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Woman And Infants

Taking Care After the Loss of Your Baby

Introduction

Our sympathies to you and your family on the loss of your child. We cannot take your pain away, but we are here for you. We know that you mourn for what you have lost, your hopes and your dreams. 

Grief is a process. There is no right or wrong way to deal with your grief. You may feel numb, angry or afraid of your feelings. Emotions cannot be rushed. You may want to talk and shed tears. Crying is nature’s way of releasing tension. 

You may have difficulty sharing your feelings or prefer to grieve privately. Fathers may grieve differently than mothers. We are here to listen and to help you create memories to hold onto and cherish for a child who will always live in your heart.

On the death of your baby

This information is for you and your family. It was written to help you through this very difficult time. The staff who has cared for you grieves with you. 

After losing a baby, it is hard to know what to do or think. It may be helpful to read the beginning of this booklet while you are in the hospital. It will help you understand the most immediate things you have to deal with. The end of the book lists resources and support groups that you may find helpful to look at later. 

You may have already seen your baby either in the Labor Room, Special Care Nursery, or your postpartum room. If you did not see your baby because you did not feel up to it at the time, we encourage you to see your baby while you are still in the hospital, even if the baby was not born alive. 

If other family members are present, we encourage them to be with you. Some people think that seeing your baby after he or she has died is odd or is a cruel thing to ask of a parent. Most find that seeing their baby helps them to grieve later, when there is time to remember.  

Sometimes you are able to see family features in the baby. This helps you when talking to your family and friends about how he or she looked. It is a nice kind of sharing. 

Some find it comforting to hold the baby. It may make you feel sad, but often helps you to see and know the baby you have lost. You then have a face to remember later, instead of feeling a kind of emptiness.  

The emptiness makes it hard to believe that the birth and death really happened. People who did not see their baby after he or she died often say later how much they wish they had. It is a way of saying goodbye.

Autopsy

While you are in the hospital someone may ask you if you want an autopsy done. An autopsy is a medical test that lets doctors look at the illness or injury present at the time of your baby’s death. There are four reasons why people may want to have an autopsy:

  1. The most important reason to have an autopsy is help find and understand the cause of your baby’s death.
  2. If the cause of death is already known, an autopsy can help to find out if your baby died from a genetic condition that could happen again with future children. This genetic condition could also be present in other family members.
  3. If your baby died from an infection or other known reason, an autopsy could help doctors determine the extent of the disease. This allows doctors to closely study and explain the effects of treatments that were used.
  4. The information from an autopsy may help in guiding treatment for other babies. An autopsy may also suggest ideas for treatments that can lead to future cures.

If you are interested, a more detailed explanation about autopsy will be provided to you separately.

Burial, cremation and funeral arrangements

After the loss of a baby, there are some reasons that a burial/cremation and funeral may be legally necessary. The baby’s age and condition at birth usually determine whether burial arrangements are required. While families are responsible for making their own arrangements, a social worker will talk with you about what you may need to do next. If you have not already spoken with a social worker, please ask your nurse to arrange a visit.

You may bury or cremate your baby. Whether to have a ceremony, like a funeral or religious service, is your choice. Some people find that this helps with the grieving process, so if you do choose to have a ceremony, we suggest that you schedule it when you will be out of the hospital so that you can attend.

These are difficult decisions. You may want to talk with your family members or friends for guidance. By making careful decisions, you will be less likely to feel angry or upset by rushed decisions when you look back on this later.

While you are in the hospital, we hope you find these services comforting.

After losing a baby, grief comes in different forms - some physical, some emotional and some spiritual. Our nurses and social workers are available to care for you and to provide you with some emotional support. While in the hospital, Women & Infants offers the following spiritual services that you may find comforting:

  • Your Clergy - Clergy of all faiths are welcomed and encouraged to visit you while in the hospital. Let your nurse know if you wish us to notify your clergy or spiritual leader of your admission to the hospital.
  • Meditation Room - There is a Meditation Room on the first floor, adjacent to the Main Lobby, that can be used by all our patients and families.
  • Eucharistic Ministry - If you wish to receive communion, please let your nurse or the unit secretary know and your name will be placed on the list to receive communion during your stay.
  • Pastoral Visits - Pastoral Care Interns, who are part of the Interfaith Health Care Ministries Training Program, are available to visit with you and your family. They can be paged at 453-4573 or through the hospital operator.

    The Rhode Island Hospital Roman Catholic Chaplains are available to patients in the hospital in emergency situations. They, too, can be paged through the hospital operator or your nurse.

    A Roman Catholic Volunteer Chaplain is also available.
  • Chapels - There are two chapels on the hospital campus. One is located at Rhode Island Hospital and another at Hasbro Children’s Hospital.

For any special needs or requests, please contact the Women & Infants’ operator at extension “0.”

How to obtain certificates

To obtain birth and death certificates for the baby, please call Vital Records at Providence City Hall at 401-421-7740 or the Department of Health at 401-222-2812.

Caring for yourself at home

It is important for you to remember that grief affects your body, too. You need extra care and attention as your body returns to an un-pregnant state. Give yourself a break - ask for help when you need it and get back into your daily routine slowly.

Activity

  • Increase your activity slowly.
  • Periods of feeling tired are normal.
  • If you are taking pain medications, they may make you tired and make driving a car unsafe. Ask your doctor when you can start driving again.
  • For the first couple of weeks, avoid heavy physical exercise and lifting heavy things.
  • Stay out of swimming pools until vaginal bleeding has stopped.
  • If you had a cesarean birth, limit your activities to doing light housework and other things that will not cause strain on the stomach.
  • After three weeks you may begin to increase your activities at your own rate, as you feel comfortable.

Eating Well

While you may not feel like eating, it is important to eat a well-balanced diet to help your body recover physically and emotionally.

How much fluid should I drink?

  • Drink 8 to 10 glasses of fluids (water, juice, milk) every day.
  • Avoid alcohol the first few weeks after delivery.

What foods should I eat?

  • Eat foods with protein (meat, fish, eggs, milk and cheese) every day.
  • Include fresh fruits, vegetables, bran and bran products to help you have a bowel movement. If you have a problem going to the bathroom, talk to your doctor or nurse about a laxative or stool softener.
  • Eat milk products (including cheeses, yogurt).
  • Eat breads, cereals, pasta and rice.

Breast Care

Your breasts may become very tender or swollen. This is called engorgement. This begins on the second or third day and lasts about 24 hours. If your breasts become engorged:

  • Wear a well supporting bra 24 hours a day. Remove for bathing only.
  • Avoid handling your breasts, and do not express or squeeze out milk.
  • If your breasts hurt, you may take Tylenol.
  • Apply ice packs to the breasts to ease discomfort and help dry the milk.

Bleeding

  • Bleeding from the vagina is normal in both vaginal and cesarean births. It usually lasts 10 days to 3 weeks.
  • The color will change from bright red to brownish to tan, and will become less in amount and then disappear.
  • If your bleeding increases without having increased activity, try resting for an hour. If your flow does not decrease, call your doctor.
  • You may take showers or baths at any time.
  • Do not douche, use tampons or have intercourse until after your six-week check-up with your doctor.

Birth Control

  • Your doctor may advise you to take time for your body to recover and for you to grieve the loss of this baby before you get pregnant again. You can get pregnant shortly after delivery even if you do not have regular periods. You should think about a birth control plan before you go home.
  • You may use condoms with or without foam that you can buy at the pharmacy.
  • If your doctor has ordered “the pill” for you, use another form of birth control (foam and condoms) for the first month.
  • Speak to your doctor about the many different choices of birth control.

Episiotomy Care

  • Soak gauze pads in cold Witch Hazel and apply to the episiotomy for 10 to 20 minutes.
  • Sit in a sitz bath or tub of warm water for 20 minutes, three times a day.
  • Take a non-aspirin medication such as Tylenol.

Warning Signs

Do not hesitate to call your doctor for any problem that concerns you, or if you should experience any of the following:

  • difficulty breathing or shortness of breath
  • fever of 100.4 or higher
  • severe pain in your chest, leg or abdomen
  • tender, painful or reddened breasts
  • increased vaginal bleeding, bright red clots or a very bad odor
  • painful or frequent urination
  • severe pain, tenderness, redness or any drainage from your incision
  • severe headaches or vision problems

Coping with the grief

Grief is a process, a kind of journey you go through. Along the way there will be ups and downs. There will be times that you will not be able to get certain thoughts or memories out of your mind. Some days things will seem sunny. Other days you will feel so sad, you think it will never end.

In the hospital, you may cry a great deal and feel like your heart is breaking. Some feel as if they are in shock. You may feel numb, or hear yourself talking about the baby, but feel detached as if the death never happened. The feelings often come through in bits and pieces. There may be times you feel uneasy, and cannot describe what the feeling is.

When you go home, you may feel your arms aching to carry the baby you expected to bring home. Or you may feel a flat stomach and feel as if there is a big hole there, or again, like it never happened. Your breasts may fill with milk and painfully remind you that you have lost a baby. The range of emotions is endless and normal. You are not alone.

Why do I feel so out of control?

At home, strong and confusing feelings start to appear. Grief appears in bouts of irritability. Small things may bother you and make you “fly off the handle” or lose control. Some feel an overwhelming need to be alone. Visitors and well-wishers may annoy you. The phone ringing makes you want to hide. At the same time, however, you may not want to be alone.

The baby can come back to you in dreams and vivid flashbacks. Sometimes the dreams are so real they can be frightening. You might even think you hear a baby cry when there is no baby there. It can feel like you are losing your mind.

Dealing with the guilt

You may find yourself going over and over the time before the birth, saying to yourself, “What if, what if, what if I hadn’t reached for that bowl, or mowed the lawn, or gotten upset with so-and-so.” Parents spend a lot of time worrying about what they did to cause the loss. They blame themselves and feel guilty. Invariably, they did nothing to cause the loss.

It is easy for a woman to feel bad about herself at this time. It is all too easy to feel as if your body is not good enough, as if you have failed. You blame yourself. Many find it helps to set up an appointment with their doctor at a later time to get answers to these feelings of self blaming and “what if’s.”

These feelings and thoughts are one way your body expresses the shock of what has happened to you. The feelings of grief are a way of healing the wound left by the loss. It is natural and necessary to have these feelings. They will pass with time.

It is natural to feel angry

One of the hardest feelings for women to deal with and express is anger. Women are brought up not to express anger, but to “be nice.” So when anger takes over, often when you least expect it, we are frightened and unprepared. The irritability you feel is part of the anger and can come in various forms.

Anger is very disturbing, but is a normal part of grief. Women who have lost a baby often feel anger at God, their husband or boyfriend, themselves, at nurses and doctors. Some of the blaming may be deserved, but the rest of it has to do with the rage we feel at a world so unjust to take away a baby.

For instance, you may find you are furious with your best friend because you have just seen her happy and pregnant. Or, you may feel an out-of-control rage at hearing a woman complain at what a nuisance it is to take care of a small baby. Or, you may want to punch the woman in the supermarket who is dragging her child screaming across the floor.

Everything changes. You no longer tend to take things for granted, and it angers you when you observe others not treating pregnancy, infants and children preciously.

Remember that you are not alone in your anger. Other people who have lost an infant will know what you are feeling. It’s alright to talk about it. A friend who has experienced an infant loss will be able to share and trade stories of the anger. The feelings of anger seem terrible and shameful...until you realize that everyone who goes through this feels the same way. In time, these strong feelings will fade.

Physical symptoms accompany grief

Grief is expressed in feelings and in physical ways. Your body shows grief by unusual fatigue and lack of energy. Your arms or chest may ache or feel tight. Your family and friends may tell you that you are sighing loudly, and you are not even aware of it. You may find it hard to concentrate. People talk to you and later you realize you did not understand or remember a word they said.

Your sexual response may be dulled for a while. You may start to worry that you have lost all sexual interest. It will come back. Give yourself some time.

You may lose your appetite for a while. Many find they can’t sleep, or they wake up early in the morning and can’t get back to sleep.

These are all normal responses of the body to the shock it has felt. You can talk about these symptoms with family, your social worker or your doctor. If you are still feeling this way after several months, call your social worker or doctor. Don’t believe that you will feel like this forever. In time, you will begin to feel normal again.

Dealing with the loss as a couple

Everyone feels grief differently and has different ways of expressing it. This is especially important for parents to know because it is easy to get into fights with each other once you are home.

If one of you is very depressed, it may make you angry to see your partner feeling good. You may interpret his or her good mood as not really caring about the baby. It may make you feel they don’t understand you. You may get angry at them for feeling different from you and want to strike out at him or her because you feel as if you have been abandoned. That may make your partner withdraw even more.

Talk to each other - give each other a lot of room. Talk to your family and friends when you feel you are being a burden to each other. Remember that it is a difference in style and timing. People grieve at their own pace. Sometimes you will cry together, sometimes not.

Sex can be a problem for couples after they go home. Some couples get closer, but others have trouble. For example, a man may want to show his love and caring for his partner by getting physically close, closer than words will bring him. The woman can easily interpret this as his being insensitive and pleasure-seeking at a time when they should be mourning.

The way to work through these problems is to keep talking. Tell each other your feelings. You may be thinking your partner is feeling something which, in fact, he or she is not. Assuming and not understanding what the other is feeling can really cause problems.

Especially for men

Nobody really knows if men and women grieve differently. There are so many ways to grieve. In this society, we expect that men hold in their feelings more than women. Men are taught to be “strong,” which means to show no feelings, while its OK for women to express emotion and to cry.

Usually, men feel that they have to protect their wife or girlfriend when they leave the hospital. They take care of practical matters and try to shield the woman. Once at home, the woman’s grief may be strong, she feels her empty stomach and aching breasts. She often relives the scenes in the labor room or later in the nursery. Then slowly, she starts to heal. In several weeks or a few months, she has more and more good days.

As she starts to feel better, the father will often start to fall apart. He might start having fights at work, be irritable at home, get speeding tickets, drink more, or stay out nights. This could be his grief showing at a time when he feels that his wife or girlfriend is safe, and he can begin to let go.

Men need to grieve, too. It may not help to try to protect the woman from her grief. Being “strong” does not necessarily mean holding in feelings, but expressing and living with them. Grief is healing...and fathers need to heal, too.

Being strong

It is sometimes not only the man’s role to be strong. There are plenty of women who feel it is up to her to be “strong for the family.” To a woman, “being strong” might mean she should not show or express her feelings, so as not to upset the children or the father. Instead she goes about her day, taking care of everything, making everything alright, smoothing things over. This makes it hard to grieve.

At Women & Infants, we believe that “being strong” is being able to feel those painful feelings, talk about them with someone safe, and allow them to be expressed. If feelings don’t get expressed, they are often acted out in negative behaviors such as drinking, overeating, fighting with others, staying out nights, physical complaints, losing or changing jobs, or moving to another area without preparation.

Talking is safer.

Grief hangs on

You may be alarmed to find that grief hangs on longer than you expect. It can last six weeks, six months, or even a year. It is different for everyone.

You may get flashback memories about the baby, the delivery or other scenes from your experience. This can happen again and again. You may feel the need to tell your story over and over. You realize that people may get tired of hearing it, but you can’t help it. Sometimes you may have the feeling that you don’t want to feel better because that would mean you would be “forgetting” the baby. You may feel you are betraying the baby by feeling happy. Don’t worry. You will never forget the memory of your baby, even when you are in a happy period. That memory will stay with you forever.

Your grief may return on certain days such as anniversary dates - the day the baby died, the day the baby was due, the day you learned you were pregnant, the day the baby was born. These anniversary dates are powerful, even years later. Respect your feelings. Give yourself the freedom to do what you want on those days.

How to help yourself

You have read a lot about talking. And it really is the best way for most to heal. There are all kinds of people you can talk to...look for them. If you can’t find someone in your family, look to your friends, counselors or a support group for bereaved parents. Professional counseling is a good choice if your family and friends are not helpful. This is a healthy choice and nothing to feel ashamed about. Women & Infants’ social workers can meet with you or help you find someone to talk to.

Take good care of yourself. Allow yourself to feel pain without confusing things with alcohol or drugs. Those make it worse. After about six weeks, be sure that you are getting enough rest, exercise and good nutrition. If you let your body go, you will feel worse about yourself, and that can make you more depressed. It can be a vicious cycle.

Be careful about changes and big decisions, like moving or changing jobs, or even separating from your partner. Sometimes these changes can’t be helped, but make sure you are not doing it to try to escape your grief. It won’t work. The grief will follow you. Change only brings more stress.

What to tell your children

You know best how to talk with your children. You know their words and experiences and can tell them what happened in a way they will understand. You also know how much they want to know and when. You will know how much they can understand by how old they are. If they are still babies themselves, you cannot talk to them like you would a five-year-old.

We strongly encourage you to tell any other children you have that the baby died. We encourage you to do this as soon as the mother comes home from the hospital or sooner, if possible. Children are sensitive to your moods. They can pick up the emotional strains in a family very quickly. When someone in the family is angry or sad, they know it first. So when you go home from the hospital or even before, they will know that something is wrong. And they will worry.

Most children assume that if their mother or father is upset, it is probably about something the child did. They need to know that is not the case. Children can easily think that they caused the death of the baby by resenting the attention the unborn baby got, or by feeling jealous of the baby’s future existence at home. These are normal feelings and common to children of all ages.

Your child may ask questions for a while, or the questions may come and go. Answer them as they are asked. Respect their pace, yet encourage them to talk when you think the time is right. Your child may re-enact the death of the baby through drawings, talking or making little sculptures in playdough or clay. This is alright. It is the child’s way of trying to make sense of a difficult mystery. Children need to say goodbye, too.

It is up to you whether your child attends the funeral or other ceremonies you may have. Family members make this decision by talking to one another. More important is that the child knows that it is alright for parents and family members to cry and grieve, and that in spite of the tears, the child is still loved.

Suggestions from other grieving parents

  • Acknowledge your pain.
  • Reach out to family and friends.
  • Share your thoughts and feelings. It helps the healing process.
  • Create a ritual or remembrance tradition.
  • Take care of yourself. It takes a lot of energy to grieve.
  • Make time for yourself.
  • Seek out a support group or professional help.

Women & Infants’ Resources

Warm Line: 1-800-711-7011
The Warm Line is staffed by experienced registered nurses who you can talk to and who can refer you to the appropriate professional services.

Behavioral Health: 401-453-7955
The Behavioral Health Department at Women & Infants is staffed by psychologists, psychiatrists and social workers who are experienced in women’s mental health issues.

Social Service Department: 401-274-1122, extension 1360
If you had contact with a social worker after your loss, you can contact her for further support or resources.

Your Health Care Provider
Your health care provider is concerned for your emotional and physical well-being. He or she can assist you in treatment and appropriate referrals.

Local Support Groups

M.I.S. Group (Miscarriage, Infant Death and Stillborn Group, Inc.)
A non-profit organization for parents who have experienced the loss of a baby through miscarriage, infant death or stillbirth. Begun in 1986, it is a refuge for the bereaved to obtain support and information from facilitators who have themselves gone through the grieving and healing process.

P.A.L.S. Group (Pregnancy After Loss Support)
A self-help organization for parents who have lost a baby through miscarriage, selective termination, stillbirth, neonatal death, sudden infant death, or accidental death, and who are now in or considering a subsequent pregnancy.

Resources for Parents

Books

Cacciatore J (1996) Dear Cheyenne, A Journey into Grief: A Collection of Angels and Love, A Celebration of Motherhood. Mothers in Sympathy & Support.

Diamond K (1991) Motherhood after Miscarriage. Adams Media Corporation.

Doerr MB (1992) For Better or Worse: For Couples Whose Child Has Died. Centering Corporation.

Faldet R, Fitton K (1997) Our Stories of Miscarriage...Healing with Words. Fairview Press.

Gradstein B, Freidman R (1996) Surviving Pregnancy Loss: A Complete Sourcebook for Women and Their Families. Carol Publishing Group.

Ilse S (1990) Empty Arms: Coping After Miscarriage, Stillbirth and Infant Death. Wintergreen Press.

Lothrop H (1997) Help, Comfort & Hope after Losing Your Baby in Pregnancy or the First Year. Fisher Books.

Marks S, Allen M (1993) Miscarriage: Women Sharing from the Heart. Wiley, John & Sons, Incorporated.

Moffitt PL, Wilkins IA, Kohn I (2000) A Silent Sorrow: Pregnancy Loss - Guidance and Support for You and Your Family. Routledge.

O’Leary J (1998) Pregnancy After Loss. Abbott Northwestern Hospital.

Woods J, Woods JE (1998) Loss During Pregnancy or in the Newborn Period. Jannetti Publications, Incorporated.

Newsletters

Abiding Hearts, a newsletter for parents who choose to carry a baby with a genetic defect to term. A donation of $5 is requested to help defray mailing costs.Maria Vissher, P.O. Box 5245, Bozeman, MT 59717.

M.E.N.D. - P.O. Box1007, Coppell, TX 75019. (888)695-MEND. Christian-based newsletter for women who have lost infants. Donation sponsored Ministry.

Our Newsletter - c/o Jean Kallantai, P.O. Box 1064, Palmer, AK 99645. (907) 746-6123. Publication for CLIMB, Inc., a support network by and for parents who have experienced the death of one or more, both or all babies from a twin or higher multiple pregnancy, during pregnancy, at or after birth, or in childhood.

Parents in Touch - published quarterly by Neo-Flight, 4634 Idlewild Lane, Carmel, IN 46033. (317)255-5242. Support for families experiencing high-risk pregnancy, premature or critically ill newborn, fetal or infant death. Yearly subscription $10, or free with $25 annual membership.

Loving Arms - Pregnancy and Infant Loss Center, Inc., 1521 E. Wayzata Blvd., #30, Wayzata, MN 55391-1939. (952)473-9372. $20 yearly subscription.

Websites

A Place to Remember, www.APlaceToRemember.com

Grief Loss & Recovery, www.erichad.com/grief

Wisconsin Stillbirth Service Program, www.wisc.edu/wissp

SHARE Pregnancy & Infant Loss Support, Inc., www.NationalSHAREOffice.com

Resources for Children

Arnold JH, Gemma PB (1983) A child dies. A portrait of family grief. Aspen Systems Corporation.

Dodge N, Lamb, Sr JM (1985) Sharing with Thumpy (workbook). Prairie Lark Press.

Dodge N (1983) Thumpy’s Story. Prairie Lark Press.

Dodge N, Lamb, Sr JM (1985) Thumpy’s story - A story to color. Prairie Lark Press.

Gryte M (1988) No New Baby (booklet).

Jewett C (1982) Helping children cope with separation and loss. Harvard Common Press.

Mellonie B, Ingpen R (1983) Lifetimes. Bantam Books.

Oehler J (1978) The frog family’s baby dies (coloring book). Duke University Medical Center.

Schaefer D, Lyons C (1986) How do we tell the children? Newmarket Press.

Tapp KK (1998) No Smile Cookies Today (for grieving children). Pregnancy & Infant Loss Center Incorporated.

Viorst J (1971) The tenth good thing about Barney. Atheneum Publishers.

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