Grieving the Loss of Stillborn Infants

On a recent trip abroad, I meandered through a cemetery reading gravestones. Some were old and faded and some very recent and fresh.

It is always interesting to me to observe how mourners memorialize their loved ones, and the variety of expressions they create when they visit graves year after year.

As I wandered, I discovered a sizable corner section devoted to babies born asleep. These stone or metal markers had only one date. Birth and death had occurred the same day.

Some of these graves were adorned with flowers, toys, stuffed animals, angel statues, and plaques with inscribed poems, sayings, and tributes to the child. Others had only a small stone or plaque on the ground with the name and the singular date, nothing more.

I made no assumptions about the mourners represented there, whether their expressions were simple or extravagant. Grief is a very personal affair. There are no right or wrong ways to show love to someone who has died.

One of the leaders of our excursion noted that life is what happens in the dash between birth and death. At this moment I shared my observation about these stillborn infants whose grave markers contained no dash. Only a dot. One day.

At that point, a woman in our group spoke up. She shared that she had delivered such a child, a daughter, more than 20 years ago.

The baby had been loved and named during the pregnancy, but sadly couldn't grow and be known beyond her birth. The baby had been mourned and buried, but her grave did not yet have a stone.

My traveling companion thanked me for helping her realize that part of her grief process was as yet unresolved. She still feels the dull ache of that loss so long ago.

As our travels continued, she shared thoughts about how she might honor in the present this daughter she had loved but never known outside the womb. There was more grieving to do, and more healing to come. She decided it would be helpful and meaningful to have a gravestone installed.

Disenfranchised Grief

Childbirth is one of the most emotionally intense experiences that occurs in the life of a woman and family. Most who have experienced it would say that having a baby changes everything.

Most people would also assert that the death of a child is one of the harshest traumas a person can endure.

To experience both of these momentous events on the same day can bring on a psychological crisis that shatters the lives of women and their partners, sometimes for many years.

According to the Centers for Disease Control (CDC), approximately 1 in 175 births are stillborn, equating to about 21,000 babies each year in the United States.

The level and duration of acute suffering after a stillbirth varies according to individual personality; mental health status; stage of life; previous miscarriages, stillbirths, or healthy births; emotional investment in the pregnancy; and the presence or absence of professional intervention and social support.

Unfortunately, after the birth of a stillborn child, many couples experience invalidation and minimization of their pain and loss. A researcher of perinatal loss notes, “Grief following miscarriage, stillbirth or neonatal death is particularly susceptible to being disenfranchised, as only parents have ‘known’ the baby, felt it move, or observed it by ultrasound.” (2)

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Well-meaning friends or family members may make insensitive comments about trying again to have a baby. Or they express as a positive that at least the parents didn’t lose a baby they had come to know and love. These reactions can make the complex recovery process even harder.

Intervention and Support

Research supports the benefits of early professional intervention. This may include individual or marriage counseling, referral to a support group, or medical treatment to address clinically significant psychological problems that may arise.

It is also important to shore up appropriate support systems.

Often, bereaved mothers will turn to their mothers, sisters, or female friends for support instead of their partners. This can have implications for the stability of the marital bond, as the partners can't effectively grieve together. Caring professionals and friends can encourage couples to stay connected and mutually supportive, even if their grief processes appear very different.

Both professional and community caregivers must take into account the entire family system. How are the siblings of the stillborn child processing, understanding, and grieving a confusing season of loss in the family? The presence of grandparents and other sympathetic extended family members can be crucial in providing a cushioning, supportive environment for children to express their feelings honestly.

Though the grief process is likely to extend for many years, longitudinal studies indicate that acute suffering begins to decline over the two years following a stillbirth.

Complicated bereavement symptoms of depression, PTSD, anxiety, and insomnia tend to occur most severely in individuals who had existing mental health problems before the loss of the child. Reactions may also be more severe for women who have had previous miscarriages or other perinatal losses.

Many people, like my traveling companion, manage their grief in healthy ways. They continue to honor the unique individuality and reality of the child they carried and lost. They acknowledge their feelings and express them to supportive people, and they utilize their emotional resilience and spiritual strength to cope with difficult emotions when they arise.