- Email: [email protected]
Grief in childbirth
O Longman Group UK Ltd 1988
Midwifery
EDITORIAL
Grief in childbirth W h e n asked w h a t m y profession is and replying 'midwife' I a m frequently told ' O h , w h a t a lovely job, it must be wonderful to help babies come into the world'. It is, I t h o r o u g h l y enjoy it and have no intention of c h a n g i n g m y occupation. But unfortunately c h i l d b i r t h is not always successful. T h e d e a t h of a b a b y , at w h a t e v e r gestation is tragic. Society a n d health carers give the impression that a miscarriage is not so much of a tragedy, and!yet parents perceive this as the d e a t h of their baby. F r e q u e n t l y a w o m a n would not know that her own m o t h e r had had a miscarriage until the w o m a n herself had one, it was a topic that was very rarely raised. It is only recently that women, and now occasionally men, have begun to talk of their feelings of desolation w h e n a p r e g n a n c y fails before the 28th week of gestation. M o r e recently we have evidence of p r o f o u n d depression occurring at a r o u n d the time t h a t the p r e g n a n c y would have been at term if it h a d continued, in w o m e n who have h a d a miscarriage. Society recognises that the parents will be sad if the b a b y is stillborn or dies soon after birth b u t the sadness is not supposed to last too long. It is as if the grief should not be so b a d because the person was not with us for very long. Recently I had an experience which h a d a profound effect on me, I took p a r t in a radio p h o n e - i n p r o g r a m m e . T h e topic was 'Miscarriage, Stillbirth a n d N e o n t a l D e a t h ' and listeners were encouraged to p h o n e in and talk on the r a d i o with a panel of 'experts'. T h e experts were a m o t h e r who h a d experienced a n e o n a t a l d e a t h and was a m e m b e r o f a self-help group, a hospital c h a p l a i n who has a p a r t i c u l a r interest in helping grieving parents, a n d myself because I have been involved in e n c o u r a g i n g health professionals to reconsider the w a y they provide care tbr parents at this time. I was struck by the courage of the men, as well as women, who shared their experiences with us. I expected that parents who h a d experienced a t r a g e d y recently would
be talking with us but I was not p r e p a r e d for those whose b a b y had died m a n y years ago. T h e r e was the m o t h e r whose twins h a d been born 23 years ago, one was stillborn, the other died within a few days of birth. This m o t h e r was still grieving for both babies, but in p a r t i c u l a r for the stillborn twin because she h a d never seen her. She was still trying to imagine w h a t she looked like. T h e r e was the father still grieving for his d a u g h t e r stillborn 44 years ago. His grief was m a d e worse because he was not allowed to hold his d a u g h t e r , he only saw her 'lying on a cold m a r b l e slab'. H e was not allowed to b u r y her in the grave o f an older sister'who h a d died in infancy. H e was told that because the b a b y was stillborn she h a d to be buried in a separate p a r t of the cemetery. I h o p e d t h a t we, and by 'we' I m e a n health carers and society, were more successful t o d a y in helping parents 'go through' their grief but I a m sad to r e p o r t that that is not the case. A m o t h e r whose b a b y was stillborn a y e a r ago phoned. A l t h o u g h s h e was very grateful tbr the help she h a d received a n d felt that the midwives h a d been very s y m p a t h e t i c , she still could not talk to her p a r t n e r a b o u t their son. She a n d her p a r t n e r h a d not been given sympathetic counselling to help t h e m come to terms with their loss. T h e p a r e n t s I felt the greatest concern for were the ones w h o m a n a g e d to p h o n e the studio b u t were too distressed to talk to us on the air. W e know that there were both men and w o m e n in this situation a n d that there were v a r y i n g periods of time since their babies h a d died. W e did have calls from parents telling us of their 'successful' travels through grief and of how grateful they were to be given mementoes of their b a b y . T h e y found it helpful to have a photog r a p h , a lock of hair, a toy. O n e m o t h e r p h o n e d a n d said t h a t she had found the p h o t o g r a p h of her stillborn b a b y very comforting, but the p h o t o g r a p h was some years old now a n d was be101
102
MIDWIFERY
ginning to fade. Although she did not experience the pain of the death any more she still wanted to be reminded of her baby. We were told of sympathetic and comforting midwives, doctors and family and friends. Grief is an intensely personal experience and our reactions to it will depend very much on the society and culture in which we
live. I grieved for all the parents but particularly for those still grieving over 40 years after the baby had died. We must strive to ensure that health professionals and the society in which we live help all those whose baby has died. ANN THOMSON
Midwifery
EDITORIAL
Grief in childbirth W h e n asked w h a t m y profession is and replying 'midwife' I a m frequently told ' O h , w h a t a lovely job, it must be wonderful to help babies come into the world'. It is, I t h o r o u g h l y enjoy it and have no intention of c h a n g i n g m y occupation. But unfortunately c h i l d b i r t h is not always successful. T h e d e a t h of a b a b y , at w h a t e v e r gestation is tragic. Society a n d health carers give the impression that a miscarriage is not so much of a tragedy, and!yet parents perceive this as the d e a t h of their baby. F r e q u e n t l y a w o m a n would not know that her own m o t h e r had had a miscarriage until the w o m a n herself had one, it was a topic that was very rarely raised. It is only recently that women, and now occasionally men, have begun to talk of their feelings of desolation w h e n a p r e g n a n c y fails before the 28th week of gestation. M o r e recently we have evidence of p r o f o u n d depression occurring at a r o u n d the time t h a t the p r e g n a n c y would have been at term if it h a d continued, in w o m e n who have h a d a miscarriage. Society recognises that the parents will be sad if the b a b y is stillborn or dies soon after birth b u t the sadness is not supposed to last too long. It is as if the grief should not be so b a d because the person was not with us for very long. Recently I had an experience which h a d a profound effect on me, I took p a r t in a radio p h o n e - i n p r o g r a m m e . T h e topic was 'Miscarriage, Stillbirth a n d N e o n t a l D e a t h ' and listeners were encouraged to p h o n e in and talk on the r a d i o with a panel of 'experts'. T h e experts were a m o t h e r who h a d experienced a n e o n a t a l d e a t h and was a m e m b e r o f a self-help group, a hospital c h a p l a i n who has a p a r t i c u l a r interest in helping grieving parents, a n d myself because I have been involved in e n c o u r a g i n g health professionals to reconsider the w a y they provide care tbr parents at this time. I was struck by the courage of the men, as well as women, who shared their experiences with us. I expected that parents who h a d experienced a t r a g e d y recently would
be talking with us but I was not p r e p a r e d for those whose b a b y had died m a n y years ago. T h e r e was the m o t h e r whose twins h a d been born 23 years ago, one was stillborn, the other died within a few days of birth. This m o t h e r was still grieving for both babies, but in p a r t i c u l a r for the stillborn twin because she h a d never seen her. She was still trying to imagine w h a t she looked like. T h e r e was the father still grieving for his d a u g h t e r stillborn 44 years ago. His grief was m a d e worse because he was not allowed to hold his d a u g h t e r , he only saw her 'lying on a cold m a r b l e slab'. H e was not allowed to b u r y her in the grave o f an older sister'who h a d died in infancy. H e was told that because the b a b y was stillborn she h a d to be buried in a separate p a r t of the cemetery. I h o p e d t h a t we, and by 'we' I m e a n health carers and society, were more successful t o d a y in helping parents 'go through' their grief but I a m sad to r e p o r t that that is not the case. A m o t h e r whose b a b y was stillborn a y e a r ago phoned. A l t h o u g h s h e was very grateful tbr the help she h a d received a n d felt that the midwives h a d been very s y m p a t h e t i c , she still could not talk to her p a r t n e r a b o u t their son. She a n d her p a r t n e r h a d not been given sympathetic counselling to help t h e m come to terms with their loss. T h e p a r e n t s I felt the greatest concern for were the ones w h o m a n a g e d to p h o n e the studio b u t were too distressed to talk to us on the air. W e know that there were both men and w o m e n in this situation a n d that there were v a r y i n g periods of time since their babies h a d died. W e did have calls from parents telling us of their 'successful' travels through grief and of how grateful they were to be given mementoes of their b a b y . T h e y found it helpful to have a photog r a p h , a lock of hair, a toy. O n e m o t h e r p h o n e d a n d said t h a t she had found the p h o t o g r a p h of her stillborn b a b y very comforting, but the p h o t o g r a p h was some years old now a n d was be101
102
MIDWIFERY
ginning to fade. Although she did not experience the pain of the death any more she still wanted to be reminded of her baby. We were told of sympathetic and comforting midwives, doctors and family and friends. Grief is an intensely personal experience and our reactions to it will depend very much on the society and culture in which we
live. I grieved for all the parents but particularly for those still grieving over 40 years after the baby had died. We must strive to ensure that health professionals and the society in which we live help all those whose baby has died. ANN THOMSON