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Stillbirth and Newborn Death
The birth of a child is one of life's greatest
celebrations. Especially during a multiple pregnancy, parents fantasize
about their babies, about walking them, showing them off to friends and
family, trying out names and how they sound. When the outlook is positive,
those close to the couple share in the journey as excitement and
anticipation mount.
Yet when one, more or all of the babies dies
by miscarriage or stillbirth, parents at times are encouraged to consider
a miscarriage or stillbirth as something less than a "real" death. People
around you often want to help, but find it difficult to understand the
special circumstances of your loss. Information from Multiple Births
Canada and other resources mentioned in this article can assist them say
and do things that are helpful and avoid those that are hurtful.
If you do lose one, more or all of your babies, you may wish the
birth and/or death certificates to reflect the fact that your baby(ies)
was part of an appropriate multiple birth set, i.e. loss of one triplet
does not make it a "twin birth", loss of two quadruplets does not make it
a "twin birth" and so on. You may need to be vocal about your wishes as
some hospitals may record only the surviving baby(ies) and not your
accurate multiple birth.
Stillbirth and Newborn Death
For women carrying multiples, prematurity remains the leading
cause of death. Approximately 10% of all perinatal deaths are multiple
birth children (Multiple Births Canada's Fact Sheet, Multiple Birth Facts
& Figures, 1998).
In spite of our best precautions, premature
birth can still occur. There are no guarantees against the early delivery
of your babies. Even in spite of appropriate and timely intervention by
hospital staff, a loss of one, more or all of the babies may still occur.
If such is the case, you will no doubt be:
- grieving for your baby(ies);
- grieving the loss of a unique type of parenthood;
- feeling shocked, empty and alone with disappointment,
anger, sadness and grief;
- wondering how this could happen and fear that you might
not have other children.
The loss of one baby from the multiple birth set, can
present complicated emotions to deal with:
- why this baby and not the other?
- Did I resent or fear the thought of looking after two,
three or four babies and thereby cause this to happen?
- Did I "wish" one or more babies "away" and cause this
to happen?
- Did my preference for one sex cause this baby to die?
- How will I tell the survivor(s) about her sister and
when?
While these thoughts are normal, they also increase the
burden of guilt and grief. Don't leave these feelings bottled up inside of
you. Talk to a grief counsellor, good friend, hospital staff, your partner
or religious support person, in order to assist you in putting your
feelings into perspective.
Losing one, more or all of your babies
leaves the parents and those who care about them to deal with complicated
issues. Some of these issues are:
- Not only have you lost a baby(ies), but you have also
lost a unique parenting experience. Seeing other people with their
multiples is a painful reminder of your loss, and may trigger feelings
of envy, anger, failure or sorrow. In addition, when there is (are) a
surviving child(ren), it can be difficult to resolve the conflict
between the two extreme emotions that you are feeling - that is, the joy
of the birth of a baby(ies) and the sorrow of the death of a baby(ies).
- Your feelings may include rage, shock, numbness, guilt,
panic, being out of control, powerlessness, confusion, and/or denial.
You are adapting to a new reality and it takes time to adjust. In fact,
we are never the same after the death of a child(ren). We adapt and go
on, but we are not the same. Grief is a journey, not a destination.
Expect powerful feelings to resurface at different times as you walk the
rocky road. It is healthiest to allow yourself the neeed time to
experience them as they arise, rather than suppressing them.
- You may not wish to be touched or held for a period of
time after your loss because of a fear of losing control of your
emotions. At work or in social situations, you may not wish to discuss
your children or your loss, afraid that you will break down in tears and
be unable to stop the flood. It helps to tell family, friends and
co-workers what you do and don't want to talk about. Every parent is
different. While some want and need to talk about their distress with
anyone who will listen, others wish to keep their personal pain separate
from their social responsibilities. It helps to tell family, friends and
co-workers what you do and don't want to talk about.
- You may find that people pay more attention to the live
baby rather than the fact that one (or more) died. They may feel that
dwelling on the dead baby may make things more uncomfortable for you.
Feel free to speak up if you wish to speak of your dead child(ren).
Others will be more open about their thoughts if they know you are happy
to hear your dead baby's name and consider him or her to be a special
part of your family.
- On the other hand, you may wish, yourself, to push all
thoughts of the dead baby(ies) out of your mind and concentrate on your
surviving baby(ies). You might wish others would stop reminding you of
the baby(ies) you have lost. You need not feel guilty about this normal
reaction. Parents can only cope with so much at once. With newborns,
especially when they are premature or ill, it is common for parents to
devote their energy to their living children and delay grief until a
later time. In due course, you will find the right way to acknowledge
the child who died.
- Parents often hear inappropriate comments that are
meant to comfort them but in fact, do exactly the opposite. To hear
"It's not the same as losing a baby, this one never drew breath." or
"You are young, you can have other children" is devastating, even if the
comment is well intentioned.
"At least one survived." [I am
truly grateful, but one crib is still empty.]
"It's God's will.
They've gone to a better place." [There is no better place for babies to
be than with their parents! ]
"It's for the best, she/he would have
been disabled. [Death of a child is not "good" and not necessarily
easier to handle than disabilities.]
"You have a healthy baby, just
forget the other and get on with your life." [You have 2 legs. If one
was amputated, how would you feel if I said "you have one healthy leg,
forget the one you lost and move on?"]
"You could never have handled
quadruplets." [Death of a child is not easier to handle than mounds of
diapers or huge grocery bills!]
- Communication is important, and a counselor may help
bereaved parents avert losing relationships with family or friends.
People often call two surviving triplets or quadruplets "twins". They
need to know what you want to call them. Likewise, one mother reported
one of her twin daughters was born very ill and died in the hospital
after a short life of two months. Her mother-in-law focused on the
surviving, healthy baby, sending the parents a card congratulating them
on the "birth of their daughter". The dead sister was never mentioned,
even though she lived for two months, was named and given a funeral. A
rift developed between the mother and mother-in-law, with hurt, anger
and hostility at the lack of acknowledgement of one grandchild's birth
and death.
- Recognize that you will have limits. Your pain may be
so intense that you will have nothing to give to the rest of the family
or spouse. Be honest and let them know when you need some space for the
time being.
Memories
It can be very helpful for parents
to see, hold and touch their dead baby or babies. I feel very strongly
that we cannot say "Good-bye" until we have said "Hello." No parents have
ever expressed to me their regret at having seen and held their babies,
but several have expressed regret that they did not. Sensitive and caring
hospital staff can encourage parents to hold their baby(ies), and bathe
them if they wish. You can take photos of the deceased babies separately
and together, with any surviving babies from the multiple birth, and with
other siblings if you desire this. Hospital staff are often exemplary in
supporting families at this difficult time, making it as easy as possible
for you, although they cannot change the tragic reality of death. Parents
are often given specially designed Memory Boxes, one per baby, which may
include: the blanket the baby was wrapped in, a lock of hair when
possible, plaster hand and foot prints, an outfit the baby wore, hospital
bracelets and several photos of each baby. Such special items are
cherished as tangible evidence of the reality and value of a baby who did
indeed live, even if only in dreams.
There are companies and
artists who can create drawings of your babies, or unite separate photos
of babies with computer imaging to create a group picture. These tasteful
and precious photographs or sketches can provide parents with much
comfort. As one Dad put it ".it [the photograph] proved to the world that
our son was real."
This article was written with grateful input
and assistance from:
Dr. Elizabeth Pector, Illinois, U.S.A.
www.synspectrum.com/multiplicity.html
Reading Resources:
Twins, Triplets and More,
Elizabeth M. Bryan, M.D., St. Martin's Press
Guidelines for
Professionals: Bereavement, Bryan, EM; Hallett F, Multiple Births
Foundation, London England www.multiplebirths.org.uk
Living
Without Your Twin, Betty Jean Case, Tibbutt Publishing
Bereavement in Multiple Birth, Part 1: General
Considerations, Elizabeth Pector, MD; Michelle Smith-Levitin, MD, The
Female Patient, Vol. 27, November, 2001
Bereavement in Multiple
Birth, Part 2: Dual Dilemmas, Elizabeth Pector, MD; Michelle
Smith-Levitin, MD, The Female Patient, Vol. 27, May, 2002
The
Worst Loss: How Families Heal from the Death of a Child, by Barbara D.
Rosof, Henry Holt
Empty Cradle, Broken Heart: Surviving the
Death of Your Baby, Deborah L. Davis, Fulcrum Publishing
Men & Grief, Carol Staudacher, New Harbinger
Publications
Trying Again: Guide to Pregnancy After
Miscarriage, Stillbirth and Infant Loss, Ann Douglas and John R.
Sussman, M.D., Taylor Trade Publishing
Empty Arms: Coping with
miscarriage, stillbirth and infant death, Sherokee Ilse, Wintergreen
Press
Other Organizations:
Check out "Useful Links" on this Web Site
Multiple Births Canada's, Loss Support Network - www.multiplebirthscanada.org
Centre
for Loss in Multiple Birth (CLIMB) - climb@pobox.alaska.net
Twin and
Multiple Birth Loss NZ (Inc.) - twinloss@xtra.co.nz
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