Our angels in heaven

When parents lose a baby

Sally* was 20 when she had her first miscarriage. “I was expecting twins – the first babies in our family, my parents’ first grandchildren. After 36 weeks of pregnancy, I had an abruption of the placenta and lost both babies. That’s when the nightmare started.” David Vella meets a mother of seven – including five stillborn babies – and Richard Cassar, from the voluntary organisation that helps parents come to terms with the pain of a miscarriage.

“I felt like an empty tomb. I was even angry at God”

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“During my pregnancy I used to dream of seeing my twins growing up, practising a sport, going to ballet lessons, and having fun with my husband and I. Suddenly I was rushed to hospital and all those visions disintegrated,” Sally says.

“I was young, and had no idea how to handle grief. I felt I had let my entire family down, especially my husband. I kept thinking I failed as a woman. I felt like an empty tomb. I was even angry at God – I couldn’t understand why this had happened to me and not to someone else.”

At the time there were no support services to help parents who had just gone through this trauma. Hospital staff were not equipped or trained to offer them emotional support. Sally was sent home soon after delivering the stillborn twins. She did not even know where her twins were taken. At home she found out that her relatives had decided to clear away all the items she had bought for the babies. “I felt like everyone was trying to erase all memories of my babies, as if they never existed.”

To add insult to injury, a few months later, she received a letter from hospital urging her to take her babies to be inoculated. The hospital did not keep records of whether a child had been born dead or alive. So Sally was sent the letter informing her that she ‘failed’ to take her babies to hospital.

Eventually she too tried to forget what happened. However, the words of relatives and friends, albeit well-intended, used to make her feel even worse. “After a miscarriage people try to find something to blame. Some told me it was because I worked during pregnancy, or because I carried out certain physical tasks such as hanging the washing on the line or scrubbing floors. My mother-in-law immediately started urging us to start trying for another child.” Sally admits that such comments were unbearable and made it harder to get over the grief of losing her babies. She felt guilty and dysfunctional.

Richard Cassar, Voluntary Services Officer at Mater Dei Hospital and a member of SANDS (Stillbirth And Neonatal Death Society) urges relatives of parents who have a miscarriage to avoid phrases that we commonly use to console bereaved persons. “In such moments, the best way to help is to support the parents simply by being by their side, listening to what they have to say, and not trying to attribute what happened to one thing or another. Any couple can have a miscarriage, regardless of how careful they were during the pregnancy, or whether or not they had similar cases in their family.” He insists that telling parents not to worry because they’ll soon have another pregnancy will not help. It is even worse when relatives try to downplay the loss by comparing it to other situations. “I’ve heard relatives telling parents ‘you’re better off this way, rather than your child growing up to become a drug addict’.”

Sally explains that even her relationship with her husband began to suffer. “I was edgy and argued with him for no reason. We started having sexual problems as well, which eventually made it even more difficult when we started trying for a child again. We later discovered that my own anxiety was keeping me from getting pregnant.”

A few years later Sally got pregnant again and had her first daughter. “It was not easy. Once you have a miscarriage you can never enjoy a pregnancy again. You’re always walking on eggshells, afraid of waking up and finding out you have problems again.” However, the birth of her first child was a relief to all the family. “We started feeling better. Holding my daughter in my arms took away some of the pain of my first pregnancy.”

Encouraged by the birth of her daughter, Sally and her husband tried for a second child. “We love children and wanted a big family. I was raised in a family of nine.” That’s when she started having more problems – in the next few years she would have another three miscarriages. “Each one was as heartbreaking as the first miscarriage. You can never get used to the pain of losing a baby.”

“I was about to give up, but then, with a lot of help from medical professionals, I managed to give birth to my son. I spent days at the Intensive Care Unit after giving birth – for some time I was in a critical condition. When I regained my health, doctors advised me to stop trying for more children. I would have loved to have another child, but it was not to be.”

In order to help parents like Sally, in November 1994 a group of volunteers, including parents and hospital staff, launched SANDS Malta to provide free support services to parents of stillborns. Richard, one of the organisation’s founders, explains how this group helps bereaved parents. Today, when a mother has a miscarriage, she and her partner are given a chance to be with their baby in a dedicated bereavement room. Members of SANDS also offer to take photos, palm- and foot-prints, and a lock of the baby’s hair for the parents to keep.

“you can never enjoy a pregnancy again. You’re always walking on eggshells.”

Some people may think that it is best to try and move on. “Parents who try to do this will simply be postponing their grief – it is likely to revisit them later in life,” Richard says, “we have seen fathers who hold back their emotions, who refuse to cry, because they feel they have to ‘be strong’. Instead, they may vent their feelings in other ways, for example through alcohol abuse. This will simply make things worse. The couple has to mourn the loss of their child together, learn to live with this pain, regain self-confidence, and fall in love again.”

A few weeks after the mother leaves hospital, SANDS members invite parents to group support sessions. Here they are given the chance to express their feelings in the presence of other couples in the same situation, as well as being offered advice and one-to-one counselling from psychologists. “Parents need to speak out,” Richard explains, “some may be angry at God, others may have complaints or doubts about how they, or their dead baby, were treated in hospital. Most of them have questions on when they can try for another baby. They are also consoled by the support and advice of parents who lived through this experience before them.”

Sally admits that 20 years after losing her babies she still thinks about them everyday. “I can never forget the babies I lost – I can never pretend that I have not been through this difficult experience. The pain will never go away, but with time and with the happiness of my family around me I learnt to live with that memory and get on with my life.”

Flowers on a white coffin

Before SANDS was set up, stillborn babies were placed in the same coffin of the first corpse that left the mortuary. Parents were left feeling that they did not have a child they could mourn – they were not even allowed to give their babies a proper funerary ceremony.

Nowadays, babies who die before 22 weeks of pregnancy are kept at the Mater Dei mortuary to be buried together in a burial ceremony at the Addolorata Cemetery, which is held once a year at the end of November. Two graves in this cemetery are purposely reserved and managed by SANDS to be used for stillborn babies. During the ceremony parents get the chance to give their stillborn babies a fitting goodbye. Nurses and staff at Mater Dei Hospital’s maternity wards also join the parents to express their support. The babies are placed in a small white coffin, decorated with flowers painted by the nurses themselves. Rev. Joseph Mizzi, the Director of the Cana Movement, and a number of other priests, accompany the parents during the ceremony.

When a baby dies after the 22nd week of pregnancy, the family is invited to hold a private burial ceremony. Sometimes, parents are asked whether they would like to donate their babies’ bodies to the University of Malta to be used for research purposes. If they accept, the university keeps the babies for a few months, before returning them to the mortuary to be buried during the annual ceremony.

There were 28 stillbirths among 4,180 babies delivered in Malta and Gozo in 2009. Another 17 babies died within 28 days of their birth (neonatal deaths), the National Obstetric Information System (NOIS) of the Department of Health Information and Research reported.

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When a relative loses a baby…

When a close relative has a miscarriage or loses a newborn baby we would do anything to ease the parents’ pain. Here’s some advice from SANDS:

  • If you’re the closest relative to the bereaved parents, visit them in hospital and show them you’re there to offer all your support.
  • If possible, ask to see the baby. It will help parents share their grief.
  • Offer to help in the practical tasks that the mother and father have to attend to in this situation – help them fill in hospital forms, take care of their other children, or arrange the funeral.
  • If you talk to the parents about the dead baby, use the name they may have given him/her.
  • Avoid ‘comforting’ phrases like “you can have another baby soon”. The baby was wanted for him or herself – other children will not replace them.
  • This is one situation where a hug is worth a thousand words.
  • You too are grieving the death of a nephew or a grandchild so if you feel like crying, do not be embarrassed to do so. The baby’s parents will find consolation in the fact that they are not the only ones grieving their baby.
  • It will take months, sometimes even a year, for parents to start recovering from the loss of a baby. Keep listening to what they have to say, even if it seems like they’re constantly repeating the same thing, day after day. Don’t condemn them if they express anger or jealousy at the fact that other parents had their babies without difficulty.
  • In future pregnancies, the parents will be very nervous. Let them express their anxieties and encourage them all the way.