After a stillbirth
After giving birth to a baby who has died you will have decisions to make, but take things at your own pace and discuss what you would like.
If you are worried about seeing the baby you might want to ask your midwife to describe how the baby looks, or ask your birth partner to look first and tell you.
You don't have to look or hold your baby if you are not ready or really don't want to. Years ago many women who had stillbirths were not allowed to see their babies. Some are still sad that they never had this experience. Think about how you feel now, but also how you might feel in the future.
There are a number of ways you could store memories of this confusing time. Ask your midwife about building a memory box. You may want to take lots of photos of the baby, or take hand and footprints. You may like to invite members of your extended family or other siblings to come and meet the baby. Or you could dress the baby in particular outfits or bath him. You might want to sleep with your baby in a cot next to you for the night or be alone with your baby. Take as much time as you need.
Post mortems
Soon after your baby is born you will be asked if you would like your baby to have a post mortem examination. The hope is that this may reveal a cause of your baby’s death. Unfortunately the results are not always conclusive, and even after a post mortem it may not be possible to give you an exact reason why your baby died.
Even if the results are inconclusive they may give you helpful clues about what didn’t cause the death, or give you some information that may mean any future pregnancy is managed appropriately.
Whether to have a post mortem is a very personal decision. You may have lots of questions about how and where it is performed, and what the results might tell you. Talk to the midwife and doctors caring for you about your concerns and questions. There is no pressure either way – it is entirely up to you. There may be religious reasons why you feel you must refuse. If you are worried about being able to have a burial quickly speak to the doctors as you may be able to have the post mortem brought forward.
If you do decide to have a post mortem make sure you are clear how long you will need to wait for the results and how they will be shared with you. Quite often you will need to wait a few weeks before the results are available and they may be given to you at a follow up appointment with a consultant approximately six to eight weeks after the birth.
Registering the stillbirth
It may seem very hard, and yet another painful thing that has to be done, but you will need to register the stillbirth of your baby. Some parents, however, are able to see this as a positive step as ensuring that their baby has a proper identity and that their details are available for generations to come.
Whilst you are in the hospital you will be given the necessary details to have your baby's stillbirth registered. In some hospitals a registrar is able to visit the ward before the mother leaves hospital. Otherwise you may need to make an appointment at the local office for registration of births, deaths and marriages. You have up to 42 days after the stillbirth to do this.
The midwife caring for you, or the registrar's office, will be able to explain to you who can register the stillbirth, when and what paperwork and information you need to take with you. Remember that the rules regarding the father being included on the form are different if you are not married.
Arranging funerals, burials and cremations
Again, the arrangements that you choose to make to mark your baby's death are very personal. You may have important religious wishes that you would like observed, or you may want a very different type of event. You may choose not to be present and to allow the hospital and their undertaker to make all the arrangements.
Whatever you choose to do there will be some decisions to be made and paperwork to be completed. Don't feel pressured to make decisions before you are ready. Take time to talk to those close to you about what you would like to do.
Organisations such as SANDS (http://www.uk-sands.org.uk/), The Stillbirth and Neonatal death charity, have leaflets and lots of information available about these choices. You may like to read their information on organising funerals for more help with these options.
Going home
Going home without your baby can be a particularly painful experience. You had probably imagined the homecoming with your baby, showing him around your house and sharing the excitement with your family. You may have left the house in a hurry for an antenatal appointment and not gone home since.
Try to think ahead and tell your family or friends what you want. Some well-meaning family or friends may think you don’t want any reminders of the baby and remove baby equipment or clothes and toys from the home, but that may not be what you want. Would you rather tidy and spend time in the nursery over the next few weeks as you grieve? There may be other practical things you can ask your friends or family to do, such as going to your home ahead of you and washing up, hovering or anything else you feel will make going home easier.
Physical recovery
Following a stillbirth the grief and shock of everyone around you can mean that it is easily forgotten that you have been through the birth and that your body will need to recover in the same way as any woman who has given birth. You may well have after-pains as your womb returns to its usual size and you may require pain killers. Your breasts will produce milk and you may have had stitches or be sore from the birth.
Do remind people that you may need help with some physical tasks and don’t dismiss your physical recovery as unimportant compared to the emotional journey that you are on. A midwife will still need to check your recovery; do ask for help if you are suffering from any issues from the birth.
Trying for another baby
This is obviously a very personal decision to make and what is right for one couple isn't right for another. You may not be ready to even read this, while another woman may want to think about trying for another baby as soon as possible. Having been so far into your pregnancy means you will need time to allow your body to recover physically from the pregnancy and birth. Talk to your doctors about how long you should wait; you will usually have a follow up appointment arranged for around 6 weeks following the birth.
They will also be able to talk to you about how any future pregnancy would be monitored and this may help you to plan what you would like to do. Other factors such as your age or general health should all be considered when you are making your choices.
Talk together as a couple, but don't be surprised if one partner feels ready before the other. This is something that you will need to discuss and agree upon. Your next period usually comes around 4 to 6 weeks after the stillbirth but you will be bleeding for a few weeks following the birth so it can sometimes be hard to know.
Remember that you will probably ovulate and be fertile 2 weeks before your first period so you could in theory become pregnant very shortly after the stillbirth. If you don't want this to happen then use contraception such as condoms.
If no known cause was found it is unlikely that you would suffer another stillbirth but talk to your doctors about your individual chances. If there were causes found, such as diabetes, pre-eclampsia or other medical conditions, then there may in theory be an increased risk. However, you are likely to be very well monitored, and potential problems could be found earlier. Your medical treatment may be altered meaning that your baby could be delivered earlier before problems arise.
Talk to your medical professionals about what you can expect and how potential problems would be avoided. If you feel that you would want to be cared for at a different hospital, or with a different medical team, talk to your GP about who you should see and how to get a referral.
Sources
Macdonald S, Magill-Cuerden J, Mayes’ midwifery, Edinburgh: Baillir̈e Tindall Elsevier, 2012
National Institute for Health and Care Excellence, Postnatal care: routine postnatal care of women and their babies, London NICE, 2006
Stillbirth (Definition) Act 1992, Definition of stillborn child, Section 1(1), London The Stationery Office, 1992
Gov.uk, Register a stillbirth, Gov.uk London, 2014. Available from: https://www.gov.uk/register-stillbirth (accessed 15 April 2014)
Royal College of Obstetricians and Gynaecologists, Late intrauterine fetal death and stillbirth, green top guideline 55. London RCOG,
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