss. You will need time to is no formal registration of a baby grieve over the lost baby just who dies before 24 weeks of • Operation. If you have as you would over the death of been pregnant for less pregnancy. than 14 weeks, your doctor may advise an operation Try to talk about your feelings called an ERPC (evacuation with your partner and those of retained products of close to you. You might also conception). It is done under want to contact the Miscarriage anaesthetic. The cervix is Association or SANDS (see page 179). 181 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.