Stillbirth is a traumatic event for all concerned – the mother, the father, the siblings, the immediate and extended families and friends. According to the Centers for Disease Control and Prevention, a stillbirth is defined as a baby who dies before or during delivery. This loss is differentiated from that of a miscarriage by when it occurs. The loss of a baby before the 20th week of pregnancy is a miscarriage. At or after 20 weeks, the loss is a stillbirth. About 24,000 pregnancies a year, or one out of every 160 in the United States, results in a stillbirth. About two million babies are stillborn around the world every year, according to UNICEF.
But those are just statistics. I’d like to share with you an excerpt of a mother’s story from the CDC’s website. This is a mother writing about her daughter, Emma:
“Fear gripped me that day. It was soon replaced by raw anguish. The pain was almost too much to cope with, and I had no idea how to move forward. I didn’t get any kind of primer on how to prepare for the unexpected death of my baby girl. Yet there I was, 38 weeks pregnant, and in full-blown labor. I knew how it was going to end—I would not leave the hospital with her. She’d be in a casket soon, and I’d be in bed, tackling the monumental task of continuing to live for another minute, another hour, and then another day.”
The Grief of Dashed Hopes
Jillian Tullis, PhD, Associate Professor of Communication Studies at the University of San Diego, teaches and conducts research on communication about dying and death in healthcare settings. She describes the unique grief that follows a stillbirth. “A different type of hope is built into a child being born,” she says. “A lot of anticipation. What it would be like for another child to have a sibling. When someone is pregnant, they’re going to have a child, they’re not thinking they might. They haven’t had time for what’s called anticipatory grief. Stillborn births don’t offer time to prepare. It’s shocking when it happens.”
How do we deal with such unimaginable tragedy? Throughout civilization, we have prepared for life’s events, both good and bad, through drama. Bryan Doerries wrote about this in “The Theater of War: What Ancient Greek Tragedies Can Teach Us Today”:
“Through tragedy, the great Athenian poets were not articulating a pessimistic or fatalistic view of human experience; nor were they bent on filling audiences with despair. Instead, they were giving voice to timeless human experiences—of suffering and grief—that, when viewed by a large audience that had shared those experiences, fostered compassion, understanding and a deeply felt interconnection. Through tragedy, the Greeks faced the darkness of human existence as a community.”
While it’s neither ancient nor Greek, I’d like to invite you to a dramatization on Zoom of a short play I’ve written to help both health professionals and families live through a stillbirth from the safety of theater. Please join us for “Untold: Creating Space for Loss After Stillbirth” on Tuesday, December 1st from 5:00 – 6:00 p.m. PST. After the play, Dr. Tullis will moderate a discussion and Q&A about the emotions that follow a stillbirth and how we can face and mitigate the grief. RSVP here.
How to Be Comforting in the Shadow of Stillbirth
Dr. Tullis suggests needing to be prepared for a range of emotions. “We don’t always know how people might react to a stillborn. A mom might be despondent. She might be angry. I suggest taking cues from her. Don’t try to coach people into feeling a particular set of emotions,” she says. “A stillborn death is worthy of the same sort of grief and mourning as any other death. The pain isn’t any less. Sometimes we want to have a ranking and that’s not helpful. Think of the pain as the same. Think of mourning the hope, the anticipation, the imagined future that will never be.”
What To Say/What Not to Say
It’s difficult to know what to say. We want to bring comfort, but saying the wrong thing could have the opposite effect. Some advice from Dr. Tullis:
Decide if showing up is helpful. Being present can be beneficial under the right circumstances. Be there to offer comfort. Or show up two days or a week later. Follow through if you are willing to offer to help in specific ways.
People are worried about saying the wrong thing. If you feel like you need to say something, offer condolences. You don’t need to try to provide an explanation. “Everything happens for a reason.” No. “This is God’s will.” No. “You’ll have other children.” No.
You can say you’ll be thinking about them. It’s ok to be at a loss for words: “I don’t know what to say.” It’s precarious to say: “I know how you feel, what you’re going through.”
You can say, “I’m sorry this happened to you. I’m sorry this is happening.”
Don’t make it about yourself. Their own emotions are overwhelming the scene: How can this happen? If this is your daughter or sister, don’t make it about what you’re facing. It’s ok to show emotion, but people shouldn’t have to comfort you. The attention needs to be on the person.
Acknowledge in the days and weeks afterwards that the baby was real. Honor the life that was lost. Make the child real by using his or her name with the parents.
It’s okay to make mistakes sometimes. When we think about ourselves, we’re not serving the grieving person. Learn from mistakes. It’s a good thing to think in advance about what to say, because the things we say and do affect others. You can’t take it back, and it’s hard to know the perfect thing to say.
The Power of Drama
“Our society has taboos that can keep us from dealing directly and compassionately with death,” says Dr. Tullis. “We don’t know how to do it. In the case of stillbirth, it’s a lifelong experience for a parent. We don’t help ourselves by avoiding the topic. It can happen whether or not we’re prepared. I see more people struggle because they’ve avoided thinking and talking about the possibility than people who have thought it through in advance.”
Dr. Tullis advocates using drama to open ourselves up to the issues we don’t want to have to face. “That’s the beauty of a play,” she says. “You don’t have to be dwelling on the issue, but can just dip your toe in and don’t have to live there. Drama is a way to live through an experience in your head and in your heart, to give you some preparation for when tragedy happens in life. In this play, the performances are really good. It’s worth going just for that. Like any good drama, it’s thought provoking. You can’t not think about these important issues.”
I hope you’ll join us on December 1st for “Untold: Creating Space for Loss After Stillbirth” and for the discussion and Q&A afterwards. RSVP here.
Author’s Note: Just before I posted this blog piece, I read the Op-Ed piece in the New York Times by Meghan Markle, The Duchess of Sussex. Losses We Share is a poignant reminder that what makes us human beings is our ability to show empathy. As we enter the holiday season, I implore you to reach out to your fellow humans who are suffering. Ask the simplest of questions: “Are You Okay?” and stay and listen to their story without judgment.