When a friend or relative announces that she is pregnant, it probably never crosses most people's minds that the outcome may not be a cause for celebration. And why would it? That's exactly the result of the vast majority of pregnancies. However, sometimes things do go wrong and despite the fact that, these days, we are much more open about a whole range of subjects that were once taboo, the loss of a baby is a topic that is not openly discussed.
Hopes and aspirations
For anyone who has not experienced the loss of a baby it is hard to comprehend the phenomenal grief that affects both the mother and the father. “Even though the foetus may only be the size of a jelly bean,” says Michael Bennett, professor of Obstetrics and Gynaecology at the University of NSW's School of Women and Children's Health, “the woman's grief can be extraordinarily deep because the being inside her is a baby, and when that baby dies, all the aspirations and hopes that the mother had for her child are also lost”.
So often when someone has suffered the loss of a baby, their friends, family and work colleagues do not know what to say and do. As a result, they can end up not acknowledging the loss at all simply because they don't know how to broach the subject.
Adrienne Ryan, a councillor for Ku-ring-gai on Sydney's north shore and author of a book on the subject, A Silent Love, has suffered several miscarriages, as well as losing twins at four months' gestation. Often, she explains, people avoid the subject, because they don't know what to say.
“My main advice to anybody is to acknowledge that there was a baby, ” she says. “And to not give in to the desire to say, ‘You're young enough to have another one’, and all those platitudes that drive you crazy when you hear them. Because although you may be able to have another, it isn't this one. ” Psychologist Dianne McGreal, who works with miscarriage, stillbirth and neonatal death support organisation Bonnie Babes Foundation, and who herself has lost three babies, agrees. “Don't even try to think how you can make it better for the person,” she says. “Just be very honest and say, ‘I don’t know what to say, or what to do, but please tell me what you need’ ”.
Fathers hurt, too
With the death of a baby, the sympathy tends to be for the mother while often the father's emotions are ignored or forgotten. Adrienne Ryan recalls that when she lost the twins, people sent her flowers and letters, but no-one acknowledged her husband, former NSW Police Commissioner Peter Ryan. “People tended to forget that Peter had suffered a loss, too, and was grieving”. Peter Ryan believes that fathers have to be prepared for that response but says that when men do talk about how they are feeling, they receive a lot more sympathy than they expect. He is also adamant that, as a father, it is necessary to discuss what has happened. “Talk to your work friends about it,” he advises. “Don't be the strong man. If you do talk about it, particularly to close friends, it gets it off your chest, and you find there is a lot more sympathy there than you think.”
Not only are both parents suffering a huge loss and overwhelming grief, but they may find that their grief processes are very different. “Quite often, dads have to grieve very quickly and acutely, as they usually have to return to work,” explains Ms McGreal. This need to get on with things can result in the father's unresolved grief issues surfacing further down the track, in the form of arguments or anger, especially if six months after the event, he's arriving home and finding his partner still crying. Ms McGreal says that it is important for fathers to realise they can't fix the problem, but they can support their partner and allow her to grieve.
Mementoes and rituals
After the death of their twins in 1987, Adrienne and Peter Ryan planted a cherry tree in the churchyard near Adrienne's mother's home in England. On the anniversary of the twins' death, their grandmother places a bunch of primroses at the base of the tree and, during a recent visit to England, Peter took photographs of the now large tree in full flower.
Teresa Streckfuss (see story, p85), who lost two babies to neonatal death, stresses the importance of the photos she and her husband took of their babies. “I found the photographs really significant in the weeks immediately after they were born,” she says. “A lot of people don't realise how important it is to be able to look at your baby again after the funeral when everyone else has moved on”. Teresa and her husband also recorded their babies' weights, and they kept their crib cards as special reminders.
Heal through grieving
“Grieving is the way we love in the absence of a person,” explains Ms McGreal, who holds a service every year for people whose babies have died. “The relationship always continues, but it continues in another form. If you carry on loving and having this relationship, it will allow you to heal”.
Mother of two Josephine Macey was about 14 weeks pregnant when, one evening in October last year, she started having cramps. The cramps were stronger than they had been with her first two children and after a couple of days, the pain got more intense, so she made an appointment to see her doctor. After having an ultrasound, she learned that she was miscarrying and that her baby had died at nine weeks.
She started to bleed heavily and the pains increased, so she was sent to hospital right away. There she was told she was unable to have a curette and, instead, had to give birth to her dead baby. Afterwards, she was placed in a maternity ward.
“It was heartbreaking losing a baby and knowing that you were meant to be in hospital because you had your baby,” she recounts. “But you don't have your baby with you, and you're hearing everyone else's babies crying around you”.
Josephine says she has never seen her husband as hurt as he was after the loss of their baby, but the experience has brought them closer together as a couple.
Her husband didn't want her to have any more children at first, because he could not bear the thought of seeing her go through that again, but now she reports she is five weeks and five days pregnant.
At her 18-week ultrasound, Teresa Streckfuss was told her baby had a congenital disorder called anencephaly. As she explains in the book Defiant Birth**, despite the doctors' presumption that she would terminate the pregnancy as the baby was expected to die shortly after birth, she decided to go full term.
Teresa spent the second half of her pregnancy knowing that her baby was sick, but she and her husband, Mark, chose to make the most of the precious time they had with this child.
They made a detailed birth plan explaining clearly what they did and didn't want. They had wonderful support from their midwife, Teresa recounts, and also friends and family.
Baby Benedict lived for just over 24 hours. He was baptised by a priest who was a friend of the family, and who also acted as the unofficial photographer. He was visited by his siblings and his grandparents, aunts, uncles and cousins.
The night before his funeral, they took his body home and his siblings also spent time rocking him, singing to him, and making sure he had teddies with him.
Nine months after giving birth to a healthy boy, Teresa found herself pregnant again. At the 12-week ultrasound, the couple discovered this baby had anencephaly, too. Teresa describes having to deal with “lots of dark, out-of-control feelings ”, as she and Mark came to terms with the fact that it was happening to them again.
Charlotte lived for six days and spent the last day of her life at the family home. “There has been so many blessings mixed in with all the heartbreak,” Teresa says about Benedict and Charlotte. “I am sad they couldn't stay, but I am so glad they came at all”.
Victoria Savinos was 39 when she fell pregnant in 2002. Being an older mum, she was concerned about miscarrying in the first few months, and also about the possibility of Down syndrome. She and her husband, Gerald, decided to keep the news of the pregnancy quiet until she reached 20 weeks.
At 35 weeks, Victoria realised she could not feel the baby moving around. Her obstetrician told her to go to the hospital, where a foetal heart monitor revealed there was no heartbeat. Then an ultrasound showed that her baby had died.
The following day she was induced and had to go through the entire birth process. Baby Adam was born at 10.15pm with the umbilical cord wrapped around his neck, which, Victoria was told, was why he was stillborn. She kept her baby with her for the rest of the night. “I’m really glad I was given the opportunity to be with him,” she says.
Victoria went back to work three weeks after the birth but admits she cried throughout the day. Eighteen months on, she is still grieving. “I am perceived as being a strong woman,” she admits. “Yet I fell apart in a way no-one expected – not even my mother. Losing a baby is the ultimate tragedy”.
Just recently Victoria has felt that she is ready to have another baby, and so Gerald and she are now trying to conceive.
One in every five pregnancies ends in miscarriage and one per cent of all babies are either stillborn – developed enough to survive outside the womb but who die before birth – or die within 28 days of birth.Miscarriage
A miscarriage is the loss of a baby within the first 20 weeks of pregnancy. According to Michael Bennett, professor of Obstetrics and Gynaecology at the University of NSW's School of Women and Children's Health, two-thirds of miscarriages are due to a major chromosome abnormality. Sometimes, when women suffer recurrent miscarriages, it is due to a congenital abnormality of the uterus or a blood clotting disorder. In 40 per cent of women the cause is unknown.Stillbirth
A stillborn baby is one who dies in the womb after 20 weeks. Sometimes the cause of death is a congenital abnormality but in many cases, the cause is unknown.Neonatal death
Neonatal death occurs within 28 days of the baby being born. Often, the reason for the death is because the baby is too premature to survive. Over the last 20 to 30 years, the neonatal death rate has fallen dramatically because of the enormous advances made by neonatal paediatricians.
If you would like more information, or if you need support, call Bonnie Babes Foundation on (03) 9803 1800 or visit www.bbf.org.au; call SANDS (Stillbirth And Neonatal Death Support) Australia on (03) 9899 0217 or visit www.sands.org.au; or call Bereavement CARE (counselling advice referral education) Centre on 1300 654 556 or visit www.bereavementcare.com.au.
* A Silent Love by Adrienne Ryan (Penguin), rrp $24.95.
**Defiant Birth by Melinda Tankard Reist (Spinifex Press), rrp $27.97.