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Preparing for a Stillborn: January 26, 2011

I hang out a lot on the grief board of a pregnancy website.  Not as much as I used to, though.  When we first lost Baby T, I was on that board every hour, checking messages, finding others who had gone through the same thing, reassuring myself that this pain could be dealt with, lived with, and that I could move on.  I don’t go to the board as often anymore – there is just too much sadness, too many broken hearts, and there’s only so much grief that you can take.

On Friday I popped in, and a girl had posted asking for advice on what she could expect, both physically and emotionally, delivering her baby stillborn.  The day before, at her 30 week appointment, they found too much fluid in her daughter’s brain, and didn’t expect her to live past 32/33 weeks.  She was going back the following Tuesday (yesterday) and if there was no heartbeat, she would be induced.  She essentially had four days to prepare to give birth to her dead child, and wanted to know what it would  be like, and what she should prepare for, and how she could start to heal with her husband.  I wrote a long response, as did several other women, all of whom shared their stories so she could get ready.

It occurred to me that a sizeable percentage of women experiencing a loss, especially a later second or third trimester loss, will have some notice.  They will need to make appointments, schedule procedures, and they have some time to prepare themselves.  Personally, I think it would be horrific to have to live with your dying baby inside of you for any longer than absolutely necessary, and in some respects I’m grateful that my loss happened so fast.

Still, I think about how lost I was in the immediate aftermath of the labor and delivery.  How I didn’t know what to do, what to think.  I was so drugged up, and people kept coming and giving me papers to sign, and new medicine, and chaplains and social workers and…. it was just a blur.

So I’ve decided to post my not-so-definitive Guide to A Loss of the things that I would have liked to have been told.  This is essentially a mashup of my own response to the original poster on the message board, with some of the tips from other responses thrown in.  If one woman googles “preparing for stillbirth” and finds this, then I will feel like I did a good thing by putting it out there.

First, if you have never had any children before, be prepared for labor.  It’s a serious bitch.  It’s not called “labor” for no reason.  It’s even harder knowing that you won’t be able to hold a gurgling baby at the end of it.  I hadn’t been to any childbirth classes before mine, so I had no idea how to breathe.  If you can just watch one or two videos before, it can make a huge difference.  Once the nurse explained the general concept to me (you don’t let your breath out as you push) it made a lot more sense.  But I went through several hours of not knowing what I was doing.

You will be offered an epidural if you want one.  I had been against them for birth, but I knew my baby wouldn’t make it, so I decided to drug myself out as much as possible, and thus, ordered one.  But because I hadn’t filled out paperwork in advance, signed legal forms, etc., mine was delayed until it was too late to do any good.  There are other options for pain medication if you’re not a fan of the whole needle-in-the-back scene.  NuBain worked for me.

Oh, and just know that labor doesn’t end after the baby comes out.  There’s also the placenta, which, for a lot of mom’s going through a stillbirth is even harder because it’s still attached to the uterus.  It took another 90 minutes for me to deliver the placenta.

It was during that point that I almost demanded a D&E to scrape it out.  I was going mad with pain, kicking and screaming, and I just wanted it to end.  The doctor was so patient, and explained to me that she just wanted me to deliver it all whole so that they knew it had all come out, and it would be much better for me to deliver it on my own than have surgery.  I wanted to kick her in the face at the time, peering up inside of me through her studious-looking spectacles, coaching me through so gently and calling me “mama” – but I’m glad I didn’t.  I got my first period only 30 days after the delivery, and I’ve heard that with a D&E it can take months.  If you can bear it, don’t ask for the surgery.

You will also want to decide if you want to hold your baby.  Grief experts say it’s an important part of the grieving process, but I just couldn’t do it – it was so sudden, so horrific, I just couldn’t bear it.  You have to do what’s right for you, and I don’t regret the decision.  If I had it to do over, I might do it differently, but at the time, with what was going on, it was right.  We said goodbye to him when he was still alive in my tummy – the last time my hubby spoke to my belly.  If you have some time to think about it, though, plan what you want to do with your hubby, and let the nurses know so they can be ready to clean your baby up, and dress him.  You also might want to have a photographer – there’s a group called Now I Lay Me Down To Sleep that sends photographers to do portraits of families with their stillborn.

You will also need to consider what to do with the remains, as well as sign the death certificate.  It can be really unnerving when the nurses come in with stacks of forms, given the fact that you just spent hours in labor.  But they will come in soon after you’re finished, giving you paperwork that needs to be signed in triplicate.  If you have the time, you should call ahead and see whether you can do any of it beforehand.  The hospital will give you a list of local mortuaries, and again, if you can ask for it and get the arrangements started beforehand, it can be a real help.  The mortuary generally needs to be handled within three days of the death, and you’ll be in the hospital for at least the first day or two, and you won’t want to do it on the third day.

You will be spending at least one day in the hospital, maybe two.  So it’s a good idea to pack a bag with some things that will comfort you.  Maybe some nice PJ’s and socks.  Clothes to wear home.  A favorite blanket or pillow. Your cell phone charger.  Extra clothes for your hubby so he doesn’t have to go home (you won’t want him to).  Also, if you have pets, arrange your petsitter beforehand so you don’t need to make the call from the hospital.  You also might want to let your neighbors know what’s going on in advance so they can be ready to help you out as needed.

One thing you will find is that the world is full of people who will want to help you.  People will come out of the woodwork telling you similar stories that they went through, or other family members experienced.  This is so much more common than you know.  And you will be bonded with the other women who have lost babies in such a profound level.  There truly is a Sisterhood with grief like this.  Of all the communities of people to be thrown into, the community of women who have lost a baby is such an amazing group.  Our support group leader says that a new person is carved out of the grief, and you become someone with much more depth and empathy than you ever thought possible, and it’s so true.  I am so proud of this community of women – the strength, the compassion, the love that they show each other.

When you’re in the hospital you’ll be pretty drugged up.  They will give you lots of strong antibiotics to make sure you don’t get an infection (like what happened to poor Lily Allen).  The loss will most likely really hit you hardest when it’s time to go home, and you are passing through the maternity ward with an empty tummy and no baby.  You had imagined going home with your little one, and this is so much more awful than anything  you had envisioned.  The walk out of the hospital will be very hard.  If necessary, just close your eyes and let your husband guide you.

Going home will also obviously suck.  You might have a nursery already set up.  You might have baby clothes lying around, as I did.  At the very least, you will have reminders – a positive pregnancy test you saved, or books on pregnancy.  Don’t deal with anything before you are ready.  I wore my maternity clothes for a good two weeks after the loss because I couldn’t face unboxing my regular clothes, which were up in the attic.  Make sure to pamper yourself an obscene amount.

Remember to give your body time to heal – it’s just gone through a colossal event.  You will need time to recover.  You will have many of the same symptoms that other women who have gone through labor will have.  Your milk may come in.  There are medicines to stop it, but my hospital doesn’t prescribe any because there are some dangerous potential side effects.  I just pumped a little to relieve the worst of the pain, and took advil.  Caffeine also supposedly stops milk production, so you can drink coffee (if you’re a coffee drinker, that will be bittersweet, as you probably cut back while you were pregnant).  You also will want to be careful in the shower for a few days as warm water stimulates milk production.  I just avoided showers for a week.  I wasn’t going anywhere, so it didn’t really matter.  Another symptom you may get is hemorrhoids from all the pushing.  You may be given Colace to help that. Remember to also drink a lot of water (you’ll feel better being hydrated anyway) and eat good foods.  Sleep as you are able.  Even if you can’t sleep, at least rest.

I highly recommend going away on a little trip with your hubby if you are able to.  Even if you don’t go far – just getting away from your home, with all its reminders, will make a big positive difference.  You and your partner will need time to rebuild your relationship in this new reality of pain.  Going away to start to heal together can be a wonderful way to begin the process.  So you might want to make reservations beforehand, just so it’s one less thing you have to think about later.

As far as how to support your husband, he will most likely be most worried about how he can help you.  It must be so hard for our good men to stand by and watch us suffer while they can do nothing to stop it.   Not only are they losing a child too, but they have to just stand there and watch their wife go through agony, and there’s not one thing that they can do about it.  For men who like to Fix Things (like my hubby) I think that is one of the hardest parts.  So let him do anything he can to help.  Even if it’s fixing you dinner, or giving you a backrub – anything so that he can see that he’s helping you.  For me, I just wanted my husband close at all times.  They had set up a cot next to my bed for him, but I wanted him in bed with me, so we squished together, underneath the IV cords, and slept fitfully, but he was close, and that’s what mattered.

Check out support groups – your hospital might have one, or they might be able to recommend one nearby.  There are also a lot of good grief and message boards.  Glow in the Woods is a wonderful website for families and their lost babies.  If you have faith and believe that your baby is in Heaven, then talk to him.  He is your child, and he will love you any way he can.  That might mean giving you signs if you ask for them.  It might mean giving you peace if you trust that he’s with you.

Eventually, the pain won’t stab at you every minute.  Little things will really please you.  When your period comes back, you will realize that your body works, and is healing.  When you feel up to it, you can start to exercise, and you will feel your body supporting you and powering you, and you will feel strong again.  As time passes, and the wound heals a little, you will start to see that this is a chance to completely reinvent yourself if you want.  You can rediscover what’s important to you, what makes you happy, and how you can bring meaning to the life of your baby.

I can’t promise you that it will be ok.  I can’t tell you anything other than that it will be the worst time in your life.  But I can also tell you that you will find reserves of strength that you didn’t know you had, that you didn’t know anybody could have, and that strength will stay with you; it’s a gift your baby gave to you.  And you will get through this.