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

The following segments are derived from extremely helpful slideshows presented by credible professionals in the field of grief and loss.  I’ve put them in this written format to ensure that anyone can access them easily.   I’d strongly encourage you to please visit the links at the end of each section, as each slideshow has a tremendous amount of information regarding the NICU, loss, and grief experiences.

What is Grief? (27)

• Grief is a normal response to an abnormal life event.
• A grieving person may experience physical and emotional symptoms along with intellectual, social and occupational responses.
• Grieving people may also question their spiritual beliefs; many experience a crisis of faith as part of the grief response.

The Body’s Response to Grief (28)

• A person experiencing a loss may experience somatic (body) complaints that include: fatigue, aches, insomnia, gastrointestinal symptoms, nausea, chest pressure, palpitations, shortness of breath, back pain, stomach pains, anxiety and panic attack.

Stages of Grief (30)

• Stages of Grief – DABDA
• Denial
• Anger
• Bargaining
• Depression
• Acceptance
• These stages should only be viewed as a tool to help frame and identify what a grieving person might be feeling, not absolutes of what they should be feeling or experiencing.

Tasks of Grief (31)

• In the 1980’s, William Worden looked at grief as a series of tasks that one works through:
• Task One: to accept the reality of the loss
• Task Two: to work through the pain of grief
• Task Three: to adjust to a different type of environment
• Task Four: to emotionally relocate the loss (deceased) and move on with life

Key Facts about Grief (32)

• Pastor Bob Deits, author of Life after Loss, a classic in the field of loss and grief, describes four key facts about grief:
• The way out of grief is through it.
• The very worst kind of grief is yours.
• Grief is hard work.
• Effective grief is not done alone.

Companioning the Grieving (33)

• Alan Wolfelt, Ph.D. talks of companioning as:
• honoring the spirit.
• learning from others.
• being curious and being still.
• walking alongside.
• listening with the heart.
• bearing witness to the struggles of others.
• being present to their pain.
• respecting disorder and confusion rather than imposing order and logic.
• Companioning is NOT about thinking you are responsible for finding the way out of grief.

Intuitive (Emotional) Grievers (46)

• Intuitive grievers feel grief intensely and find expressing emotions by talking or crying is helpful.
• They are comfortable with expressing strong emotions, are sensitive to their feelings, and are aware of the feelings of others.
• Sharing feelings about the loss and providing support to others can be very healing for the intuitive griever.
• The intuitive grief style or emotional style is the one often associated with the typical female grief.

Instrumental (Physical) Grievers (47)

• Instrumental grievers experience grief, but it is less intense or emotional and more physical than the intuitive griever.
• Instrumental grievers like to think or problem solve ways of coping with the experience.
• For instrumental grievers the grief tends to be more private or hidden.
• They may be reluctant to talk about their feelings.
• The instrumental grief style or physical style is the one often associated with the male grief.

The above information is borrowed from the work of Kirsti A. Dyer MD, MS, FAAETS, NCBF Physician, Grief Educator, College Instructor from the Grief in the NICU: Identifying, Understanding and Helping Grieving Parents slideshow (marked by number)

Basics of Coping (34)

• Take it one hour at a time, one day at a time.
• Maintain a normal routine.  Keep doing normal activities.
• Get enough sleep or at least enough rest.
• Try to get some regular exercise; even walking helps relieve stress, tension and improve moods
• Maintain a healthy, balanced diet.  Limit junk food.
• Drink plenty of water.
• Avoid using alcohol or other drugs to mask the pain.
• Do those things and be with those who comfort, sustain and recharge you.
• Remember past losses and the coping strategies used to survive them.  Use these inner strenths again.

Remember TAKE CARE:

• Time is needed to handle the grief.
• Avoid alcohol or other medications.
• Keep to some routine or schedule.
• Eat a balanced diet.  Focus on healthy foods and water.
• .
• Converse with others, especially those who have “been there” and “survived that.”
• Art can help keep the hands busy, whether journaling, building, crafting, or other.
• Rest and sleep are important to help the body heal.
• Exercise to reduce stress and improve one’s mood.

Helpful Strategies (35)

Initial Minutes:

• Reassure parents that what they are feeling is normal.
• Listen to their story of loss.  It provides comfort.

Early Hours:

• Advise parents about available resources.
• Share information that others have found helpful.

Later (Weeks):

• If a parent remains distressed after several weeks or is profoundly affected, a referral to a professional grief counselor would be beneficial.

Grief Responses (36)

• Each person experiences grief in his or her own unique way.  People have very different grieving styles.
• It can be very helpful for parents to realize that each of them may respond quite differently.
• Parents can be encouraged to grieve separately as well as together; this enables each person to express grief in his or her own unique style and way.

Conventional and Masculine Grievers (37)

Conventional Grievers:

• Identify others as sources of support
• Openly expresses feelings
• Temporarily withdraws from responsibilities
• Allows time to experience inner pain
• Joins support groups
• Chooses ways to express feelings – journal, quilt, project

Masculine Grievers:

• Shelves thoughts/feelings to cope with present
• Chooses active ways of expressing grief – hobbies
• Uses humor to express feelings and manage anger
• Seeks companionship
• Uses solitude to reflect and adapt
• Writes – journals

Cultural Aspects of Grief (38):

• Language – use interpreters as necessary.
• Social Unit, Role of Elders – determine who makes decisions.
• Family History – consider possible prior discrimination or challenges.
• Gender Differences – how their culture regards men and women.
• Spiritual/Religious Beliefs – Role of Hope
• View of the Future
• Expressions of Grief – determine how their culture expresses grief.

Perinatal PTSD Questionnaire (45)

Have you had the following experiences within 6 months of your birth experience?  “Yes” answers are only those that you experienced for longer than 1 month, in that 6 month timeframe (a “yes” answer to 4 or more would be an indication of referral for further evaluation):

1. Did you have bad dreams of giving birth or of your baby’s hospital stay?
2. Did you have upsetting memories of giving birth or of your hospital stay?
3. Did you have any sudden feelings as though your baby’s birth was happening again?
4. Did you try to avoid thinking about childbirth or your baby’s hospital stay?
5. Did you avoid doing things that might bring up feelings you had about childbirth or your baby’s hospital stay (for example, not watching a TV show about babies)?
6. Were you unable to remember parts of your baby’s hospital stay?
7. Did you lose interest in doing things you usually do (for example, did you lose interest in your work or family)?
8. Did you feel alone and removed from other people (for example, did you feel like noone understood you)?
9. Did it become more difficult for you to feel tenderness or love for others?
10. Did you have unusual difficulty falling asleep or staying asleep?
11. Were you more irritable or angry with others than usual?
12. Did you have greater difficulties concentrating than before you gave birth?
13. Did you feel more jumpy (for example, did you feel more sensitive to noise or more easily startled)?
14. Did you feel more guilt about the childbirth than you feel you should have?
15. Would you like to talk to someone about your responses to these questions or feelings about this questionnaire?

The above information is borrowed from the work of Kirsti A. Dyer MD, MS, FAAETS, NCBF Physician, Grief Educator, College Instructor from the Identifying, Understanding and Working with Grieving Parents  in the NICU slideshow (marked by number)

“Childbearing losses may affect women and their families for a lifetime.  The affects of childbearing losses may occur well after the childbearing years have ended.”  -Wisconsin Association of Perinatal Care (2)

“Grief reflects the psychological and spiritual attachment to the baby that was lost physically and strongly resists abandonment of the baby.  It is based on the primeval energy of parental attachment, which is used, although there is no baby.” -Leena Valsanen, Author, Family Grief and Recovery Process When a Baby Dies: A Qualitative Study of Family Grief and Healing Processes After Fetal or Baby Loss.  Department of Psychiatry and Department of Nursing, University of Oulu, Finland, 1996. (3)

Perinatal losses need to be treated as unique bereavements that are different from other types of bereavements.  According to Leon, 1990, these losses: (4)

• disrupt a significant milestone (pregnancy, birth, infancy)
• cause isolation from peers
• cause inner conflicts for the griever
• reorganize self esteem

A 1995 study by Zeanah et al reported that stillborn and the deaths of infants are equally painful to parents and that the length of the gestation does not effect the extent of the parental attachment. (5)

Mothers and Grief (9)

• Mothers who experience the sudden death of a child (eg stillbirth, SIDS) tend to have more intense grief reactions than those mothers whose children die as a result of a chronic condition.
• Mortality rates are higher in mothers who have experienced the death of a child (2003 study conducted in Denmark).
• 20% of mothers who have experienced stillbirth, experience a prolonged episode of depression and one in five mothers suffers from post traumatic stress disorder (2002 UK study).
• Mothers who experience stillbirth are at risk of developing postpartum major depression.  The risk of depression is highest within the first six months after delivery.  The mothers who are at highest risk of becoming depressed are those who fail to show any signs of grief during the first two weeks after the stillbirth or those whose grief does not show any signs of diminishing six to nine months after the stillbirth.
• Thoughts of suicide are not unusual in the aftermath of stillbirth.  30% of mothers report having had such feelings.

Fathers and Grief (14)

• Because fathers tend to be less verbal about their grief, their grief has been underestimated in grief research.
• Grief in fathers tends to peak around 30 months after the death of the baby, whether that baby is stillborn or whether that baby dies shortly after birth (2002 study, University of Queensland, Australia).
• Study conducted by Swedish researchers (2001) concluded that fathers’ “general trust in life and the natural order was suddenly and severely tested by the death of their child, which they perceived as a terrible waste of life.” Being able to protect their partner and grieve in their own way was important to the fathers interviewd by this group of researchers.
• Fathers initially grieve by doing – by caring for the mother.
• They may try to mask their own grief in an effort to protect her.
• Father’s can have a difficult time separating their own grief from the mothers grief.
• Father’s can experience both physical and emotional pain in response to their grief.
• The father’s grief feelings may not be validated to the same degree as the mother’s grief feelings.

Children’s Grief (16)

• Children who have lost a sibling through stillbirth may tend to minimize or delay their own grief symptoms in order to avoid “upsetting” their parents.
• Girls who are age 7-12 and who had strongly identified with their mother’s pregnancy are especially likely to want to “fix” their mother’s grief.
• Children don’t have the same support systems as adults to help them cope.
• Children who have lost a sibling through stillbirth suffer in other ways as well.  At the very time they need their parents most, their grieving parents may be emotionally treading waters themselves.

Grandparents and Grief (18)

• Grandparents grieve a stillbirth on two levels: they grieve the death of their grandchild and they hurt because their children are hurting.
• Sometimes a bereaved grandmother will try to “shut down” her daughter’s grief – an indication about her own feelings about the power of grief and the fact that women are vulnerable to suffer losses like stillbirth.

The Unholy Trio: Grief, Trauma, and Guilt (21)

• Trauma can freeze or delay grief, but it doesn’t make grief go away.
• Complicated Grief is believed to occur in 21% of cases of perinatal bereavement.
• The loss of one or more multiples can take a particularly long time for a parent to process.  One study found that it took three to five years to be able to incorporate their loss without significant sadness or depression.  Part of the challenge is having the language to label surviving children (eg two surviving triplets are not twins).
• Dealing with guilt (in most cases, unwarrented guilt) and regret about difficult decisions that were made with regard to their baby’s stillbirth only adds to the pain.

A study by researchers at Millersville, Pennsylvania (2001) found that the majority of parents describe their child’s death as precipitating a crisis in meaning that resulted in stronger connections with other people, desire to engage in activities that would give their child’s life and death meaning, enriched beliefs/values, personal growth, and feelings of connection with the child who had died.

The above information is borrowed from the work of Ann Douglas, Author, Speaker of Canadian Foundation for the Study of Infant Deaths Converance from the Still Unanswered, Always Remembered slideshow (marked by number)

This article begins, by serving to provide support specifically to mothers who’ve endured the loss of their child or children, after enduring the struggle of medically assisted conception (or Assisted Reproductive Technology – ART).

There are many forms of medically assisted conception, as well as many forms of pregnancy loss or reasons for grief following this support.

Regardless of the method(s) of assistance you endured to conceive, it has likely been an expensive, emotional, painful, seemingly isolating journey that challenged your marriage, your understanding of motherhood, and even your identity.  After enduring all of that, to finally have conceived – to likely have been able to bond sooner with your baby than most other mothers because you may have found out about your pregnancy sooner than most, and may have even been given a photo of your embryo – to have experienced that amazing and profound joy, and then to have it end in loss, is devastating.  Please know, that you are not alone.

Here are some methods of conception assistance, and you may have utilized any of these:

• Ovulation Induction
• Ovarian Drilling
• Intrauterine Insemination
• Female Surgery: Laparoscopy
• Female Surgery: Tubal Sterilization Reversal
• Female Surgery: Hydrosalpinx Removal
• Male Surgery: Testicular Biopsy
• Male Surgery: Testicular Sperm Aspiration (TESA)
• Male Surgery: Percutaneus Sperm Aspiration (PESA)
• In Vitro Fertilization (IVF)
• Embryo Freezing
• Embryo Donation and Adoption
• Embryo Adoption Awareness
• Blastocyst/Embryo Transfer
• Traditional Surrogacy / Gestational Surrogacy
• Other

Pregnancy loss, or reasons for grief, can occur at any point after conception takes place, and can include any of the following:

• Any of the types of pregnancy loss listed here at stillbirthday
• One or more of the implanted blastocysts/embryos did not continue into a complete and vital pregnancy
• Grieving the loss of multiple blastocysts, either by medical discarding, selective reduction, freezing expiration, embryo adoption or any other situation
• In traditional surrogacy, the “intended mother” grieves the biological experience that the father has
• In either traditional or gestational surrogacy, you are the surrogate mother and you grieve the “loss” of the child as the baby is welcomed by their family
• In either traditional or gestational surrogacy, you are the surrogate mother and you experience pregnancy and infant loss and experience a grief that can feel complicated in your situation.
• Discovering that implantation never took place after transfer

For surrogate mothers, the grief of loss can feel complicated because:

• You stand to validate the decisions and journey of surrogacy.
• You have prepared your heart and mind for the understanding that you are not “relinquishing your child” but that you play an integral role in growing someone else’s family.  Yet experiencing pregnancy and infant loss as a surrogate can feel very personal and deeply grieving.
• You can be faced with feeling as if your body failed you, and failed the family you intend to honor with your surrogacy commitment.  This can be compounded with a suspicion that somehow the family may accuse you or suspect some kind of negligence or fault, when in fact this is not true.
• You can be faced with feeling that the journey of surrogacy is pushing too far, that experiencing pregnancy and infant loss is proof of that, when in fact this is not true.
• It is your blood that you see, it is your very intimate obstetrical experience, including birth planning and birth methods in the experience of miscarriage or stillbirth that you are witnessing.
• You have the painful privilege of bearing sacred witness to this loss the family is experiencing, and this may or many not be the first time their fertility struggle is shaped by loss after conception – via miscarriage or stillbirth.
• You have the painful privilege of inviting the family to experience the miscarriage or stillbirth by allowing them to bear sacred witness to your labor or in some way be involved in the welcoming or the farewell.
• Because you are surrogate, if it is medically necessary to have a medically assisted birth – in the case of D&C, D&E or later in which an autopsy may be requested or in any instance in which the physical form of the baby may be received by medical staff, it is best to articulate very clearly who the parents are and what their wishes are.  If you do not know what those wishes are or if they are not yet sure, please consider the options that will give you the most options later – meaning, it is best to articulate very clearly to medical staff prior to their receiving the physical form of the baby, that you will like to have the physical form of the baby returned to you.  Having this expressly written, read and understood by all involved can help clear up any possibly confusion or hospital policy issues later and can potentially expedite the process of having the physical form of the baby returned to you.  If this turns out to be an impossibility, seeking to retrieve any photocopies of any microscope slides can be a tangible, visual way that the parents can have their baby’s physical form.  This, in addition to any medical records, reports and information.  Please see the birth plans that would be the most appropriate to your circumstances.

All of these reasons for hurt or grief deserve to be validated.

You are invited to see our library of personal stories shared by parents (visit the right sidebar), which include:

• Snowflake Babies
• Living Grief (grieving aspects of parenthood, related to children who are alive: includes birth trauma, adoption, surrogacy, menopause)
• Selective Reduction
• Ending Fertility with a Loss

You are also invited to share your story.

Some supportive resources for any of these concerns:

• Information for emotionally preparing for surrogacy
• Information on state laws regarding surrogacy
• Information on grief after selective reduction
• Online contact form specifically for grief after ART
• Information for men on the emotional aspects of pursuing ART
• Information on emotional aspects of embryo freezing
• An SBD Doula may support you through a specialized surrogacy birth plan

Additionally, if you are experiencing a pregnancy loss while utilizing medical assistance for conception, you may wonder what the best birth method for your pregnancy loss might be, and if there is any difference in your choices when your pregnancy loss relates to ART in any way.  Your birth methods are, for the most part, still the same for pregnancy loss.  You can view the birth methods for pregnancy loss here.

Specific options that may be discussed between you and your care provider might include:

• If your hormone levels are a factor that could inhibit the process of natural delivery, or you are eager to begin the next cycle, level, phase, or ART attempt and time is a factor, a more medically assisted delivery of your pregnancy loss may prove to be better for your situation. For example, miscarrying naturally can take several weeks to complete, but a D&C wouldn’t-but could come with additional risks.
• If you are Rh-negative, your provider may suggest getting the Rhogam shot to protect you against Rh incompatibility, which could affect future pregnancies.  If you experienced a miscarriage under approximately 12 weeks gestation, your provider may suggest the micrhogram shot.
• Your provider might suggest IVIg therapy.  It would be important to know why this is being suggested, what the potential risks and potential benefits could be, and any alternative therapies available depending on the already stated variables (these might include Intralipid, Lovenox, other medications or natural therapies that a holistic healthcare expert could possibly provide suggestions for).
• Any of these topics and all specific issues pertaining to your pregnancy and pregnancy loss experiences need to be discussed with your care provider, and they should be apprised of all ideas and suggestions you are evaluating.

Articles related to ART (these will be updated as often as they are submitted and deemed to have possible relevence)

• Twin embryo IVF success rate
• stillbirthday’s Recurrent Miscarriage section may prove useful for emotional support as well as alternatives and other parenting options

Please know that you can share your story, or any helpful resources with us here.  You can access yours and others stories related to loss after ART here.