Breaking the silence : let’s talk about baby loss

By Dr Stephanie Borg Bartolo, Counselling Psychologist

The 15th of October marks Pregnancy and infant loss Remembrance day. As hard as it is, I am hoping this short post will help spread awareness to both those parents who experienced loss, and to those who were lucky enough to not endure the heartache.

Unfortunately, some parents will lose a baby through miscarriage, stillbirth, or neonatal death. Different types of death carry with them different emotions, adjustments, and disruptions in the parents’ dynamic. When a couple goes through a miscarriage or stillbirth there is a shattered illusion of their hopes and expectations of what this baby could have brought to their lives.

Around 10–15% of pregnancies will end in miscarriage in the first few weeks

Miscarriage is fairly common. It is estimated around 10–15% of known pregnancies will end in miscarriage in the first few weeks (March of Dimes, 2021). However, the idea of this being common can offer little consolation to mothers who experience it. Apart from the physical pain that comes with a miscarriage, there is a mixture of emotions that are experienced, including shock, disbelief, sadness, anxiety about future pregnancies, and guilt. Some parents find themselves going over every little detail to explain why they may have lost the baby. Fathers and partners also go through similar emotions and can often feel lost as to how they can help the mother who sometimes may shut the other parent or partner out in her grief. A systematic review done by Campbell-Jackson and Horsh (2014) shows that stillbirth for example is significantly distressing, symptoms can last up to 3 years and is considered a life-changing event (Burden et al., 2016).

At times people in the outer or inner circle of someone who experienced loss find themselves not knowing what to say, leaving the parent feeling even more alone. It is not uncommon to hear things such as “at least you know you can get pregnant”, “focus on your daughter who is still here she needs you, you can’t keep crying all the time”, “it was only 6 weeks at least”. Loss, at any gestational age, is a very personal experience and can be quite traumatic. I have had many friends and clients tell me, after those comments “ I just stopped mentioning him, I didn’t want to make people uncomfortable”.

Unfortunately, while we have moved forward in many aspects, talking about loss, especially perinatal loss, is still a bit of a taboo subject. I find there is a lot of secrecy surrounding it. According to the WHO “women who lose their babies are made to feel that they should stay silent about their grief, either because miscarriage and stillbirth are still so common, or because they are perceived to be unavoidable”. However, some parents want to talk about their experience, about their child, when they are ready and on their terms. Given that this month also marked World Mental Health Day, I would like to shed light on the importance of perinatal mental health. We need to keep checking in on these parents, and that means even months after. Grief is not linear and it does not just go away after a few weeks or when the person starts smiling again.

Parenting after loss, rainbow babies

A rainbow baby is a child born following a loss. Many times it may be an oversimplistic symbol since the arrival of a new baby does not remove the grief parents feel. However many parents find it a symbol of hope after a very difficult period in their lives.

One must be prepared for conflicting emotions. It’s ok to feel happy and sad at the same time. It is normal to feel joy at this new arrival while also wonder what their sibling might have been like, or how he/she would have reacted to becoming a big brother or sister. It is paramount not to put pressure on yourself, especially since the arrival or birthing process may in itself be a trigger. Again, this is not to say that all parents experience the same things. It is a very personal journey. Some parents also feel very guilty. They feel like they love their child so much that they are somehow disloyal to the child they lost. Others feel guilt because they are aware that had the other child survived, the one they had may have not existed.

At times parents may have fantasies that their anxieties will dissipate after their baby is born, however, sometimes this continues. They may find it difficult to accept that everything is okay and keep expecting bad news. Some anxieties are normal, but at times this can develop into post-natal anxiety and the parents would need to seek professional to help with this as the thoughts can become incessant and cause the person significant distress.

Coping with difficult questions

Some parents find it especially hard dealing with questions such as “is this your first baby” or “is she an only child”. Knowing how to answer these questions can be tricky, especially if you have not yet defined your experience. Many parents choose to think of themselves as “ a mother of 3, two here and one in heaven” for example. Some parents decide to talk about their previous losses, others don’t. Both options are personal and perfectly okay.

How can you help someone who has experienced perinatal or neonatal loss?

1- Remember to be a human first. Listen and be present, sometimes it’s all you can do. A simple “how are you today?” can be enough to show the person you genuinely are interested. Be sensitive, rarely can anything you say make things better, what makes things better is connection. For example, rather than saying “everything happens for a reason”, try saying “I am so sorry for your loss”.

2- Ask what would help them and accept that their needs may differ to what you may need in their situation. Do they wish to talk about it or not? Do they need a distraction or just a warm plate of food?

3- Follow up, check in on them. Unfortunately, during loss, we find that sometimes you may have people be very present- in the first week, but then this support tends to start fading, people move on and this can feel even more lonely when the person who experienced the loss, or multiple losses has not.

To all the parents who have lost a baby, here are some things that can help

Try being kind to yourself first of all and don’t be afraid to acknowledge your loss. No matter at what stage, your baby existed, and your baby mattered. You matter and so do your emotions. Take time to recover in whatever way helps.

Find a way of commemorating your baby, this could be done by planting a tree or a plant in her name, ordering a token with your baby's name or a quote and place it somewhere comforting, or making a donation in his name. Sometimes writing a letter to your baby on her birthday or due date can also help (if you are in a good place to do this).

Reach out, many parents talk about how helpful it was to speak to people who went through something similar, there is a shared emotional experience and that helps them feel connected to something bigger than them.

Some parents go on to develop mental health issues following the loss of a child (WHO, 2021). Seek professional help. Some people are not there yet, and fear that talking to a professional may open “the floodgates”, and that’s ok. Everyone moves at their own pace. However, if you do experience perinatal mental health issues it is paramount to seek help. There is no shame in admitting that the loss is taking a toll on you, it is perfectly understandable.

Here are some places that offer free perinatal support locally

Parent and infant mental health alliance Malta

Perinatal mental health clinic Mater Dei

Final reflections

Yes, miscarriage is common. Yes, stillbirth happens as does neonatal death. Yes, the statistics are what they are. But, we are stories, not statistics, every person has their own journey, their own emotions, their own coping mechanisms and yes, their own story. If you take one thing from this article, remember this, connect on a human level, allow people to share their story if they choose to, let people feel like it is a safe space to do so. And to those who are still grieving, you are not alone, if the statistics mean anything, it means someone out there has a shared experience and as I said before, rarely can a response make things better, what makes things better is connection.

This article is dedicated to all friends and family who have experienced perinatal and neonatal loss and to all their angels, including my own.

Dr Stephanie Borg Bartolo - Counselling Psychologist & Intervention Lead

Dr Stephanie Borg Bartolo is a warranted counselling psychologist and has worked both in the U.K and Malta. She has a special interest in trauma, personality, attachment and projective techniques. She also has a special interest in perinatal and infant mental health.

Apart from teaching at the University of Malta, she is also TAASC’s Lead on Intervention.