Most of the time they don’t want reassurances. They just want you to acknowledge that it stinks. It’s not fun. That no matter how early the loss, as soon as you see those 2 lines you’re a mom again. That’s it’s okay to grieve. And just sit with them if they want it. Or give them space if that’s what they need.
A late loss (one where you actually see the baby and know it was a baby) is a little trickier. When I would have patients with stillborn or losses in late pregnancy I honored their wishes. Letting them see or not see the baby whenever they wanted. I would clean the baby as much as I could and position them respectfully so they look like they are sleeping. In the grief keepsake box I would make an effort to hang white sheets and do pictures as I would were the baby alive and sleeping. Often I had to use caps for their heads to hide deformities. I would focus on the tiny details, shots of their little feet or hands artfully placed, keeping the parts of the room that declared it as. Hospital space hidden in the shots. I once had one mom who didn’t want to see pictures. I still took them and hid them in the bottom of. The box in a book behind the last page. I told her she never had to look at them if she didn’t want to. It was still there. It’s about facilitating grief and anticipating healing.
With open ears, closed mouth to your stories and feelings and lots of understanding. I stayed with a patient that carried her baby to 37 weeks and came in for a scan and found the baby was gone. She didn’t speak English so we lived on the blue phone. She was my patient for two shifts, she gave birth and we all cried. I stayed after my shift for 4 hours to be present for the baptism, dress the baby, make hand molds for them to take home. It was so hard but it’s important to stay strong and supportive. Be sensitive and read the room.
One way to provide support is to mark the pregnancy and it’s loss with planting a flowering shrub or a tree in the yard.
One of the hardest things to do... I am a Bereavement Counselor on my L&D unit and my education started with taking a course from Resolve Through Sharing. The most important thing is to be there, and to explain everything that is going to happen. Also include what the baby will look like. Resolve through Sharing has bereavement boxes that have proven to be well-received, as it offers a box of memories of the baby, no matter the gestation. Always remember that, no matter what, this baby is real to them and they have had plans, have bought things, etc... and now those dreams are gone. Often, this is a new finding, so they have to be able to process the loss in their own way and in their own time. Baptismal certificate, saving a lock of hair or creating a set of plaster footprints, as well as photos, serve as something tangible they can have when the baby is gone.
Please don't say "you will get over it" or "don't worry, you're young, you'll get pregnant again". A simple I'm so sorry for you're loss will do.
It is no different than any other death of a loved one. Just be there for them and do not try to rationalize but acknowledge their grief and the grieving process for the individual and couple.
there are many excellent books on the subject ( for example"When Hello Means Goodbye"), so it is best to be prepared with accurate information and support the woman (and her support network , if possible) in the grieving process. many communities have pregnancy loss support groups as well, Such as HAND (Help After Neonatal Death) who also support women experiencing miscarriage, and stillbirth. there are on line support groups as well. So immediate grief support and referral to community resources. all Maternity units should have fetal loss support procedures tailored to the length of pregnancy.
