There are an estimated 80 to 120 stillbirths in Singapore annually or an average of two to three stillbirths out of every 1000 pregnancies. 2019 saw 73 stillbirths in Singapore out of a total of 39,279 live births recorded in the 2019 Report on Registration of Births and Deaths.
But when it comes to losing a baby during pregnancy, including loss due to stillbirth (death in the womb after 28 weeks of pregnancy), there seems to be an uncomfortable air of silence surrounding grieving parents and their loved ones and friends.
According to research published by lead author Katherine J. Gold from the Department of Family Medicine, University of Michigan, parents who experience stillbirth or infant death often struggle with postpartum guilt.
“This (guilt) may be an adaptive response or can become chronic and maladaptive,” the study revealed, hindering the process of recovery from grief.
Image source: iStock
A positive depression screen at 9 or 15 months was associated with risk for higher guilt levels, and according to 311 bereaved mothers in Michigan who responded to the survey, most reported guilt or self-blame at 15 months.
Of them, 147 mothers (47 per cent) agreed that their baby would not have died if the physicians or nurses had done something diﬀerently.
However, despite attributing blame in ways to cope with the loss of their baby, the study revealed that the “blame served no apparent protective function”.
A notable percentage, one out of six mothers (17 per cent) agreed that others blamed them for the loss of baby even if it was not their fault.
Although it is said that many of these stillbirths are preventable, 25 to 60 per cent of all foetal deaths are due to unknown causes.
Why Do Stillbirths Occur: Possible Causes of Stillbirth
For known causes, they can be grouped into three main categories:
Birth defects in the baby
- Foetal chromosome, genetic or metabolic abnormalities
- Foetal structural abnormalities
Problems with the placenta or umbilical cord
- Foetus gets entangled with the umbilical cord
- The placenta separates, causing interference with, or a cutoff of the flow of blood, oxygen and nutrients to the baby
Image source: iStock
Maternal illnesses or conditions
- Maternal consumption of nicotine, alcohol and/or recreational drugs
- Maternal diabetes
- Pre-existing maternal medical conditions like diabetes and hypertension, especially if she is not getting regular antenatal care
Despite the possible reasons for stillbirth, and even if they have done all that they could to protect their baby, bereaved parents, especially mothers, seemingly face a heightened sense of responsibility and guilt of losing a baby whose survival depended on her.
In addition, she feels a sense of shame as she links the loss of her baby to her own personal failure to care and protect him/her.
However, if not dealt with in healthy ways, or when trapped in excessive or inappropriate guilt, it could lead to “much worse psychological outcomes including depression, post-traumatic stress disorder (PTSD), and complicated grief,” the study revealed.
How To Provide Support To Grieving Parents
Going through stillbirth is an extremely traumatic experience for any family, and being pregnant is much more than just a process.
While it can be difficult to ascertain the cause of stillbirth, healthcare providers can help grieving parents cope by taking extra time and care to help address their questions and provide information as to the cause of death as far as possible.
Whether healthcare professionals, family, or friends, listening to and showing empathy to their dejection and concerns can go a long way in helping them feel less alone in face of such a vulnerable time.
The causes of stillbirth can often be beyond your control. | Image source: iStock
It also helps to normalise the guilt that parents might already be experiencing, even when it is clear that they did nothing to cause the loss of baby.
Acknowledging the loss and allowing parents to express their feelings and pain as much as and as often as they want to is one helpful way to provide support to them. Try starting the conversations with statements like:
- “I’m so sorry…”
- “I’m here for you…”
- “Tell me about your baby…”
- “How are you feeling about the baby?”
As for bereaved parents, as much as you feel like closing yourself off to others, try surrounding yourself with positive people who are able to support you through these tough times.
And perhaps, no one would know the feelings of a bereaved parent better than another and we hope you may seek comfort knowing that you are not alone in this fight.
Here are some support groups for bereaved parents:
- Miscarriage, Stillbirth and Child Loss Support Group by theAsianparent – A closed group for women who have suffered a miscarriage, stillbirth and/or child loss, that are looking to share their experience with others who understand them, offer a shoulder to cry on to other women who have experienced such loss, or a way to move forward, and heal.
- Child Bereavement in Singapore support group — An informal network of bereaved parents who support each other through their grief. Join in their monthly support meetings and gain access to resources and information through their website, https://www.cbss.sg/.
- Pregnancy and Infant Loss Support Group Singapore — They recognise the grief and pain, and that has led to the creation of this support group. It is a platform that allows those who are grieving the loss of their baby to seek emotional support and friendship. To join the group, do send a private message with a brief note to ‘Fiona J C O’Carroll (Clarke)‘ in order to become a member.
- KK Women’s and Children’s Hospital, Department of Psychological Medicine (Mental Wellness Service) — Their Bereavement Support Committee lend a helping hand to patients who have lost their loved ones. Apart from providing counselling, they also advise bereaved parents on the next steps and help them create memories of their loved ones, amongst other services.
A more comprehensive list of support groups can be found here: https://bit.ly/3kFI8Io
The experience, and perhaps the pain of losing one’s own baby is unimaginable, and a lot of patience, care, and understanding is required to help bereaved parents pull through. But no matter where you are, know that your baby is always close to your heart and just a thought away.
5 Reasons Why We Need To Talk About Losing A Baby During Pregnancy
Stillbirth: How Having The Right Environment And Support System Help In Breaking The Silence
Stillbirth: Surviving the Emotional Aftermath