When Joy Turns To Grief
By Audrey Silverman FooteThe flowers in bud on the trees
Are pure like this dead child.
The East wind will not let them last.
It will blow them into blossom, And at last into the. earth.
It is the same with this beautiful life
Which was so dear to me.
While his mother is weeping tears of blood,
Her breasts are still filling with milk.
May Yao Ch'en
When an Expectant Mother Finds Herself Grieving… Instead of Rejoicing
The death of a baby during pregnancy, birth, or shortly afterward is one of the most excruciatingly painful losses that a person can face in life. When a pregnancy ends suddenly with death there are three major losses: the loss of the pregnancy, the loss of the actual baby that the mother has carried within her body, and the loss of the fantasy of who this baby will be and what life with a baby will be like.
Loss of Pregnancy
For many women, being pregnant is an extraordinary time in their lives. Although there are obvious physical discomforts that women face in varying degrees, there is also a heightened sense of elation and of being tuned to the miracle of life. Every day an expectant mother feels the effects of her pregnancy, including increased hunger, nausea, her swelling belly, the baby's hiccups and kicks. Each time she shops for food and eats, it is with the baby in mind. Her calendar is filled with midwife or doctor appointments. But when the baby dies, suddenly the pregnancy and all that goes with it dies too. Now when a bereaved mother eats, a searing pain goes through her heart because she is no longer feeding her beloved baby.
A woman who loses her baby still has a postpartum body, but instead of a joyous bundle of baby to go with it, she has only grief. A bereaved mother also has to face the physical and emotional anguish of having her milk come in. Her breasts may produce this milk for many months. It is a sorrowful experience to watch this nourishing fluid flow and have no suckling babe. All of these changes, along with the immediate hormonal shifts, are an incredible shock to the bereaved mother. The feelings that accompany these changes are visited upon the mother time and time again, and it can take from many months to several years to heal from the loss of the pregnancy.
Loss of the Actual Baby
Many women feel very attuned to the child they carry within. Mothers all feel their babies' heartbeats, the movements of their little feet, hands, bottoms, and their patterns of waking and sleeping. Many mothers also have a sense of their babies' personalities or soulful essences. When a pregnancy ends in death, this unique and precious being no longer exists and cannot be replaced with another child. Many people try to assuage a bereaved mother's grief with statements such as, "Oh, you can have another," “You're lucky it happened now," or "God wanted the baby."
While these statements may be well intended and meant to help the bereaved mother feel better, they are problematic. Some people make these statements to avoid experiencing their own pain about the baby's death. However, these statements deny the magnitude of the loss that the mother is facing and add to her sense of isolation. The death of a baby, whether before or after birth, is the death of a human being who was already loved and cared for. The hurt, sorrow and anger that bereaved mothers and fathers feel is immense and often hard for other family members, friends, and even health professionals to understand.
Loss of the Fantasy of a Baby
From the time a woman knows she is pregnant she begins to fantasize about life with a baby. For example, when the due date is known, the pregnant couple begin to think about the time of the year that the baby will arrive, how old the baby will be for Christmas or Chanukah, what it will be like to share this child with his or her grandparents, and what it will be like to see the baby playing in the backyard next summer. The parents imagine the sex of the baby, the various physical and emotional characteristics he or she will have, and all of the many ways the new baby will be a part of their lives. The fantasies, hopes, and dreams that fill a pregnancy are endless. When the pregnancy ends in tragedy, all of these fantasies and dreams come to an unbelievably abrupt end.
Duration of the Grief Period
It takes a long time to heal from the wounds of having one's infant die, whether the death occurs before, during or after birth. A study in the Journal of Marital and Family Therapy (August '91) reported that it takes an average of three to four years to recover from an infant's death. Susan Borg and Judith Lesher in When Pregnancy Fails state that the grieving process can take from 6 to 24 months. In both my personal experience and in my experience with clients, I find that it takes a minimum of one year to move through the most intense part of the grieving process, and at least several additional years to more completely come to resolution.
During the first year, as each month, holiday, and season occur, the bereaved mother painfully remembers what life was like last year at this time and what she thought life would be like now. For example, when spring arrives after her baby has died, a grieving mother may think and feel something like, "Last year at this time I was six months pregnant. I was so innocent, and I had no idea my baby would die. I was happy having my baby inside of me while all of nature was blooming, too. I thought I'd have a 9 month-old-baby with whom to share spring. Instead I have this horrible ache, sadness, grief, and anger. I want my baby back!"
Each one of these experiences is excruciatingly painful. The feelings of shock and numbness are most intense during the first few weeks, and then peak again at the one-year anniversary of the death. Feelings of anger, guilt, restlessness, heightened sensitivity, and yearning are extremely high in the first four to five months after the death, then intensify again around the one-year anniversary. Bereaved mothers often experience intense depression, guilt, loneliness and general difficulty coping during the first year. All too often the bereaved mother experiences these feelings in isolation, as other people do not understand the lengthy duration of the grief process.
Our society expects the bereavement process to be short, and it clearly is not. Grieving parents often hear comments such as, "You're still depressed?" three weeks after the baby has died. This societal injunction to quickly resolve grief pressures the mother to feel wrong for grieving so long. Attending a support group for bereaved parents, seeing a therapist, and. connecting with other mothers and fathers who have experienced the tragedy of infant death can be invaluable for the grieving mother. These connections can help assure her that she is not crazy for experiencing the depth and range of emotions that she is feeling. On the contrary, she is moving through a sorrowful and difficult healing process.
Guidelines for Relatives and Friends of the Bereaved Mother
1. Acknowledge the depth and magnitude of the mother's loss. Some friends and relatives mistakenly think that if they don't talk about the baby's death, the mother won't feel her grief. On the contrary, other people's silence only intensifies her sense of isolation and anguish.
2. If the bereaved mother wants/needs to share her story, experience, and grief, support her in doing so, even if she has shared it before. Grieving will naturally occur while she is expressing the story of her pregnancy, the events leading up to her baby's death, and the aftermath. Talking about it to a supportive, caring friend or relative helps to validate that she really was pregnant, she truly did have a baby, and that it is natural for this to be one of the most difficult and profound crises she will ever experience.
3. Remember the grieving process may be intense and seemingly unrelenting for several years. The first year is particularly difficult. The monthly anniversary of a child's death is always a poignant and sorrowful date. If the baby was premature, the mother will have to live through the much waited for and now anguish filled due date. The bereaved mother is often filled with despair on other holidays, including Mother's Day, Chanukah and Christmas. The media are prolific with images of joyous parents and their children on these holidays, intensifying the bereaved mother's emptiness and sadness. At these times invite her to share her feelings, cry and be held. Send her cards, flowers and remembrances. Some people write poetry or stories for the parents, while others may make a little memorial out of clay or other creative materials. Any form of reaching out is vitally important in supporting the mother through her healing process.
4. Provide practical help with cooking, cleaning, doing errands, and giving child care as needed. Particularly in the first several months, the mother is physically exhausted from grieving. It is quite difficult to carry on with normal day-to-day tasks; thus; help on this level can be an enormous relief.
5. Remember the father. Although the focus of this article has been on the bereaved mother, remember that the father too is grieving for the loss of his beloved child. In addition, he suffers as he watches his wife's struggle. He often carries the burden of providing the income while his wife heals. He too desperately needs support and tenderness.
6. Avoid statements that deny the magnitude of the loss. For example, do not say, "It was for the best." No mother feels it was best that her cherished child died. "God wanted it that way." "Aren't you glad you didn't get to know the baby more?" No. This mother like any other mother loves her baby and wishes for any extra precious moments with her child. 'You're still depressed?" The grief process is long, and statements such as this only make the mother feel she is not doing it right. "You can always have another." - Possibly. However, there is a lot of fear and unknown involved in a future pregnancy and, even if there is a future baby, it will not replace this beloved baby.
7. Above all, try to be caring, compassionate, and loving with the grieving mother. You will never fully understand what she is experiencing, but your genuine concern will help to carry her through this time of darkness.
Audrey Silverman Foote, M.A., MFT, is a licensed psychotherapist who specializes in perinatal issues including counseling grieving mothers and fathers following a neonatal death. She is the mother of three children, the first of whom was stillborn.
Suggested Reading List
After a Loss in Pregnancy: Help for Families Affected by a Miscarriage, a Stillbirth, or the Loss of a Newborn, Berezin, Nancy,When Pregnancy Fails, Susan BorgAn Ambitious Sort of Grief, Deutshe Cohen, MarionEnded Beginnings,Panuthos, Claudia, and Romeo, Catherine,Still to Be Born, Schwiebert, PatEmpty Cradle, Broken Heart, Deborah L. Davis www.glowinthewoods.com www.carlymarieprojectheal.comwww.handonline.org www.whisperedsupport.blogspot.com www.babylosscomfort.com www.babylossdirectory.blogspot.com www.kotapress.comwww.missfoundation.orgwww.stillbirthalliance.org