Coming Home Empty Handed

(Trigger warning, not recommended to read if you’re currently pregnant)

The other day, my husband and I were in a cab with a woman cab driver, and over the course of the 40-minute drive, after she mentioned her son, I asked that fateful question, “how many children do you have?” She answered quite calmly, “one, and one I lost 5 years ago.” After several months of complications, she had given birth during the ninth month to a baby boy who lived only for a few moments. She quietly described how the nurse had let her take a picture of the baby, how her husband had not understood her mourning, but how she was so thankful for the hospital staff for how they handled the incident. “The whole hospital cried with me that day,” she said.

For our final June post on birth in Israel, I thought I would focus on a difficult, but essential topic, that of what they call in Hebrew “leidot shketot”, “quiet births”, a stillbirth. I realize that this is not a happy topic, nor one that people like to speak about, but it affects more families than we realize and we need to discuss the issue so that if we, or someone we love, encounters this heartbreaking moment, we will know what our resources are.

Years ago, I had a friend who lost her child during the ninth month. By then, she had a big belly, and everyone who had seen her within a few weeks prior, and saw her again without the tummy, naturally asked, “what’d you have?” She would quietly explain that she’d had a stillbirth, but quickly realized that people weren’t really listening. They’d not enthusiastically, say, “Great, great. Mazal Tov” and then go on their way. She realized that they had so expected the typical answer that they haven’t even heard about her tragedy! She figured out the problem that had caused that first stillbirth (over clotting issue) and went on to have four healthy children. She was able to mourn her lost child and move through life with happiness, but that experience of going through something that others couldn’t really compute is still with her.

In the latest data, there were 602 stillbirths in Israel, out of 136,000 births, for a rate of  3.4 out of 1,000 overall, and 3.0 out of 1,000 for Jewish mothers. These are reasonable numbers, given that the majority occur because of congenital birth defects, but the statistics do not explain the 602 families that year who went home empty-handed.  Women who experience stillbirth are significantly more likely to suffer from postpartum depression and PTSD (post-traumatic stress disorder) than women who experience live births.

As of April 2016, a woman who lost a baby from the 22nd week of gestation and onward is eligible for paid maternity leave and demai leidah (one-time birth payment). This expanded the former law, that allowed women from 26th week and on to receive these benefits. A woman cannot be fired within 60 days of the end of her maternity leave, the same as with a woman with a live birth.

It used to be the case that the baby was whisked away so that parents wouldn’t have to suffer, but the majority of recent studies demonstrate the positive effect of the parents when they see or hold their baby, and have some form of ‘goodbye’. If a woman is admitted to the hospital, already knowing that she will have a stillbirth, it’s important to ask the hospital what their protocol is. There is not standard procedure, so it’s important to know what to expect and ask ahead of time if you know that isn’t their usual practice. (for example, letting them know you will want to hold the baby afterward.)

Some hospitals offer support groups for women for suffered stillbirths, and, while in the hospital, the mother should ask the department’s social worker (yes there is one), if there is a group in that particular hospital.

It is also highly recommended that a woman meet with a therapist after this experience. It is traumatic and can affect her in many ways, some of which she may not be aware of. Some women may think they need to just get up, move on, and have the ‘don’t worry, you’ll get pregnant again,’ mentality. Seeking out psychological support does not lessen a woman’s coping abilities or prevent her from moving on, but will rather strengthen her, and prepare her, all being well, for the next, healthy birth.

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