Silent birth: when the birth is also a farewell

For parents who learn of the loss of their child, it is often unimaginable at first how they can cope with the unmanageable, difficult path that now lies ahead of them. If you can take your time, you will become more capable of acting again step by step.

Take your time

If the parents have learned that their child has already died or will soon die, the desire for a "quick release" from the stressful situation is often great. An immediate induction of labor or a cesarean section may then seem to them to be the only conceivable solution. However, it is advisable not to rush into anything, to think about the decision carefully and to weigh it up with the midwife, the doctor or the physician.
A separation from a child that is completed too quickly can make it difficult for parents to say goodbye and can burden them later on. Following the natural course of events and waiting for the birth may make it easier for them to keep up with the event mentally as well and give space to their grief. Perhaps there is still time to prepare for the birth and the farewell in peace and quiet. The couple can think about how they want to handle this special task and challenge and what might best help them to do so.
A birth that is also a farewell can be a profound and unforgettable experience.

Induce or wait for the birth?

Normally, from a medical point of view, it is possible to wait for the natural onset of labor, even if the unborn child is no longer alive. This can take several days, or even two weeks or longer, depending on the maturity of the pregnancy. During this time, intensive support from the midwife, the doctor is important. As long as the accompanying examinations remain inconspicuous and there are no special signs such as bleeding, waiting does not pose a health risk to the mother.

Even from the deceased child there is no danger for the pregnant woman. The widespread concern about "cadaveric poison" is unfounded. As long as the amniotic membrane is intact, the child and the amniotic fluid are germ-free. Even if the dead child has been born, its tissues do not contain disease-causing bacteria – unless it had a serious infection. If after waiting longer (three to four weeks or more) labor doesn’t start on its own, make sure it doesn’t interfere with the mother’s blood clotting.

The birth processes and the formation of the associated hormones and endogenous pain-relieving substances are controlled by the maternal brain. The nervous system is always closely linked to the emotional processes. Body and soul work hand in hand: The physical processes during birth can make it easier for the soul to say goodbye.

Other women and couples nevertheless opt for induction with medication. If birth is induced with medication immediately after the sad diagnosis, the artificial labor hormones often meet a uterus that is not yet ready for birth at this time. During this time, the body is still adapted to hold and protect the unborn child. It is not always easy, therefore, to induce labor soon with artificial hormones. It can sometimes take up to several days before the cervix is ready to open, despite noticeable contractions. Sometimes it is necessary to try again at a later time.

Can the "silent birth" be as painless as possible?

If the emotional pain is already excessive, the desire for a birth that is as painless as possible is often particularly urgent. Sufficient pain relief is provided in the clinic, usually a strong local anesthesia (peridural anesthesia) is offered. If the mother does not want this, she can ask for other forms of pain relief at any time during the birth.

If the birth takes place in a secure and harmonious atmosphere and the woman has familiar people and a sensitive obstetric team by her side, it may also be possible to cope with the birth without painkillers. Feeling the labor and birth pain physically can make it easier for the soul to say goodbye.

Why isn’t a C-section always done when the baby is dead?

Even though cesarean section has become significantly safer than in the past, it still carries a higher risk for the mother than a natural birth. The possible consequences for another pregnancy and birth should also not be underestimated.

The anesthesia during the operation makes the birth itself painless, but in the days after the operation the abdominal incision can cause pain. In addition to the emotional pain of the loss of the child, there are also physical impairments caused by the intervention.

Bringing the child into the world step by step under one’s own steam with each contraction makes the parting "tangible" for many mothers. It can fill the parents with joy and pride, even with all the pain of parting, to manage this birth and to actively receive the child.

Is a home birth possible?

A birth at home or in a birth center is generally possible, provided it is professionally attended and there are no special health limitations.

Continuous support by a midwife often opens up greater scope for responding to the couple’s personal wishes. In a home birth, it is usually possible to greet and say goodbye to the baby together with the siblings and other close people. Intimacy in the comfort of their own home helps some families make this special birth and parting with their child as personal as possible and help them cope with it.

If the baby is born alive but has a short lifespan, it is important that the midwife, the (pediatric) doctor are prepared to accompany him or her as he or she dies. However, the security and love of the parents is the most important help for the dying child.

Consciously shaping the farewell

A "silent birth" and the early parting from their child will remain unforgotten for most parents. Many feel connected to the dead child for a long time to come. Being intentional about saying goodbye can help to make the loss comprehensible and to take new courage. If medical circumstances allow enough time, parents can reflect on what they want for this special birth and discuss this with their midwife and health care provider. They can decide where the baby will be born and who they would like to have with them at the birth. If it is already certain that the baby will be stillborn or will die immediately after birth, the couple can consider preparing a farewell ritual.

Accompanying the dying baby

When parents have learned that their baby has very little chance of life outside the womb, they can prepare to share its short life with it. These few moments or hours together are a precious time. Even before the birth, parents can agree with the obstetric team and the pediatrician on how to proceed with end-of-life care after the birth. It is useful to record this in the birth records. In order for the child to die without suffering, the most important prerequisite is that it experiences peace and security and is not disturbed or frightened. So the baby can feel the reassuring, loving warmth and closeness of his parents. Maybe it can even drink a little breast milk. If necessary, the doctor can help the baby with pain medicine or breathing support.

Meeting the dead baby

Plaster mask of a premature baby who died

If their baby is stillborn, parents may need some time before they can open up to meeting him or her and want to hold him or her in their arms. Many parents have never seen a dead person before. They may be afraid of what their baby will look like and feel overwhelmed. What will possible deformities look like or how has his skin changed if he died a few days before he was born? The obstetricians will prepare them for this, will stand by them at this moment and will look at the child with them when they are ready for it. Often the parents experience moments of happiness in addition to all the grief during this encounter. They can see who their child is. If they have not named him or her yet, they may do so at that moment. Maybe they discover its very own beauty and feel it, despite everything, as a miracle and enrichment that it has developed so far and that they have walked its path with it.

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