After infant loss, when should we try again?

I saw this article on Examiner.com and thought it was interesting.  I know everyone has their own time table, and this can be a sensitive subject.  I think the important thing is knowing if you want to try again, and if so, waiting until you feel ready.  That can be very different for each person.  However, I thought I'd post this article and see what you thought.  

 After infant loss, when should we try again?

by Carol A. Ranney

Whether you have suffered a miscarriage, stillbirth, or an infant death, often your first impulse is to try again.  The loss of your baby has left a huge vacuum, and there is nothing that will fill it and relieve the terrible aching emptiness.  The only possibly comforting thought is to be pregnant again, to feel once again the anticipation of another precious baby in your arms.

Grieving is not only very hard work, it is terribly painful.  To face again each day the absence of someone you loved with your whole being, to try and work through the questions, the anger, confusion, sadness and weariness of grief, to endure the gnawing vacuum inside you that constantly cries out for relief, is agonizing work.  As easily as water runs downhill, your thoughts go to another baby, another pregnancy, and some relief from constant sorrow. A friend who became pregnant not long after her toddler died said to me, “It feels so good to be happy again.”

However, grief will not be dismissed.  It has integrated itself into your life, and will not be satisfied until you have completely worked through it and emerged from the other side, a changed person.  There are no shortcuts through grief, as tempting as the illusion might seem.  The choice to have a child too soon after the death of another one may also be motivated not so much by the desire for another child as the longing to fill that empty hole in your hearts.

You are grieving a unique, never-to-be replicated child.  Even though you may never have had the chance to look into his or her face, your dreams were whole and complete, for this child and all he or she would become.  When you have had an early miscarriage, you mourn the loss of your “dream child,” the one you envisioned, dreamed about, imagined a relationship with, and gave your whole heart to.  Perhaps others did not yet know you were pregnant, and there will be a deep loneliness in mourning your loss.

If you have had a stillborn child or have lost an infant, you mourn the loss of the brief time you had, the moments of memory as well as all the future dreams, hopes and plans.  Because this child was not known by many others, those around you will likely expect you to recover as rapidly emotionally as you do physically.  A friend said to me once of a young woman who had had a stillborn child a week before, “She’s doing much better now, I think she’s come to terms with it.”

A week, however, is not even long enough to get past the shock and begin to comprehend what has happened.  Many weeks will pass before the full impact of the loss will be felt, and by that time, most people will have forgotten or assume that you have "moved past it."  Grieving a pre-born infant is a lonely experience, and it is important to get all the support you can, to affirm your right to grieve as well as to walk through it with you.

While a pregnancy, or thoughts of a pregnancy, seem so comforting and hopeful during this time, the reality is that you will never again experience the innocent excitement and anticipation of your earlier pregnancy.  You now know the truth:  not all pregnancies go to term, and there is no guarantee with any pregnancy.  To deal with this reality is hard enough without struggling with mourning your loss at the same time.

You also may be stricken with guilt if you become pregnant again too soon.  Many people experience the regret of not having given their deceased child his or her own time to be remembered, mourned, and memorialized, and feel that a subsequent pregnancy is a betrayal of their child who died.  Another problem that arises with a pregnancy too soon after loss is the constant fear of losing the new pregnancy, and along with that, a fear of bonding fully with the expected baby, knowing the pain ahead if this pregnancy, too, is lost.  These feelings may persist even after the new baby arrives safely.

Counseling can be very helpful after loss, as you begin to think about trying again.  Having someone to talk through the experience with, whether a grief counselor, your obstetrician or midwife, or a trusted friend, can help to clarify your thoughts and feelings and help you understand where you are in the grief process and whether or not you are ready.  Some people decide to designate the first year as a year of mourning their deceased child.  This may be too long for you, or not long enough.  

A medical opinion is also important.  Trying again too soon, before the woman's body has had time to adjust and heal, can jeopardize a future pregnancy.  You circumstances and cause of loss need to be thoroughly understood before making this life-changing decision.

There is no one answer to when it is time to try again.  Your situation is as unique as you and the child you lost.  Everyone grieves differently, and at a different pace.  Give yourself adequate time to fully experience your grief and comprehend your loss, and to come to a degree of peace with it.  Wait until you can anticipate a new baby with minimal fear, and even though you are now aware of the risks of loving and the pain of losing, with real joy at the thought of a new baby.

Surprising Facts About SADS (Unexplained Stillbirth)

I saw these facts about stillbirth information on the website Still No More.  I wanted to share them with you all.  It is truly amazing that there isn't more research done to find the cause of SADS (Unexplained Stillbirth).  This information was taken directly from their website.....

SURPRISING FACTS ABOUT S.A.D.S.  

 

We’ve all heard about SIDS – the sudden unexplained deaths of babies in their cribs that occur for no determinable medical reason. And yet fifteen times as many babies die due to SADS - sudden antenatal death syndrome - about which little is written or spoken.

On average there are over 2,000 SIDS deaths in the United States every year. Stillbirth deaths number close to 30,000 babies.

Stillbirth is the death of a baby in its mother’s womb, after 20 weeks gestational age and up to the moment of delivery, which is when many babies die…. at the “finish line”!

Stillbirth is unpredictable and random. It often strikes like lightening in a thunderstorm. There is no way to know when or where it will strike next. The reason is one-half to two-thirds of stillbirths occur for indeterminable reasons. They are the ones that cannot be attributed to a specific identifiable medical cause. And yet there must be one. These babies, like grown ups, don't die for no reason. We just need to find the reason!

Because of its randomness, and the lack of any warning, stillbirth, can be said to be "An Equal Opportunity Destroyer of Dreams". It cuts across socio-economic classes, races, body types, religions, and maternal age groups. No woman is immune from stillbirth.

Even women who have had successful prior births can suffer a stillbirth loss.

That so many stillbirths occur at or near late term - when the developing baby is well beyond the point of viability and could survive outside the womb - is devastating.

Autopsies, when performed, rarely uncover any cause of stillbirth not already apparent from a physical examination of the baby and placenta.

There is no uniform stillbirth post-mortem (autopsy) protocol in use today anywhere in the United States. Every autopsy is done according to local practice. Because of that fact there is no uniform data available for analysis.

When a post-mortem procedure is performed, it is rare for the mother to be interviewed, this in spite of the fact she may have vital clues to her baby's cause of death. A uniform protocol would address this shortcoming among other things.

There is no centralized repository for autopsy data. If there were it would make analysis and comparison of findings possible. Imagine the chaos that would reign if police kept fingerprint cards in each department's file cabinet. Crimes would never be solved, just as stillbirth isn't being solved because the data - when autopsies are performed - is not made available to researchers but kept at each hospital, if it is saved at all.

The practice of “counting kicks” – fetal movements – is a low-tech test women can do at home on a regular daily basis. By monitoring her baby’s rate of activity she can identify any sudden change and immediately have her baby evaluated. Sudden changes can be a sign your baby is in distress. The National Stillbirth Society, in cooperation with Dr. Jason Collins, founder of The Pregnancy Institute, has a pamphlet entitled "Kicks Count". It's available for download free of charge at www.protectyourpregnancy.com.

Another sign of possible fetal distress - other than a change in the frequency or intensity of fetal movements - is hiccups. Hiccups often accompany cases of cord compression. A pregnant woman who becomes aware of her baby having multiple episodes of hiccups lasting 10 minutes or more should have an ultrasound examination of baby's umbilical cord for any indication of compression or entanglement.

There is virtually nothing a woman can do - or not do - that can cause the intentional or accidental stillbirth of a baby in late term. "Substance abuse", if engaged in, typically causes miscarriages early in the pregnancy, but not late term stillbirths. ("Substance abuse" can cause birth defects, however, and for that reason should always be avoided.)

Late term stillbirths remain a case of "natal roulette", played by nature, and is as deadly as the well-known "Russian Roulette". All a mother can do is be on the alert for - and act on - any symptoms of fetal distress and have regular stress tests. The National Stillbirth Society has posted a Preferred Pregnancy Management Protocol provided by Dr. Collins of The Pregnancy Institute. Few insurance plans cover all of the recommended testing listed in this protocol but mothers-to-be may want to come out of pocket themselves just so they can have benefit of the added level of monitoring. The protocol can be found at www.protectyourpregnancy.com.

Mothers wishing to exercise an abundance of caution can investigate the availability of night-time fetal heartbeat monitoring via the Internet. A relatively recent procedure it is available through The Pregnancy Institute founded by Dr. Collins. A "white paper" explaining the procedure can be found atwww.protectyourpregnancy.com.

One in every 115 deliveries is a dead baby. If deliveries were aircraft landings, Phoenix Sky Harbor airport, with about 700 landings daily, would have 6 fatal crashes every day. How long does one think the FAA would allow that to continue? Twenty-four hours? And yet as a nation we tolerate 80 pregnancies on average "crashing" daily in the U. S.

Until all causes of stillbirth are identified there can be no cure. Until there is a cure, there can be no peace of mind for pregnant women. Babies will continue to be vulnerable to "reproductive roulette", where the majority is lucky...... but 30,000 a year aren't.

Remembrance

Remembrance

Tears fall from my eyes
as softly the memories flow,
with the tears, salty on my tongue.
I miss you so much.

Tomorrow is frightening
except for the thought
of seeing you again;
another time, another place.

I hear your voice...
in my dreams you come.
We talk and laugh
about silly, important things.

Each day without you is less;
less bright, less full, ...less.
I feel your love with me,
yet, I want you to hold.

Faith in God eases the pain
for moments, sometimes days.
Still, I cry; but not for you,
for the loss I feel in me.

by Brenda Penepent
In Loving Memory of her daughter Carrie Carpenter

A Lasting Footprint

I'm really excited today to have a guest post by Rachel from A Lasting Footprint and mom to Emily.  Rachel has also been busy putting together a Pregnancy and Infant Loss Blog Directory to help angel parents stay connected and find the resources they need.  She has done such beautiful things to honor her Emily and all those that have lost their sweet babies!  You can read Rachel's guest post below........

Our daughter Emily Faith was born on January 26, 2011 at 23 weeks 3 days. She lived for almost 10 hours and then went into the arms of her Heavenly Father. Two days after Emily died I started my blog as a way to express my grief. In the days after Emily died I found some wonderful women who also blogged about their journey through grief and it was so helpful to me to find other moms who had lost a child and that life does go on.

I decided early on that I did not want Emily’s memory to die with her, that I wanted to do something to give back to the baby loss community. For several months I have tossed around ideas, but recently I decided on my project.

I have created the Pregnancy and Infant Loss (PAIL) Blog Directory. There is another directory that was so helpful to me in the first few days, but I soon realized that it has not been updated in over a year. It was this realization that started me thinking about starting a new directory. I am pleased to announce that two weeks ago the new blog directory went live. I have been overwhelmed by the response. I invite you to visit the Pregnancy and Infant Loss (PAIL) Blog Directory, and please submit your blog to be added to the directory.

Emily Faith’s Story

(This is the shorter version of Emily’s story. To read the full story please go here)

Our story started in November 2006 when my husband and I met on Match.com. We were married on February 23, 2008, and on January 14, 2009, we welcomed our first child Madalyn into the world 5 weeks early. She was healthy and we took her home a few days later. We knew that we wanted to add at least one more child to our family, but were not sure when that would be. On September 14, 2010, we got a positive pregnancy test. We were excited for the arrival of our 2^nd child.

From the beginning, the pregnancy was very different from when I was pregnant with Maddie. I started spotting at 5 weeks, but no reason could be determined and after a day or so the spotting stopped and the pregnancy progressed easily.

At our first official doctor’s appointment at 10 weeks we discussed our concerns over having another preterm delivery. I fall into a category of 10% of women that they have no explanation for why they deliver early. It is not very comforting to have your doctor tell you “we don’t know why it happened and we don’t know if it will happen again.” However, the doctor told us that research suggested that a weekly progesterone shot, starting at 15 weeks and continuing through 35 weeks, helped prolong pregnancy in over 50% of women. 

During the first 15 weeks, there had been some minimal spotting, but it had always been really light and only lasted a day or so. So, when I started spotting two days after my first progesterone shot and it went on for several days I began to get worried. When I went in for my shot at 16 weeks I mentioned the spotting and the doctor saw me that morning. He was not sure what was happening, but did not seem concerned. The spotting stopped that day and was gone for several weeks.

Then, the Saturday before Christmas I started spotting again. It was heavier and so I called and talked to the doctor on call. He did not seem very concerned since I was not having any contractions. He told me to wait until Monday and mention it to my doctor. By Monday the spotting had stopped, so I mentioned it to the nurse and let it go at that.

On January 7, 2011, I started spotting again and this time also passed a blood clot. I immediately called the doctor on call and he did not seem concerned since I was still not contracting. But I was scared so we went to the ER to be seen.  We spent 4 hours in the ER that day and were sent home with instructions for modified bed rest.

Just 3 days later on January 10^th we had an ultrasound to check growth and we also found out we were expecting another girl. There was a bit of discussion that the baby was measuring a bit small and that maybe they should change my due date, but no changes were made. Our Due date was May 23^rd.

The next week was great, no spotting or bleeding. We celebrated Maddie’s 2^nd birthday and started our baby registry for our new little one. Our next doctor’s appointment was scheduled for January 24^th; we never made it to that appointment.  

On the evening of January 18^th, I felt like I had horrible gas.  I decided that was what it was and went to bed. By 4AM I realized that I was having contractions. I started timing them, hoping they were Braxton Hicks contractions and would go away. But they didn’t.

At 8AM I called the doctor’s office and by 9:30AM I was at the doctor’s office. They did an ultrasound and determined that my cervix had thinned from the last ultrasound. The doctor put me on a med to try and stop the contractions and sent me home.

I took it easy the rest of the day. The contractions stopped for a while but by the next morning they were back, so we went to the hospital.

We got to the hospital about 5AM and saw the doctor at 7AM. During the time between they tried to monitor the baby, but it’s hard to keep a 22-week baby on a monitor because there is so much room for the baby to move. They also had me mark when I was having a contraction.

Once the doctor came in, I was started on Ibuprofen to stop the contractions. It worked and I was sent home after 6 hours, with instructions to rest, but not to take anything. I spent the rest of Thursday and all of Friday resting, but by Friday evening the contractions had returned. I spoke with the doctor on call and he told me to take more ibuprofen and see if that worked. It did work for a while but at 5AM on Saturday I woke up with bleeding so we got dressed and went to the hospital.

I was monitored in the ER first because there were no beds available in L&D. In the ER the doctor did an ultrasound and discovered that my cervix had shortened even more. I went from 4cm on January 10^th; to 2.5cm on January 19^th; to 1.3cm on January 22. We had been told that 4cm was normal; 2.5cm was border-line and 1.5cm was a concern. As soon as the doctor knew the cervix length he said I could not get out of bed and immediately put in a catheter. Not the most fun experience in the world, but they thought it would help.

Within the hour I was moved to L&D and put into Trendelenburg. They also started me on an antibiotic in case I had an infection, Ibuprofen to stop the contractions and Zantac to help with the heartburn.

The plan was simple: see what would happen over the next day or so. I responded well to the Ibuprofen so I was moved to another room that was less busy and they continued monitoring me.

On January 23^rd I was doing so well that they removed the catheter and allowed me to get up and go to the bathroom. The doctor had even talked about letting me go home that afternoon. But after some discussion she agreed to let me stay until the morning and get my weekly shot before letting me go home.

I am so glad that she listened to me and let me stay because things got crazy after that.

By 4AM the next day, I was contracting and bleeding again. It was decided that I needed to be airlifted to a hospital 300 miles away. Usually they will not even think about a transfer until 24 weeks gestation, but by a miracle the Chief Doctor agreed to take me (I was only 23 weeks at the time of transfer).

The rest of the day is mostly a blur of being transferred to a new hospital, meeting a whole new team of doctors and undergoing many tests. I had to do all this on my own since my husband was taking care of things at home before he could drive over and be with me.

It was discovered at the new hospital that I was 1cm dilated and the bag of water had slipped down causing an hourglass effect. I was so nervous to cough or sneeze or really even move, but the doctors assured me that it was all okay. I need not have worried, my membrane never ruptured.

January 25^th was a good day. No contractions and very little bleeding. We were very encouraged and began to think maybe this pregnancy would last for several more weeks. Around noon Ron sent a text to our family saying, “Update… Today has been a good news day. Baby is no longer Breech. Rachel’s bleeding has slowed down and she has not had any contractions for over 13 hours! Thank you for all your comments and prayers!”

That night we spent an hour looking at names and decided on a name for our daughter. I just had a feeling that we needed to do it that night. I am so glad that we took the time that night since we would be in no frame of mind to come up with a name the next day.

I had a really rough night, lots of contractions and bleeding, the nurse later told me that she was pretty sure I would deliver in the next 24 hours based on what was going on with my body.

By 5am things were really starting to get intense, and by about 9am, when the doctor checked me I was already 10cm dilated. Emily Faith was born at 12:10pm fully enclosed in her bag of water. The doctors ruptured the membrane and took her to the warming room, she was alive. A few minutes later they brought her by for me to see on their way to the NICU. I remember thinking she looked like a little elf, so perfect, but so tiny. She weighed 15.3 ounces and was 13.4 inches long.

Just before 3pm we were told I needed to come to the NICU because Emily was not going to make it. I had still been recovering from the birth and the loss of blood. I quickly got up, but before I could make it to the NICU my husband came back and told me that she had died.

I still wanted to see her so I was transferred to a wheeled chair and we began the trip to the NICU. But before we left my room the doctor came running down the hallway with a smile on his face. After they had stopped trying to resuscitate Emily and turned off the machines she started breathing on her own. The doctor told us he had never seen that happen before. It was a miracle.

We finally made it to the NICU to see Emily and I got to touch her and spend time with her.

The rest of that day was spent with family and friends who had made the drive to be with us and with Emily in the NICU. About 8pm everyone had left for the night and we went back to the NICU to be with Emily. We spent a lot of time talking to the doctor about how much we wanted to do and for how long. While we were there Emily had to be resuscitated two more times. When her stats started to drop a third time we decided that it was time to stop, she was getting worse and the doctors had done everything they could for her. We decided to spend her last few minutes of life holding her and letting her know how much she was loved. So the doctors disconnected all the wires and tubes and gave Emily to me. She was still alive and breathing when she was placed on my chest. She actually took a few more breaths while I was holding her. I am so thankful that we had that time with her before she died. She knew she was loved and the three of us has that precious time together. Emily Faith died at 10:30pm on January 26, 2011.

I was discharged from the hospital the next morning.

Thank you Rachel for sharing your sweet Emily with us and for putting together such a Baby Loss Directory!