Fallen Tree: On grieving a miscarriage, stillbirth, or early infant death during a pandemic. *TW*

By: Sarah Cline, LCSW, PMH-C

I believe the analogy goes, if a tree falls in a forest at night and no one is around, does it even make a sound? This analogy inspired the title of this post. Let me explain why. In normal times, no pandemic times, if a pregnant person miscarries, or has a baby stillborn, or has an infant who dies very shortly after birth……their grief may not be recognized in the same way that other types of death losses are. This is true for many reasons and it is very difficult for the people experiencing these types of deaths. Now there is a pandemic that has increased social distancing, reduced the amount of large gatherings people have/or attend, and not allowed for as many hospital visitors (if any at all). In turn it has reduced the ability for those grieving a perinatal loss (miscarriage, stillbirth, early infant death) to mourn in ways that are helpful in their healing. We heal by having our loss seen and validated by not only ourselves but by others. So that tree in the forest is a perinatal loss in a pandemic. It most definitely occurred but can anyone hear the sorrow of those that mourn? In this article I will briefly explain what some of the challenges are when a perinatal loss occurs in a pandemic and then offer some tips on how to cope despite these obstacles. To those who are grieving, we see you.

What does one do when their baby dies in a hospital at 1, 2, 3, 4, days old? This baby never gets to go home, doesn’t get to meet extended family, doesn’t get to do all the things it’s parents hoped for. Prior to covid, extended family could come in and see the baby, hold the baby, get a photo with the baby (not always was this possible but frequently it could be done). Now hospital visitor restrictions have made that impossible. Another challenge covid-19 has created is in regards to support groups. One way that many families cope with a perinatal loss is by attending support groups with other parents (or even grandparents groups sometimes) who are grieving. Due to Covid, many support groups are online now and lose some of that in person connection. It is certainly better to do a virtual group rather than no group but it does bring more challenges (such as other kids/caregivers who may be in the home and able to hear the group). I know some parents don’t attend support groups virtually because of a lack of privacy to do it at home.

Another challenge that the pandemic has created and that was mentioned previously is hospital visitor restrictions. This impacts not only the ability for family members to visit but also the ability for professionals to come to the family’s side in the hospital. Many parents who have a stillborn or early infant death want photos taken (or they are advised to do it and keep them in case they ever want to view them). In the early pandemic days additional people weren’t permitted in the hospital. Parents could rely on their own photos but I know many grieving parents who cherish the professional photos that were taken of their deceased baby. This situation is further complicated if the birthing person’s partner is unable to companion them to the hospital because they have to quarantine. That creates even more complications and challenges for the birthing person.

Additionally, during covid-19 many expecting people have had to attend their ultrasound and OB/midwife appointments alone. Often times a miscarriage or fetal death is discovered during those appointments. No matter what, hearing that your baby is no longer alive is a very traumatic experience but now you have pregnant people facing that moment alone without their support person by their side. This just adds an additional layer of trauma to an already very traumatic experience.

So what can we do? The following are some suggestions of things you can do (in a pandemic or not) that can assist you on your path of grief and healing:

• If you are going in for an induction due to your baby’s prenatal death find out the visitor policy at the hospital right away. Some make exceptions when someone has died.

• If you are in the hospital and your baby has died (and you want photos, please consider this even if you think you don’t in the moment) ask a staff person (nurse or social worker most likely can help) to take some photos of you holding your baby. Take photos yourself of your baby if you can but if you can’t ask someone to do it. Have them include close ups of baby’s hands, feet, and any little part you just want to remember.

• If you have had a perinatal loss ask about support groups, ask if any are in person right now if you are comfortable asking. (hopefully you are just given this info but if not just ask).

• Ask for a list of therapist that specialize in perinatal loss.

• Ask for any mementos from your baby (blanket used, lock of hair, hand/foot prints)

• Remains, you can ask for the remains of a miscarried baby as well as a stillborn and early infant death (stillborn/infant death will require a death certificate and plan for burial or cremation). Earlier miscarriages can also be buried or cremated. If you are in a hospital ask. If you miscarry at home it is ok to remove the remains that you see and place them in a box for burial or cremation. It is also ok if you don’t want to do that. It is completely up to you.

• Know that it is ok to grieve the loss of a pregnancy no matter how early the loss occurred. Some choose to name the baby lost due to miscarriage, some do not.

• If you would like a traditional funeral or memorial service don’t be afraid to ask for that. Reach out to your local church community or funeral home. They will be glad to walk you through it all.

• Know that it is ok to NOT be ok. You will come through but these losses are very difficult and take time to heal.