EXPLORE PAST ISSUES
Stillbirth and perinatal death
Vol. 15 No 4 | Summer 2013
Feature
Care for grieving families
Cathy Buntting
MSc, PhD
Vicki Culling
BA (Ed), MA (Applied) Social Work, PhD


This article is 6 years old and may no longer reflect current clinical practice.

Through Sands, there are a variety of services available to support individuals affected by reproductive loss. Health professionals, too, can positively influence how families meet and farewell their precious baby.

In 1998, Vicki was ten days overdue with her first baby and preparing to be induced when she was told that a heartbeat could not be found. She delivered an eight pound girl, Aster, whose stillbirth remains unexplained. Cathy’s first baby, Megan, was stillborn eight years later in January 2006. She died in utero, most likely due to blood clots trapped in a true knot that had formed in the umbilical cord.

Both girls were wanted, loved and longed for. Dreams had been created. Bedrooms were ready. Homes were waiting. Their deaths were unexpected, traumatic, heartbreaking, life changing.

Each baby was delivered naturally, cared for, bathed, dressed, held, cuddled, introduced to family members, photographed and wept over. As a result of gentle persuasion from a midwife, Megan was flown to Wellington for an autopsy. From there she was cared for by a funeral director until her funeral – her parents had not realised that they could have had her at home. Aster, on the other hand, went home with her parents before she was farewelled and cremated.

Each year, versions of these stories repeat numerous times – around 700 babies die in New Zealand between 20 weeks gestation and one year after birth. Thousands more die prior to 20 weeks gestation – records are not kept on a national basis.

In the vast majority of cases, the parents are devastated. What was to be a time of hope and wonder is suddenly heavy with the deepest of heartaches. ‘It wrecked me,’ says one mother.

In the midst of the utter devastation, health professionals have an incredible opportunity to positively affect how the parents and whanau (family) meet and farewell their precious baby. Sometimes this may be through just a few words…acknowledging the immensity of the loss, encouraging the parents to look at and hold the baby or suggesting that the baby be given a name, especially if born before 20 weeks, when the birth is not registered. At other times it can be information, offered with clarity and kindness: what an autopsy is and why it might help, options about taking the baby home, physical responses that the mother might expect, such as her milk coming in, or taking some time to stop. One mother remembers a specialist gently pointing out the reality of the journey she and her partner were about to embark on: ‘You and your husband are going to grieve differently, and that’s okay. Be kind to each other. You have both lost your daughter.’ For others, the fact that they were given choices is something they remember with gratitude.

Of course, in many instances, it is difficult to know what to say. There is concern that words might trivialise the depths of the parents’ pain. Those of us who have experienced the death of a baby know this well: there is nothing that can be said to ease the immensity of the heartache. However, acknowledgement and care can steer the family in the direction of ‘healthy’ grief.

In time, many parents also reach out to others who have had to tread similar paths. It can be incredibly empowering to realise that so many of the feelings and emotional responses are ones that are commonly experienced. It is also important to many to realise that, while their baby (or babies) will never be forgotten, it is possible to once again live a full and meaningful, even happy, life – but that this takes determination, courage and time.

Sands New Zealand (www.sands.org.nz) helps connect and support bereaved parents nationwide and many hospitals have a relationship with their local Sands group. We are a voluntary, not-for-profit organisation that provides information and peer support. Our Sands Support Packs, funded by the Ministry of Health, include information on funerals, grief, children’s grief, legal requirements, memory making and transportation. They can be obtained by emailing [email protected] Sands is also active in Australia (see www.sands.org.au).

Sands volunteers offer a wide variety of support and services to bereaved families, without judgement, no matter what the age or gestation of the deceased baby or infant. Depending on the region, services include phone support, support meetings in the community, online support, newsletters and special events such as during Baby Loss Awareness Week (9–15 October each year) and at Christmas. As a national organisation we also have an active online community, with over 350 parents having joined a private forum available on Facebook. Most Sands groups provide local hospitals with support and memory-making items, such as candles, memory books and teddy bears. Some provide Moses baskets for the baby.

In many regions, Sands volunteers are available to visit families while they are still in hospital. Often it is helpful for bereaved parents to talk with someone who has been there. In some cases they may help the family collect a lock of hair, take photographs of the baby and make hand and footprints; and some offer a free service to create casts of the baby’s hands and feet. With so few tangible memories, each of these becomes a special memento for the family in the months and years ahead.

Health professionals, too, can play an important part encouraging families to consider doing some of these things themselves. For example, while photographs are routinely taken for medical purposes, health professionals can encourage the taking of photographs of the baby with family members or close-ups of the baby’s hands or feet or button nose. No one has ever said that they have too many pictures. In cases where the mother is unconscious, health professionals might suggest to a family member that the baby be placed with the mother and photographs taken – in this way she might feel she was able to care for her baby even in her unwell state. Many parents express later a wish that they had opened their baby’s eyes.

Health professionals also have an important role to play during a pregnancy after a loss and sometimes later pregnancies as well. These women are often extraordinarily concerned about their baby’s wellbeing and understandably so: they know that babies can die. Reaspecting the pregnant mother’s emotional distress, no matter how illogical it may seem, can help her to feel supported and heard.

The death of a baby changes so much: who we are, who we becomes and how we recreate our futures. It places immense stress become and how we recreate our futures. It places immense on relationships, including those with wider family and friends. In many cases, others do not know what to say or do and parents can end up feeling isolated. In cases where early delivery has been induced for medical reasons, the feelings of isolation can be particularly severe, with parents not always feeling able to share with others what has happened.

Offering dignity and respect to the baby and parents, during each interaction, is critical if the parents are to go on to once again embrace life while, at the same time, gently carrying the memory of their baby or babies with them.

Further reading

  • Douche, J (ed). Baby Gone: True New Zealand Stories of Infertility, Miscarriage, Stillbirth and Infant Loss. 2011 Wellington: Hugs Press Ltd.
  • Thompson, A and Irving Hendry, T. Beyond Words: Grieving When Your Child Has Died. 2012. Wellington: Skylight Trust.
  • Culling, V (ed). A Tribute to Tabith-Rose: Stories of Baby and Infant Loss in New Zealand. 2012. Wellington: Sands Wellington-Hutt Valley.
  • What’s Happened to Baby? Wellington: SIDS Wellington, Sands Wellington and Skylight Trust.
  • Miller Clendon, N. Life After Baby Loss: A Guide to Pregnancy and Infant Loss and Subsequent Pregnancy in New Zealand. 2003. Auckland: Tandem Press

About the Authors

Vicki Culling (PhD) is the principal trainer for Vicki Culling Associates, a NZ company that specialises in perinatal and infant loss training for health and caring professionals. She has worked in the area of bereavement support and perinatal and infant loss for over ten years, primarily through Sands, an organisation that supports parents and families following the loss of a baby or infant. She was a member of the New Zealand Perinatal and Maternal Mortality Review Committee (PMMRC) for six years. She is a bereaved parent whose daughter’s stillbirth changed the course of her life in an unexpected yet inspiring way.

Cathy Buntting (PhD) is the immediate past Chair of Sands New Zealand and active in her local Sands group. She sees her work with bereaved parents as a very special part of the legacy of her first child, Megan. She also believes that she is a better mother to her two living children, Carrie and Jayden, because of the lessons about life that Megan was able to teach. Professionally, she works as an education researcher at the University of Waikato.


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