Archives for December 2011

This article works in conjunction to our article that describes what to expect from the appearance of your baby, and the condition of your baby’s skin.  Please see The Skin of Your Stillborn for additional information.

Even the smallest of babies can benefit from a bath of sorts – babies born before ossification begins (approximately 16 or 17 weeks gestation and younger), can be gently placed in a clear container of saline water, which can allow the parents to hold and bond with their baby without damaging the physical form, and, this water can help restore a visible “fullness” of the physical form.  You can visit our early pregnancy at home birth plan for more information.

Related: How to Photograph a Baby Not Alive

Caregivers often are concerned about showing a stillborn baby to the parents, because of the compromised condition of the baby’s body. A baby who has been dead in utero for even a short time can have macerated and discolored skin and a misshapen head. Cleansing the skin of the compromised baby often may be viewed as adding more injury because the skin will slip even farther if a wash-cloth is used. The following information gives practical suggestions on how to care for a macerated stillborn infant.

1. Place the baby into a bath basin of warm bath water which has had baby shampoo added (I like to add Serenity essential oil).

2. Squeeze a washcloth with this shampoo water over the baby’s body; do not rub.

3. With gloved hands, place baby shampoo in hands and gently glide over the stillborn’s body to remove all drainage. Shampoo the hair gently also.

4. Next take the baby out of the shampoo water and discard the bath water. Rinse the soapy water off the baby by placing in a basin of warm water or by holding the baby under a gentle stream of warm running water from the faucet.

5. Take the baby from the rinse water and place on absorbent towels or underpads. Dab with a soft cloth, such as a Chix, to dry the baby – do not rub.

6. Place Vaseline gauze over macerated areas and hold in place with dry gauze wrap.

7. Transparent dressings (i.e. Opsite or Tegaderm) can be used over macerated areas if the skin next to these areas is intact. This type of dressing can be used over a weeping autopsy incision as well.

8. Dry ear canals and nostrils with Q-tips, gently.

9. If nostrils continue to seep fluid, place a small amount of petroleum jelly into each nostril. This will give shape to the nose and prevent further seepage.

10. Choose clothing that opens completely from the front or back. The important thing is to have clothing that promotes the least amount of handling and rubbing of the stillborn’s skin. The least amount of handling prevents further skin slippage.

11. Parents appreciate their baby dressed in blue clothing for a boy and pink clothing for a girl. Sometimes only blue or pink blankets may be available; use the appropriate color.

12. Diaper the baby.

13. Use a baby brush or comb to comb the baby’s hair. A bow can be placed in a baby girl’s hair by placing a small amount of petroleum jelly on the back of the bow to hold the bow in place. Give the comb or brush to the parents for a memento.

14. Snip a lock of hair from the back of the baby’s head for the parents’ baby book. Be sure this is within the family’s culture or belief before providing this memento.

15. If the baby’s head is misshapen, find a cap or hat that when tied under the chin makes the baby’s face appear more round. Fill in areas of the hat with gauze or cotton balls if more roundness is needed.

16. When taking the stillborn baby to the parents, line the baby blanket with absorbent underpads so any further weeping can be collected in the underpad without saturating through the baby blanket. Spraying the underpads and the blanket with a commercial baby powder freshener gives a pleasant baby scent memory and lasts longer than baby powder.

How to Take Photos of a Stillborn Baby

17. Take pictures of the baby clothed and unclothed in uncluttered backgrounds. Sinks, garbage cans, cleansing equipment do not provide backgrounds for memories. Remember whatever you see in the camera viewfinder will be in the picture.

How to Position a Stillborn Baby in the Morgue

18. Positioning the baby in the morgue is very important. If the baby is not in good alignment with the head straight, pooling of blood occurs on the side of the face in which the head is turned. Proper positioning allows for subsequent viewings by the parents with little change in the baby’s facial appearance and color. Use diaper rolls around the head and remainder of the body to promote good alignment.

Related: How to Photograph a Baby Not Alive

Our stillbirthday birth & bereavement doulas offer guidance in bathing and more.

[Used with permission, RTS Counselor Training Manual, 1993, p. 132]

Care providers can provide positive memories even when the stillborn’s skin is compromised. Hopefully, these tips will provide some practical ideas. For more information, please call or write:

Bonnie K. Gensch, R.N. RTS Bereavement Coordinator Lutheran Hospital—La Crosse 1910 South Avenue La Crosse, WI 54601 Phone: 608-785-0530, ext. 3796

(This article was copied in its entirety from WiSSP)

At the close of this article is the Mentorship Agreement that all mentors and mentees will need to read prior to establishing a mentorship relationship.

The Mentorship Program

The mentorship program is designed to create a one-on-one relationship between a newly bereaved parent and a parent of the same gender who has had a little more experience in this path from grief to healing.

The relationship will last 3 months, from the first contact, and will consist of one email exchange a week, for the period of 3 months.   Both the mentee and the mentor will be aware of the timeframe of their relationship, and both will know that they are expected to participate in exchanging a weekly email for no shorter and no longer than the three month timeframe.

To Find a Mentor

You choose the right mentor for you.

To find a mentor, first read through our guidelines here, then visit our list of mentors.  You can contact mentors who you feel are a great match for your needs, and if any are not already in a mentorship relationship, they will email you to begin one with you.  He or she will first make sure that you have read this article, as it contains the outline and expectations of the program.  After that, he or she will contact you weekly via email, for a period of 3 months, to listen to you, encourage you, and learn about other aspects of your life, particularly things that you find enjoyable.  He or she will help you identify tangible barriors in your process of healing, identify support systems and techniques for you to lean on, and help you identify your own inner strength as you find your way through healing.  The goal at the end of the 3 months is to affirm to you that you are not alone, and that other parents have come before you on this journey from grief to healing.

Boundaries/Expectations/Exceptions (Mentorship Agreement)

Grief can bring with it a whole host of unexpected reactions, which can potentially serve to abuse the mentorship relationship and/or the mentor.  For this reason, boundaries are important for this program to be successful.  Basic expectations of this program include:

• respect for the once a week contact, and not to over-use this resource or the mentor.
• respect for privacy and space, and not to demand any more information from the mentor/mentee than he or she is willing to share.
• respect for time, and not to contact in a way that is disruptive to the other person’s life/lifestyle.
• respect for the duration of the mentorship program, and not to demand, beg, insist or pressure for additional time.
• respect for the mentor/mentee, and limit use of explitives or anything else that could be deemed inappropriate whenever possible.
• respect for the emotional limitations of the mentor, and understanding that he or she is not a licensed therapist and that more intensive support may be needed for your grief process.  The mentor is not liable to perform or behave as a psychological professional, and he or she may suggest that you seek additional support if they believe it could prove useful.
• respect for differences between the mentor and mentee.  Your mentor/mentee may have different beliefs than you, including but not limited to religion, faith, family, death, life after death, reasons for death.  It is not a program requirement that you both align in every way, but both the mentor and the mentee reserve the right to terminate the relationship if these values/beliefs differences serve to be unproductive.
• respect for your self, and understanding that any threats to harm yourself or others is reason for the mentor to terminate the relationship, referring you to crisis hotlines and your local mental professionals for support.
• the mentor will check in with the Site Creator and their Mentorship Advocate(s) at least once a month for updates on the progress of the relationship, and together will determine the status of the mentorship relationship and in particular circumstances, will reserve the right to suggest supplemental resources and/or terminate the relationship if it is becoming toxic, harmful, or unproductive.
• both the mentee and the mentor should have access to their Mentorship Advocate(s) and to the Site Creator, and all extreme differences that prove to make the relationship unproductive should be shared with either the Site Creator or the Mentorship Advocate(s).  The best way to do this, is to submit your reply at the end of the Mentorship tab.
• Mentors take their role very seriously.  If there is a delay of 3 weeks in your communications, the mentor may be matched with another mentee, and you may need to re-enter your information to be possibly matched with another mentor.  You can enter the mentoring program in this way a maximum of 2 times.
• If you complete your full mentoring relationship and would like to be mentored further, you can re-enter your information to be possibly matched with another mentor.

To Become a Mentor

Becoming a mentor is a great way to relate to another grieving parent, and to help you to see how far you have come in your own journey.  It is a way to have a positive impact, get involved, and to allow your tragic experience to be used for good.  No official training is necessary, it is free, fairly simple, and can be very fun.

• You must be a loss mom or dad, with at least one year of time from your most recent loss.
• You do not need to have had a “perfectly pretty” journey in your own grief experience, but a willingness to see that the difficulties and frustrations you faced can help provide insight, awareness and even prevention for another bereaved parent who may fall into similar steps.
• Engaging in “continuing education” through activities that are relevant to birth and bereavement mentoring is recommended.  You can use our resource for guidance with this.  The stillbirthday doula training is highly recommended but not required.  The Psychological First Aid online resource is invaluable and strongly recommended.  If you obtain certification through any of their programs (many are free), this will be highlighted in your bio section.
• The site creator reserves the right to request a letter of recommendation from a pastor, counselor, or leader in the pregnancy loss community.
• It is not required that you have had a pregnancy or infant loss, but that you have lost a child under the age of 21 years of age.
• After you submit your information, you will be added to the stillbirthday mentor list.  It is up to you to check your email regularly to see if a newly bereaved parent wishes to begin a mentorship relationship with you.
• If you receive a mentoring request at a time you feel a match is not appropriate, you should help the mentee locate a stillbirthday mentor who is a better match for them.  Reason for this referral should be clearly articulated that you believe the third party to be a better match to better serve the mentee – you should never imply an issue with the mentee, whatsoever.
• You must be willing to commit to exchanging an email with a newly bereaved mother/father weekly for a duration of 3 months.  You should utilize our SBD Mentoring Activities as a guide.
• After a 3 month mentorship relationship, it is recommended that you take 3 months “off” before beginning a new mentorship relationship with another newly bereaved parent.
• You must be the same gender as your mentee.
• You should harness and promote positive relationships, resolutions, behaviors, and perspectives to the mentee.
• You should advocate hope and peace and overcoming negative effects of grief or loss.
• You should not foster or encourage violence, attacks (physical, verbal, or writing) or harboring feelings of bitterness, retaliation, aggression, depression or passive aggression.
• You should maintain the highest level of maturity, discretion, and discernment at all times in all communication with your mentee.
• You should uphold confidentiality and not share any information about the mentee with anyone, at any time, unless it is with the mentor advocates in regard to seeking additional insight into a concern.
• Physical location (state, province, country) will not be a barrior in matching mentors and mentees.
• You should not mentor more than one parent at a time.
• You do not need to give out your phone number to the mentee, and should not give out your address.  Offering more to the mentee than a weekly email is at your own discretion but is not required nor expected.
• You are expected to update the Site Creator and your Mentorship Advocate(s) at least monthly through the course of each mentorship relationship, so that we can assess the progress and determine additional or alternative support as necessary.
• Please join our Mentors Facebook group to get updates on fun and exciting ways to engage your mentee in conversation in various topics both related and not related to loss and grief.
• Stillbirthday is not liable to any damages, whatsoever, to either party, in the mentorship relationship.
• What happens during the course of pregnancy loss, at any gestation, is in fact, the birth of a child.  It is important to validate this experience for what it is.
• If we have additional skills, talents or services related to pregnancy in any way, that is run as a business, we do not use stillbirthday as an advertising front to pressure mentees to purchase goods or services.
• We understand that the form of contact made by stillbirthday mentees is through email.  Therefore, we strive to visit our email regularly, and the group regularly.  Willingness to serve is crucial to our role.
• When participating in our online group or in other communications, we will respond to each other in a manner that brings the most consideration to feelings (we are loss parents, too), while still cultivating an environment of exploration of ideas.  Our mentor advocate leadership team decide individually and/or collectively on ways to navigate conflict resolution, including offering alternative perspectives or approaches and private consultation/mediation.
• The site creator reserves the right to request to be forwarded any or all email exchanges in a mentoring relationship or be CC’d in any email exchanges.
• All stillbirthday content is copyright protected.  Ideas, conversations, and information learned through email updates, phone calls, any form of social media including our private online group, anything learned or derived through the website, or in-person contact between any members of stillbirthday (doulas or mentors) should maintain creative copyright protection; we will properly credit sources of content.  Additionally, we will maintain confidentiality through each of these avenues as appropriate.
• We aim to connect the family with as many applicable resources as possible; therefore, we refer families back to stillbirthday for ideas, resources, and information.
• We strive to continue learning more about pregnancy loss through our online group and through self-study, so that we may provide optimum care to families.
• All services, including mentor services, are listed through stillbirthday voluntarily.  There are no paid employees and the site creator and each mentor has the right to remove her listing at any time.

If you would like to become a mentor, simply join our private group and you’ll get connected with Heidi Faith.

Role of the Mentorship Advocate

The mentorship program is the longest support program offered by stillbirthday.  As such, additional strong leaders are important to running a smooth program.  Two mentorship advocates for mothers, and two mentorship advocates for fathers, help to run the Facebook mentorship group, including: helping to work through various obstacles to healthy mentoring relationships, giving tips, suggestions and resources to the mentors participating in the program, and offering counsel and advice in specific situations.  Having two for each parent/gender helps to ensure that there is someone in a leadership role who is available and who can understand best the specifics that may be involved in a particular situation.   You can email to mentoring@stillbirthday.info or visit our main mentoring page with any issues with the mentoring program.

Breaches of This Contract (by either the mentor or the mentee) and How to Share Concerns

Breaches of the mentoring agreement contract will be handled either by the site creator directly or by the mentorship advocates as a team, but resolutions to breaches are not limited to: referral to additional, professional support for the mentee, interjection/mediation by the site creator and/or mentorship advocates, termination of the mentoring relationship, mentor removal from the program.  It is extremely important for mentees to know that you have a vital line directly to the site creator, to submit any complaints, concerns, compliments and feedback you have about the program and your mentor.  Conflicts or concerns about a mentee or a mentor should be made confidentially with the site creator through the link given, and not made in a public, condemning, shaming or judgemental way.

Preparing to deliver and to meet your stillborn baby can be an extremely overwhelming time.  It can also be very unsettling to discover that he or she has skin changes or a physical appearance that you were not anticipating.  The information provided in this article serves to work in conjunction with our How to Bathe a Stillborn Baby article.

Preparing for what to expect in the appearance of your baby can be very helpful – but it can also be painful.  Please know that the information in this article may be upsetting.

Maceration (from Latin macerare  —  soften by soaking) includes all the changes which occur in a fetus retained in utero after death – in a stillborn baby, prior to birth.  The appearance of your baby’s skin and features can help determine the time of your baby’s death.  Changes take place to your baby’s skin within a few short hours after his or her death.

Classifying stages of maceration:

Estimating the time of death in stillborns:

• Desquamated skin measuring 1 cm or more in diameter and red or brown discoloration of the umbilical cord correlated with fetal death 6 or more hours before birth.
• Dequamation involving the skin of face, back or abdomen (12 or more hours)
• Desquamation of 5% or more of the body surface (18 or more hours)
• Moderate to severe desquamation, brown skin discoloration of the abdomen (24 or more hours)
• Mummification is seen in fetuses who had died 2 or more weeks before birth

Additional damage to your baby’s skin can be caused by:

• Asphyxia (depletion of oxygen) causing Hypoxia (causing skin to either appear a light blue or a deep cherry red)
• Instrumental delivery (forceps delivery can cause damage to the baby’s skin)
• Vaginal breech delivery
• Macrosomia
• Prolonged or rapid delivery
• Cephalopelvic Disproportion (CPD) (fetopelvic disproportion)
• Bathing your stillborn baby incorrectly (see our article on How to Bathe Your Stillborn Baby)

You can have an idea of what to expect when you meet your baby by viewing our photo section of babies, all donated by mothers of miscarried and stillborn babies.

You can learn about how your baby appears now, in Heaven, by viewing our devotionals section.

Parts of this article were borrowed from the Atlas of Neonatal Pathology