Grief and loss during childbearing : the crying times

Today the public expectation in developed countries is that pregnancy leads to the birth of a live and healthy baby. There is also the perception that with the advances in medical technology very little should and can go wrong during the childbearing experience. The reality is that this is not always the case"”miscarriage, genetic abnormalities, premature birth, stillbirth and neonatal death still occur; the reality is they probably will always occur even in the future we can't imagine yet. In Australia, despite rapid advances in medical technology and high rates of intervention, the perinatal mortality rate has not changed in over a decade. So, on the one hand we have a perception that perfect outcomes during childbirth are increasing, yet this is not the reality we see in the perinatal statistics. Each situation where a women and her partner experience loss creates ripples that impact significantly on family, friends and community. As De Frain et"¯al. (1991, p 165) said 'the death of a baby is like a stone cast into the stillness of a quiet pool; the concentric ripples of despair sweep out in all directions, affecting many, many people'. As midwives we witness the despair, we wipe the tears, we hold those shaking shoulders and we learn to walk through the fog that grief and loss creates in lives. However, knowing what to do and say, and more importantly what not to do and say, is not always so intuitive to midwives. It is beyond the scope of this chapter to discuss all of the events where bereavement can occur during pregnancy and childbirth. We have also not reviewed the physical care associated with different experiences of loss. This can be found in other areas of this textbook. It is our intention in this chapter to take you by the hand and show you the ripples of despair that sweep out in all directions when a baby dies and how you as midwives can make such an important contribution to the journey families who experience perinatal loss will go on.