L Is for Loss
Chemical pregnancy. Etopic pregnancy. Early-term miscarriage. Blighted ovum. Molar pregnancy. Preterm delivery. Stillbirth. Placental abruption. Cord accident. Incompetent cervix. Chromosomal abnormality.
No matter the term used or the reason given — a loss is not just the loss of a baby, it’s the loss of hope, potential and a future. As anyone who’s peed on a stick knows, the instant that second line appears, there is a primal shift in your core being — it’s that moment that you have been transformed from a “me” to a “we.” And whether a loss happens within days of the little pink line, or 9 months later, the foundation of who you are as a woman and mother is forever changed.
“In our society, pregnancy and infant loss is shrouded in silence. When you don’t hear about it or have it reflected back to you, it’s not something that’s okay to talk about — so you just don’t,” says Michelle La Fontaine, program manager with the Pregnancy and Infant Loss Network (PAIL), a division of Sunnybrook Health Sciences Centre’s Women and Babies Program.
We all know the stat: 1 in 4. It’s estimated that 25 percent of pregnancies end in miscarriage before 20 weeks, and according to Statistics Canada, perinatal mortality (loss after 28 weeks of pregnancy or during the first week post-birth) occurs at a rate of 0.6 percent, equating to 2,259 babies that died either just prior to or within days of being born in 2011.
Shelby Foster is one of the “1.” She’s not a statistic, but a person — a mother, a wife, a sister, a daughter, a woman. She lives in Cambridge with her husband and two girls, Tessa, 5, and Molly, 7-months. She could be your colleague, your neighbour or that bubbly mom running after her oldest as she learns to ride her two-wheeler. There’s nothing fundamentally remarkable about her. There’s no visible sign of the “L” she wears on her heart. She will forever carry her loss with her — but won’t be hiding in the shadows of shame and silence where many women involuntary find themselves.
Shelby admits to being an open book, and made the decision after losing her son Calvin at 28 weeks to a placental abruption that she wasn’t going to sweep the death of her son under the rug and mourn silently. “I decided I would talk about because I needed to,” she says. And when she started opening up about her experience, she says she was surprised by the number of people who knew what she was going through first-hand. “I had never heard these stories before. Women who are still suffering 25 and 30 years later because they haven’t had an opportunity to talk about it,” she remembers. “People are carrying around a lot of stuff. One day you’re pregnant and the next day you aren’t, and people don’t even say anything to you? That’s pretty crazy.” And by speaking about her experience, she’s hoping to be part of the catalyst for more open discussion about the subject.
A discussion that registered psycho-therapist Nicole Schiener believes needs to happen to help in the healing process. “The therapist I was seeing prior to my own early-term miscarriage discouraged me from telling others to prevent further upset,” explains Schiener, clinical supervisor at the Family Counselling Centre of Cambridge and North Dumfries. “This is not something I would ever tell a woman as it left me feeling alone and invalidated. Trying to pretend everything is fine when it isn’t is exhausting and can ultimately prolong the grieving process.”
We know that the first 12 weeks of a pregnancy is when expectant mothers are at the highest risk of pregnancy loss. The first trimester is when about 80 per cent of miscarriages (medically termed spontaneous abortion) happen. Once women move into the second trimester, the chance of losing the pregnancy significantly drops to between one and five percent, according to research from The March of Dimes. During those early days many women keep their special news to themselves, their partners and maybe a select few close friends. Doctors and midwives don’t tell them to keep it hush-hush, but it’s the societal norm. Potentially rooted as well-meaning advice, an unintended consequence of the “12 week rule” is that an early-term loss can feel like something to be kept quiet.
“I’m a bereaved mother myself,” says PAIL’s La Fontaine. “I had an early-term miscarriage at eight weeks. I told my best friends, my mom and sister. It really didn’t feel like I could grieve. That was about 13 years ago. And I don’t think much has changed. But a loss is a loss. No matter the stage,” she continues, explaining that even when you lose a pregnancy in the first trimester, especially first-time moms, it can be traumatizing and it’s important that both parents are able to grieve — and should feel justified in doing so. “You’ve already started to imagine what life will be like. That’s what people grieve. It’s not necessarily grieving the loss of the baby, but the loss of what you thought your family would look like.”
Maggie Hilton, registered labour and delivery nurse, childbirth educator and owner of Balancing from Birth to Baby, says that the veil of silence goes both ways. “Sometimes we are so scared to say the wrong thing that we say nothing at all. I think medical professionals, as well as friend and family, could do a much better job of offering support through a loss. People just want to have their feelings validated, not to be shut out by their care providers or loved ones.”
Hilton has experience loss in a way most of us can’t imagine. “I’ve worked with women in a wide range of awful scenarios. I’ve helped women who have come to the emergency department experiencing very early losses, and also bathed and handed couples their over 40-week stillborn wrapped in a warm blanket. People think working as a nurse in labour and delivery is all happy sunshine and baby holding. It’s really not. It can be sad and dark.
“The parents and babies faces appear in your dreams and play in your mind. I’ve often found myself in tears driving home or lying in bed unable to sleep because I’m thinking of how sad I am for the families I’ve cared for. How I wish I could have said more to comfort them or done more for them. As someone who aims as a nurse to be a healer, it’s awful to know that no matter what you say or do, you can’t bring that baby back for them. I can’t fix it, I can only hold and comfort them, and help them begin to grieve.”
For Foster, and for many others, it’s those moments immediately after a traumatic incident that can help or hinder moving forward. Two days after Calvin’s passing, Foster’s family had a small and very private ceremony. Foster said this was very helpful for her and her family to find closure. While both Hilton and Schiener agree that community support is available, we still have a long way to go to crush the stigma of loss and offer true support to beavered families.
“There is support offered through the hospitals in the form of counselling, which I would recommend to anyone seeking support,” says Hilton. “Our social workers are experienced in counselling specifically when I comes to a miscarriage of stillbirth. There are also spiritual ser-vices available if needed, and our hospital holds a candle lit ceremony once a year to remember the babies we have lost. Parents are invited to attend — some come, some don’t.” Hilton adds that while she’s “glad that the issue of pregnancy loss is becoming more forefront in conversation, I do strongly believe that families need more resources available and timelier access to them.”
La Fontaine says that because of this cloak of silence about pregnancy and infant loss, most women are not prepared for a loss after the get through the first trimester. She doesn’t suggest that the medical community put fear in the minds of pregnant women but more education about what could happen needs to happen — more education and support for when it does.
But true support goes beyond just the availability of resources or the acknowledgement that something needs to change. There are practical steps our society could be taking. “Grief impacts our ability to focus, concentrate and remember details, which could impede work,” explains Schiener. “Often in the early days and weeks, people are in survival mode, feeling lost, distracted, having low energy and easily triggered. Depending on the circumstance, women may also need to heal physically.” Healthcare providers should be encouraging women to take a short-term leave from work if that what they need, and women should be feel supported at all levels if that’s the path she wishes to take. Schiener adds, “Friends, families, employers and co-workers need to be flexible and sensitive to the needs and feelings of the couple during and after their experience.”
This is where organizations like PAIL come into the equation. Advocacy and getting these issues into the public mind will help break down barriers. Healthcare providers needs to be encouraged to education themselves on proper support. Community outreach needs to be accessible. Attitudes need to be shifted. Private counsellors and bereavement doulas needs to be more readily avail-able, and the public needs to understand what resources are available before, during and after a loss.
Nothing is going to change overnight, but for every woman who feels validated, supported, loved and heard is one less woman residing in the shadows. Especially in Canada, statistics around pregnancy and infant loss are scares, out-of-date or non-existent. One of the biggest issues surrounding miscarriage is that there are no cut-and-dried answers as to why. A woman’s age, pre-pregnancy health and lifestyle play factors, but so do generics, uncontrollable fetal development issues and plain ol’ luck (for lack of a better term).
There’s also still this prevailing attitude of “it just happens,” almost like because it’s common we should just brush it off as normal and move on.
Almost two years later, Foster says that she’s come to terms with the loss of Calvin, but accepted and forgotten are far from the same thing. “I’ve accepted it and I’m okay that it’s happened, but I’ve had to re-arrange in my brain to what my life looks like now,” she says.
Talking about losing Calvin is what helped her through the experience and strongly encourages other women who experience losses to consider opening up. “We need to be more open about [pregnancy and infant loss]. It shouldn’t be the elephant in the room. It doesn’t matter when you lose the baby. Even if it’s a pregnancy at five weeks, you still had hopes and dreams. It’s not easy to go through that by yourself.”
This article originally appeared in the Fall 2017 issue of The Holistic Parent. To read the full piece, click here.