Stillbirth

When you have heard that your baby has died in your womb, your whole world collapses. Everything you had been looking forward to goes black. Expecting a new life turns to fear and sorrow. You have questions like “What’s in store for us now?” and “What options do we have?

You will never get the coming hours and days back. It is therefore important that you do what feels best for you. Your feelings should be the guiding motivator. As a parent, you can often help decide what happens and when. 

Your baby died in the belly

Some mothers feel that something is wrong. They feel fewer or no movements, are worried and ask the midwife for an extra check-up. Sometimes the bad news comes during a regular check-up and you don’t realise at all that something might not be right. If your midwife can’t find a heartbeat, you will always be referred to a hospital. Only a doctor can officially confirm that your baby has died. This will be done by means of an ultrasound scan. They will check whether there are any peculiarities and whether the cause of death can be found immediately. The baby will be measured and urine and blood samples will be taken from the mother. Often the doctors will not be able to tell you the cause of death yet. After the birth you can choose to have your baby and the placenta examined further. 

Usually you can go home after this. They do this for a reason, it is important to get used to the idea that your baby is no longer alive and that you will have to give birth at short notice. Doctors have good (medical) reasons not to rush in or perform an unnecessary caesarean section.
You could also use this time to make arrangements for practical matters, such as making a nice place to take your baby home, thinking about burial or cremation or looking for a (specialised) funeral director. Please also see the help card days until the funeral.

Childbirth

The doctors will discuss with you when and how you are going to give birth. In most cases, labour will be induced. This is not done through an IV, but through the administration of a pill or as a vaginal suppository that induces contractions. Sometimes, you will be asked if you want to insert the vaginal suppository yourself. This differs per patient and per hospital. You are also often asked to take a type of medication at home in the days before the birth to soften the cervix. This may be a difficult experience for you, because it will take you definitively down the painful path of termination. If you have had a Caesarean section before, you will likely be given a slightly lower dose of this medication. As a result, it may take longer before your baby is born in that case. You will no longer be allowed to go to the toilet from that point on, instead you will have to pee on a chamber pot (or potty) because your baby may suddenly appear. 

You will be asked to take contraction inducers every three hours until the contractions start. When the contractions start and how long the delivery will last cannot be predicted. Sometimes the contractions lose strength and often medication has to be administered.

You can always ask for pain relief, which could come in the form of an epidural or as morphine injections. Keep in mind that morphine can cause you to be a bit ‘out of it’, so you may not be fully ‘there’ when the baby is born. An anesthetist is needed to give you an epidural, and he will have to be summoned first. It may take a while before he gets there. When the delivery is almost over, an epidural is no longer an option. So if you want pain relief, it is best to indicate so in time and keep in mind that it can be refused depending on the stage of delivery. 

In case of premature delivery, there is a considerable chance that the placenta will not come loose and has to be removed surgically. It will be removed under anesthesia, for which you will have to go to the O.R. and your baby will remain on the ward. You can ask if the father can stay with the baby so that you don’t have to leave him alone.

In the first phase of childbirth, you will still be very lucid and you will be able to tell the nurse what your wishes are. We have listed for you what you could think of with regard to things you can discuss or ask for: 

• Who’s going to be at the delivery? 
• Special wishes regarding posture (bed, birthing stool, skippyball) and contractions (shower, bed, bath, music, light). 
• Pain relief 
• What do you expect from healthcare providers (midwife, gynaecologist, nurse)?
• Photos and video
• Seeing your baby after birth or not seeing it right away
• Having your baby directly on your belly/chest after birth
• Dressing up your baby
• Washing your baby
• Cutting the umbilical cord
• Visitors after childbirth
• View/Save Placenta
• Are there any other things the caregivers need to know?
• Contact with siblings. When do you want others to see your baby? Under which conditions? 

These points are also on this help card.

What does my deceased baby look like?

Many parents wonder what their baby looks like. Because your baby has passed away for a while, most parents are afraid of this image. Also, some parents feel that the baby is cold when it is born and therefore don’t want the baby on their tummy. Your baby is coming out of your belly where it is 37 degrees and so your baby will be warm when it is born. However, your baby will look slightly different. Because he has passed away, he will no longer produce any more skin which will protect him from the amniotic fluid. Because he will often be in the warm amniotic fluid for a while (a few days), his skin may start to wrinkle (just like with us when we wash dishes or take a long bath) or even let go. So: don’t worry if you see that his skin is not completely intact. This is called maceration and is a normal part of this. It has nothing to do with the reason for death. 

When your baby is born, you will of course want to meet him: 

• It can be placed on your breast immediately after delivery.
• You can also wait a while and ask people who are at the birth to describe him first.

It is important that you think carefully about this, because this moment will never come back. Most mothers like to have their warm baby close to them right away. Your baby will cool down soon after birth and won’t get as warm as it did immediately after birth.

Because his skin is so fragile, it is better not to dress or bathe your baby for the first time. The water can damage him even more and clothes can stick to his skin so you won’t be able to loosen them later on. We therefore recommend that you first rub your baby with baby oil and wrap it in the back of a cellular mat. This plastic side will protect your baby. In the days leading up to the funeral, you can then see how it goes and dress your baby. Taking a bath will remain difficult because of the fragile skin and we do not advise you to do so. 

Taking your baby home

Many parents choose to take their baby home with them. This gives you all the time you need to take a good look at and “get to know” your baby and make memories (see help card memories and days until the funeral).

When you take your baby home, it is important that your baby is kept cool. There are several ways to do this:

1. Baby cooling
2. Water Method
3. Cooling elements
4. Embalming / thanatopraxy

Investigation into the cause of death?

Sometimes the cause of your baby’s death is immediately obvious, for example if an infection has been diagnosed or because the placenta has come loose. These are things that can be seen on the outside. If the cause is not immediately known, you can request to have your baby examined further. Read more about the different ways of examining your baby here.