How long does it take to deliver a stillborn baby

Stillbirth (Before Delivery): Care Instructions

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Overview

Stillbirth is the loss of a baby after 20 weeks of pregnancy. When a baby dies while still in the uterus, this may also be called fetal loss.

A doctor may deliver the baby by giving you medicine to start labor. Or you may have a procedure called D&E (dilation and evacuation).

The loss of a baby can be hard. And you may wonder why it happened. Fetal loss can happen even during a pregnancy that has been going well.

In the weeks to come, try to take care of yourself physically and emotionally. Take care of yourself in whatever way feels best.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens next?

After a fetus dies, labor will usually begin on its own within 2 weeks. But if you don't want to wait that long, you can choose to have labor induced. This means going to the hospital and, usually, getting medicine that starts the labor process.

If labor doesn't start on its own, your doctor may take steps to get your labor going.

Your doctor may use medicine to soften your cervix and help it begin to open.
Then your doctor will likely give you medicine to start labor and keep your labor going.
You will be given medicine for pain if you need it.

After delivery, you will be able to see the baby if you want to. Although this can be hard, some people want the chance to hold the baby and say goodbye. Hospitals may have trained staff to help support you.

You will probably go home the next day.

Options instead of labor

You may be able to choose a procedure called a dilation and evacuation (D&E) instead of going through labor. Your doctor will discuss whether this is an option for you.

Delivery by cesarean section is rare in fetal loss. It is major surgery, so it's only done when going through labor would be more dangerous.

Deciding about autopsy

If the exact cause of death isn't known, you may face a decision about whether to have an autopsy. This can be a hard decision. But an autopsy may help you find out why a fetal loss happened and whether it could happen again. If you have had multiple fetal losses in a row, your doctor may suggest testing to check for other possible causes.

How can you care for yourself at home?

After a stillbirth, there are things you can do for your physical and emotional health and comfort.

Taking care of your body

You may have some bleeding. Use pads instead of tampons.
Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), to ease cramps. Be safe with medicines. Read and follow all instructions on the label.
Ask your doctor about when it is okay to have sex.

Taking care of your emotional health

Rest whenever you can. Being tired can make it harder to cope with your emotions.
Try to eat healthy foods, get some sleep, and get exercise (or just get outside) while you heal.
Tell your family and friends what they can do. You may want to spend time alone, or you may seek support from family, friends, or religious or spiritual groups.
Talk to your doctor about how you are coping. The doctor will want to watch you for signs of depression. You may want to have counseling for support and to help you express your feelings.
Think about making a memory book of your pregnancy and baby. You may choose to name your baby and want to take pictures and keep a lock of hair. The hospital may take photos or footprints for you. Some people have a ceremony, such as a christening or other blessing or a memorial service.
If you can, try to talk to others who have gone through this loss. You can make connections online or in person. Here are some organizations that can help:
- The Compassionate Friends. This is a resource for people who have lost a child. The group can help put you in touch with one of its support groups in your area. Go to www.compassionatefriends.org for more information.
- Share (Pregnancy and Infant Loss Support, Inc.). This group can offer advice and connections to others who have lost a child. Go to www.nationalshare.org for more information.
- The International Stillbirth Alliance. This group offers information and resources. Go to www.stillbirthalliance.org for more information.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have severe vaginal bleeding.
You have severe pain in your belly or pelvis.
You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

You have signs of preeclampsia, such as:
- Sudden swelling of your face, hands, or feet.
- New vision problems (such as dimness, blurring, or seeing spots).
- A severe headache.
You have a fever.
You have belly pain or cramping.
You have any vaginal bleeding.
You have had regular contractions (with or without pain) for an hour. This means that you have 8 or more within 1 hour or 4 or more in 20 minutes after you change your position and drink fluids.
You have a sudden release of fluid from your vagina.
You have low back pain or pelvic pressure that does not go away.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter B273 in the search box to learn more about "Stillbirth (Before Delivery): Care Instructions".

Preparing for labour and birth with a stillborn baby

It is devastating to find out that your baby has died before labour has started. If you are in this situation, your midwife or doctor will talk to you about the different options for giving birth. If you're alone in hospital, ask the staff if they can contact someone close to you to come in and be with you.

You may find it extremely difficult to process anything you are told at this point because of the overwhelming shock you are in. It can be helpful to ask another person – such as a parent or friend – as well as your partner, if you have one, to be with you while you talk to doctors and midwives about the next steps.

"There was a lot of information to process and part of me wanted the decision to be taken out of my hands… I felt an enormous burden to try and work out what to do in the midst of feeling so utterly devastated. Kate [midwife] was incredibly helpful at taking time to sit with us, listen to us and give us space to work it all out."
Lucy, who lost her son Jude. Read Lucy’s story.

Legally, it is the mother/birthing person’s decision how they decide to give birth to their baby. Because of this, the information on this page is aimed at them, but we hope that dads, partners and birth partners will find it useful too.

If there's no medical reason for your baby to be born straightaway, it may be possible to wait for labour to start naturally. You might not need to decide this immediately. You may be able to go home for a day or two first.

In some cases, you might be offered medicine to help induce labour. This can either be one medication or a combination of two medications. This might take up to 48 hours to work.

Preparing for the birth

You may be offered the opportunity to go home to prepare for your birth. If you go home or get the chance to collect some things from home, ask your midwife about what you should bring. Here are some suggestions:

cool clothes (hospitals can get very warm)
food, snacks and drinks to keep you going through labour
home comforts such as a dressing gown, slippers and pyjamas
big pants and maternity pads for the post-partum bleeding (this bleeding is much heavier than a period)
breast pads
things to relax you and make you feel more comfortable such as essential oils to smell or music to listen to.

Although it may be very difficult, try to think about anything you would like to bring for your baby. Perhaps a special babygrow, a blanket or a cuddly toy. If your baby is very premature, the hospital might be able to provide very small clothes, if you don’t have anything suitable.

Waiting to go into labour naturally

You may be given the option of waiting for labour to start naturally, rather than being induced.
If you decide to wait, here are some things to consider:

You’ll need to have a blood test after 48 hours and then twice a week to check your health.
If you haven’t gone into labour after 2 or 3 weeks, or there are concerns about your health, the doctors will advise that you have an induction.
As time goes by, your baby’s condition will deteriorate in the womb. If you decide to have a post-mortem, this may affect the results. It will also affect how your baby looks when they are born.

You can change your mind

If you decide to wait for labour to start naturally but then change your mind, that is absolutely fine. You will be making difficult decisions after receiving this devastating news. It’s completely understandable to change your mind and rethink your decisions. Your healthcare team will not think you are 'being a nuisance', which is something parents have told us they worry about.

If you go home before giving birth to your baby, the hospital will give you a contact number so you can call them with any questions or concerns at any point. If they don’t give you a contact number, make sure to ask for one before you go home.

Who to bring with you to the birth

Having a partner, friend or relative as a birth partner to help you through labour can be a huge support. You might choose to have more than one birth partner. This is helpful during a long induction.

Your birth partner will also be able to talk to you about the birth afterwards, and help if your memory is hazy or you struggle to piece together what happened.

Choosing between a vaginal birth or caesarean section

In most cases, a vaginal birth is safer than a caesarean-section so this is probably what your doctor will recommend. But how you give birth is your decision and your options will depend on your circumstances. For example, a c-section section might be needed if:

you have a condition where your health is at risk such as placental abruption or severe pre-eclampsia,
you have had a c-section or surgery on your womb previously
the amniotic sac (fluid around the baby) has broken.

The caesarean may have to happen quite quickly.

"Our initial reaction when we were told that our son had died was that we wanted to have a caesarean section. The thought of giving birth to a dead baby was almost unbearable. But of course this wasn’t just a dead baby this was our precious son and I am so glad that I was persuaded to give birth to him naturally. I feel proud of going through that for him. I held him within a minute of being born, after the midwife had dried him a little and wrapped him in a blanket – what a wonderful feeling that was to finally meet him."
Kathryn, who lost her son Arthur. Taken with permission from the book, ‘Life After Stillbirth’ by Sarah Smith.

Induced labour

If you’re offered an induction, you will be given medication to help prepare your womb for giving birth. This can take up to 48 hours to take effect so you may need to go home during this time. Talk to your midwife if you’re unhappy about leaving the hospital.

An induction may be done immediately if the health of the mum/birthing person is at risk. This might include if:

you have severe pre-eclampsia
you have a serious infection
the amniotic sac (the bag of water around the baby) has broken.

Labour can be induced by inserting a pessary tablet or gel into the vagina, or by swallowing a tablet. Sometimes, medicine is given through a drip into a vein in the arm. Your midwife can tell you more about this.

It can take time for contractions to begin and they may be irregular at first. As your cervix dilates, your contractions are likely to become more intense and regular.

If the pessary or tablets don’t bring on established labour, you may be given hormone medication through a drip in your arm and will need to stay in hospital. This is the next level of induction and should help your labour progress. Alternatively, you will be given a chance to rest and the procedure will be started again after 24 hours.

"The midwives might leave you on your own during labour, but if you feel vulnerable or anxious and being left alone is making things more difficult for you, please talk to your midwife. Often staff leave parents because they feel they need privacy or are managing fine on their own. It’s all about communication."
Vicky, specialist bereavement midwife

Pain relief during labour

There are lots of different ways to manage contractions yourself, including massage, movement, different positions and breathing techniques. As labour progresses and contractions become more intense, you may want to use some pain relief. You can use most types of pain relief in labour. You may be able to give birth in water for pain relief in certain circumstances.

Gas and oxygen (gas and air, Entonox)

This is a mixture of oxygen and nitrous oxide gas, which you breathe through a mouthpiece. It won’t remove all the pain, but it can make it more bearable. Some people find it makes them feel sick, or sleepy, while others find it very relaxing. Many people like it because it’s easy to use and you can control the mouthpiece yourself.

Pethidine or Diamorphine

Pethidine or Diamorphine is given by injection into your thigh or bum. It doesn’t numb you completely but can reduce the pain. It takes about 20 minutes to work, and lasts between 2 and 4 hours.

It can make some people feel woozy or sick. Some people find they can’t remember all of the birth – it becomes blurry or fuzzy – and you may feel drowsy afterwards. Anti-sickness medication can be given (by tablet or by an injection) to help reduce this if you’re feeling sick or dizzy. Speak to your midwife if you start to feel this way as there is usually a way to reduce this side effect.

Epidural

An epidural is a type of local anaesthetic. It numbs the nerves that carry pain impulses from the birth canal to your brain. It shouldn’t make you feel sick or drowsy.

If your baby has died sometime before you are in labour, your blood clotting will usually need to be checked before you have an epidural. Therefore, it is a good idea to let someone know you are thinking about this type of pain relief in advance. A very fine tube is inserted into your spine by a specialist doctor (anaesthetist) and remains there throughout the birth. You or your midwife may be able to top up the epidural by pressing a button on a machine.

An epidural usually gives complete pain relief. However, it isn’t effective for everyone. The Obstetric Anaesthetists Association estimates that 1 in 10 women who have an epidural during labour need to use other methods of pain relief.

You may need a catheter to empty your bladder. You’ll be monitored regularly, and your blood pressure will be taken.

As with all effective pain relief there are some risks involved, which the anaesthetist will talk you through. For example, 1 in 100 people get a severe headache after having an epidural.

Read more about pain relief during labour.

Delivering the placenta

If you’ve been through labour, you’ll also need to give birth to the placenta. This is known as the third stage of labour.

You may be offered an injection of oxytocin in your thigh to help deliver your placenta. This is known as ‘active third stage’ and it is your choice whether you have the injection or not.

It can be difficult at this point because you might just want to be left alone with your baby. But the midwives need to continue caring for you until your placenta is delivered.

If the placenta doesn’t come away from the womb or there are complications, you may be taken to theatre and given a spinal anaesthetic so your doctor can manually remove it. This is more likely to happen in stillbirths that happen earlier in pregnancy.

Your baby can go with you to theatre. It might be possible for your partner to go too. Keep talking to the doctors about what is right for you.

Caesarean section

Doctors usually recommend a natural or induced labour to deliver your baby. This is because a caesarean (or c-section) is major sugery, which carries more risks and can affect future pregnancies. It usually requires a longer recovery period in hospital, and at home, too.

However, there may be reasons why you want to have a c-section. Discuss this with your doctor. They will be able to talk through the risks in more detail so you can decide what you would prefer.

If you have a c-section, you’ll usually be given a spinal or epidural anaesthetic. This means your partner can be with you in the operating theatre and that you’ll be awake when your baby is born. It carries fewer risks and usually leads to a faster recovery.

A screen is placed across your body so you cannot see what’s being done but the doctor or nurse can talk you through it. A cut about 10 to 20cm is made across your lower tummy and womb. You may feel some tugging or pulling.

The whole operation normally takes about 40 to 50 minutes.

A general anaesthetic puts you to sleep during the c-section, and may be needed in certain circumstances. There may be some discomfort in your tummy for the first few days and you’ll be offered painkillers.

After the birth

Seeing your stillborn baby

If it is possible, discuss what’s going to happen straight after the birth with your midwife beforehand. You may want to see and hold your baby straight away. You may want the midwife to take them first. Or you may not want to see them at all.

"I had asked my lovely midwife, Tina, to look at him first as I didn't know what was for the best and as we didn't know when he had died I didn't know what to expect. She brought him to me, to us, and we were in love immediately with the perfect little boy that we never had the chance to meet. He was perfect-looking like a sleeping baby."
Sarah, who lost her son Tristan. Read Sarah's story.

It’s also fine to change your mind. Taking some time to think about what you want to do in advance will help.

"The midwives asked if I would like to see him but I was too frightened, something I will always regret. They asked if I’d like pictures, which I refused at first. If it wasn’t for the support of a very lovely midwife I could, in my mind, have made the biggest mistake of my life. Thankfully I changed my mind later that night."
Shelley, who lost her son Joseph. Read Shelley's story.

When your baby is born, you can ask your midwife to describe them to you. The midwife could take a photo of your baby before you see them. Or you might decide together to just look and touch your baby’s hand and feet, while the rest of them stays covered.

"Many parents tell us that they’re worried and anxious, sometimes frightened, about seeing their baby at birth. This is normal and understandable. It’s important to take the time to make the decision to see your baby. This should be supported by midwives, doctors, partners and extended family. Sometimes a couple may feel differently about seeing their baby and, again, that’s a normal reaction. Parents should be individually supported with the decision they make."
Vicky, specialist bereavement midwife

Your midwife can wrap your baby in a blanket for you, which can help cover up any deterioration, if there is any. They can also place your baby in a Moses basket, or cot, in the room, so that you can choose when to see them.

"I didn't want to hold my baby Erin after she had been born but my husband did, which I totally respected. We also arranged for the hospital chaplain to bless her, which was beautiful. I later changed my mind however and went to the chapel of rest to hold her and completely broke down. I’m glad I now made that decision, but everyone will feel differently."
Bethan, who lost her daughter Erin

Spending time with your baby after they're born can be a precious time to create special memories and help you grieve. Your hospital may have a Cuddle Cot, which is a cot that keeps your baby cool. This slows down deterioration so that you can spend more time with them. You may also be able to take your baby home in a cuddle cot if you wish.

"Heidi, my angel was put straight into my arms while I lay on the operating table. She was perfect. She had dark hair, long fingers and big feet. She was beautiful. They took her away to clean her up and the next time I saw her she was dressed in a special Moses basket waiting for us. There are no words to describe how utterly lost you feel at that point. I needed to grieve. I needed to go into a quiet room and completely break down."
Rachel, who lost her daughter Heidi. Read Rachel's story.

Read more about spending time with your baby and creating memories.

More information and support

If you decide to spend time with your baby after they're born, we have put together some suggestions for things you can do, such as bathing and dressing your baby, and ways you can create memories.

We also have more information about what to expect in the next few days and weeks, including coping with the physical effects of the birth, such as your milk coming in and postnatal care.

If you're worried about the practicalities of what happens next, please read our section on the practical issues, such as registering your baby.

Going through this experience can often be very traumatic. A bereavement support officer or bereavement midwife will be able to offer support. Tommy’s is also here to help you. You can talk to a Tommy’s midwife for free, Monday-Friday, 9am-5pm. You can call them on 0800 0147 800 or email [email protected]. All our midwives are trained in bereavement support and will be able to talk to you about what you’re going through.

Stillbirth

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Why is it important for us to talk about the loss of a child

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As part of the continuum of reproductive health services, antenatal care (ANC) provides a platform for. ..

Over five million cases of perinatal death, making it an important goal of international health efforts...

Pregnancy is a time of great expectation for all parents-to-be and their families who dream of raising and loving a healthy baby.

“A baby died in my stomach”

In February 2019, Canadian resident Allison Harley-Queen gave birth to twins Gwen and Clara. They were born at the 25th week of pregnancy already dead - the sisters had intrauterine circulatory disorders. The fact that her girls had died, Allison found out before the birth and planned a farewell in advance.

She went to the hospital with her husband and a photographer friend. Pictures of babies and a touching story titled “A stillbirth is still a birth” was published on social networks and collected more than 8 thousand comments of support. “I’m sorry for your loss!”, “I pray for you”, “You are so brave that you share this experience with the world” - these are just a few of the thousands and thousands of replies from users.

Under the post of Muscovite Yana Yatskovskaya, who lost her son Alexander in the fall of 2018 at 27 weeks of pregnancy due to a true knot in the umbilical cord, a scandal erupted. The story got into the press with the headlines “The model posted a photo with a dead child on the network,” and some of Yana’s followers wrote: “Why publish such pictures? It's disgusting!" As a result, Yatskovskaya simply closed the comments in her account.

We are talking to doctors, psychologists and representatives of charitable foundations that work with perinatal loss about why the conversation about the death of a baby is so painful in Russia.

How to survive the death of a child?

"Doctors don't like to talk about it"

Stillbirth is not that uncommon. WHO gives statistics: up to 3.2 million annually around the world. For Russia, the statistics are not obvious, since in our country all deaths of a child under the age of one are considered infant mortality. However, there is data for 2010, when more than 8,000 episodes of intrauterine death of a child were recorded at terms of 20 weeks of pregnancy.

When I was looking for a doctor willing to comment on this topic, I came across refusals or silence. “Why are you digging into medical details? Women don’t need to know how a dead baby is born,” an experienced obstetrician-gynecologist, an employee of one of Moscow’s private clinics, told me.

“Nobody likes to talk about this topic. And no one likes to take such births either. This is a closed topic, ”anonymous confession of the deputy chief physician of one of the large metropolitan maternity hospitals.

Quite a whisper and with a request “just not for print!” doctors said: it's all about the statistics. No one wants to see infant mortality rates rise in the maternity hospital - they spoil the reputation and can cost the hospital a reduction in funding, and the head doctor's job.

“Our society still treats a pregnant woman as a kind of vessel that should give out the contents. And if the “product” turns out to be of inadequate quality, they look at her as if she were plagued. There is an order for healthy, pink, successful children. Everything else should be forgotten,” says the doctor of the Center for Traditional Obstetrics and Family Medicine Veronika Nazarova.

“It is better for such women in labor not to meet mothers of healthy children”

At the moment, childbirth with intrauterine death of the fetus takes place strictly in those maternity hospitals that have the so-called 2nd obstetric department, or observation. This is a kind of “maternity hospital in a maternity hospital” with stricter sanitary rules, regular disinfection, wards for one, maximum two people. Usually, women in labor come here with various kinds of infections - from the commonplace SARS to HIV. Give birth in separate boxes.

“This happens only for one reason – that women in labor have the opportunity not to meet other women who have given birth to healthy children. This is for their own peace of mind,” explains Roman Getmanov , an obstetrician-gynecologist at the Moscow City Clinical Hospital No. 70.

Childbirth with a dead baby is still childbirth. Protocols in the vast majority of situations forbid a caesarean section, because there is a risk of blood poisoning. On condition of anonymity, an obstetrician-gynecologist of one of the private clinics in Moscow explains that in such a situation, doctors are constantly waiting for complications, they are afraid of sepsis, so they usually stimulate the patient without waiting for the birth to begin on their own.

According to her, Russian doctors prefer to act quickly when they learn that the baby is dead in the womb. So, if the diagnosis is established in the antenatal clinic during an ultrasound scan, an ambulance is called, the woman is taken to the hospital and given an emergency delivery, most likely with anesthesia.

In foreign practice, on the contrary, expectant tactics are possible - of course, if the pregnant woman has no complications, for example, bleeding, and with the control of blood tests, pressure, heart rate. For example, a Canadian study cites the following figures: more than three-quarters of women give birth spontaneously within two weeks after the death of the fetus, most of the rest within four weeks of the death of the child. At the same time, the earlier during pregnancy the child died in the womb, the later childbirth can begin, and the more mature the fetus, the less time it will take for the body to reject it.

“It's not about sepsis, it's about fear”

So far, expectant management is hardly possible in Russia, for a number of reasons.

“The difficult situation is not around the problem of blood poisoning - after all, in obstetric practice there is an approach when one of the twins dies, and the pregnancy is kept in order to bring the second child. Sepsis does not start immediately. But such a speed of delivery, which we often observe in Russia, is associated more with psychological reasons than with medical ones,” says the coordinator of the perinatal program of the Children’s Hospice “House with a lighthouse” Ksenia Popova, former obstetrician-gynecologist.

According to her, the whole point is the desire of doctors to protect the woman, and themselves, too, from worries. “Midwives are those who welcome life. And suddenly, death. How to meet a dead child, how to help? Almost no one here knows about it."

“Well, who wants to do this when a person works in a maternity hospital, accepts living children? And suddenly a child who died in utero. We are all living people, everyone understands that this is a misfortune,” Roman Getmanov confirms her opinion.

“In residency, I happened to attend such births,” recalls Ksenia Popova. – I really sympathized with this mother, I wanted to come to her room and console her. But I did not know how to do it - we were not taught this at the institute. I was afraid and she was afraid too. We both did not know how to talk about it, and preferred to remain silent.

Sometimes a woman herself demands that everything be left behind as soon as possible, and doctors are accustomed to such a course of events, they willingly meet the wishes of the patient.

“Moms think that if the child is dead, nothing can be done. In fact, a lot can be done. Look at the child or touch him, say something, mourn, give a name, bury. Mom needs to find a way to survive this grief, how to say goodbye to the child, how to remember him and pray,” says Ksenia Popova.

“You have time to wait and think about everything”

Foreign practice regarding stillbirth is different. Mom has time: to comprehend what happened, talk with her loved ones, find support and prepare for a sad but important event in her life. Yes, at least - take clothes for the baby with you to the hospital, solve the issue of photography, if necessary, and take into account many more important, in her opinion, little things.

There are quite a few articles on stillbirth in English on the Internet. All these are quite user-friendly materials that describe in detail and calmly what awaits the mother in the maternity hospital, how the birth will go, and how to organize a farewell later. They discuss the possibility of using epidural anesthesia, describe the pros and cons of different ways to stimulate labor. The obligatory advice is to take an accompanying person with you to the birth: a husband, mother, girlfriend or doula, so as not to be left alone.

Books for pregnant women include such information in a special section. “In one of the Australian publications that I came across, there is a chapter on what to do if the child died, in utero or during childbirth. The author warns readers: “I understand that you are now preparing to become happy parents. You do not need to read this chapter in advance. Just know that it is in the book, and you can get information if something goes wrong,” says Veronika Nazarova.

The death of a child: how to talk about the worst

If you want to say goodbye, get ready to defend this right

“I teach childbirth preparation courses, and there I also communicate with women with such a sad experience. From their cautious reservations, you can roughly guess what they have to go through. It happens that there is rudeness, especially on the part of middle and junior medical personnel, - says Elizaveta Novoselova, obstetrician-gynecologist, perinatal psychologist, author and teacher of the educational project "School for Parents".

– The very moment of childbirth is perceived as unnatural, because you are giving birth, but in fact there is no one to give birth. And you are still reminded of this, not embarrassed in expressions.

The situation can definitely be corrected by the presence of an escort - a husband, mother or someone else you trust. At one time, I was present at such births in this capacity, and I can say that the attitude towards the woman in labor was excellent: everyone felt sorry for her, sympathized and communicated with her extremely politely. But who knows what it would be like if she were alone?

Lawyer and human rights activist Ruslan Trofimov informs that much of what could protect women in such a difficult situation is already written into the law. You just need to know your rights.

So, in the law "On the protection of the health of citizens in the Russian Federation" there is Article 6, which speaks of respecting the priority of the patient. This means that the interests of the woman (and not doctors) are at the forefront, and not only the issues of her health and life, but also the observance of cultural and religious traditions. In other words, in the case of a stillborn child, the mother has the right to say goodbye to him and observe all the rituals that she considers necessary.

The law regulates the creation of comfortable conditions for the patient. On the basis of it, one can demand that a woman in labor who has experienced the loss of a child be placed separately from other mothers and their babies, allowed visits from relatives who could provide her with moral support.

Part 2 of article 51 of the federal law says that the child's father may be present at the birth. It does not specify which child will appear in such childbirth - living or dead.

“Look at him anyway”

Often the main question for a woman in childbirth of a child who died in the womb is the dilemma: is it worth looking at him?

According to Alexandra Feshina, director of the Light in Hands Charitable Foundation , there is no single correct answer to this question.

“We have parent support groups after a loss, and we've noticed this. Parents who did not see their baby, did not look at him, most often regret it. But there are situations when for women who saw the baby, it became a severe injury, mainly because of the appearance. The best thing to do in this case is to listen to yourself.”

Obstetrician-gynecologist Roman Getmanov , on the contrary, I am sure that it is not worth looking at a dead child. “I have been in the profession for 35 years, and I can hardly look at it. If the child died a few days ago, it's decomposed flesh. What is there to show mothers? On the contrary, we try to take it away as quickly as possible, otherwise she will later associate it with children. ”

According to the coordinator of perinatal programs of the Children's Hospice "House with a Lighthouse" Ksenia Popova , by blocking the problem, we do not solve it.

“It seems to doctors that by their silence, by the fact that they take away and immediately take away the child without showing it, they protect the mother from worries, help her “start living on” as soon as possible. But because of this silence, mother with her grief and horror is left all alone. The memory remains haste, averted glances, silence, as if something shameful had happened.

It is difficult to say in advance in what form her dead baby will appear before her mother. It depends on many different factors - how long ago the child died, what was the cause of his death, how the birth went, and so on. But Ksenia is sure: the mother should have the opportunity to think about whether she wants to say goodbye to the child, and if so, how.

“It is important to discuss this with your mother before giving birth. She may not see the whole baby, but only the arm or leg, while the body is covered with a sheet. In foreign practice, it happens that the midwife describes to the mother what the child looks like, and then the mother decides whether she wants to see him or not. You may not look, but touch, stroke through the fabric of the diaper. In our country, it is not sometimes offered to take the body of a child and bury it, although the family has the right to do so. Everyone tries to pretend that there was no child. But for my mother, he was and always will be.

In foreign practice, there are options that can be applied even in extremely ambiguous situations and have a therapeutic effect. “In Britain, midwife Sally Kelly practices, which fundamentally deals only with complex cases - the birth of unviable children, babies with severe pathologies and intrauterine death. Even if it is not possible for the mother to show the body of the child for aesthetic reasons, Sally Kelly takes a photo for her as a keepsake - for example, a tiny hand hugs a teddy bear, ”says Veronika Nazarova.

“Maternity hospitals are not ready to give such mothers boxes of memory”

“Last year we tried to launch the “Box of Memory” project,” says Alexandra Feshina. - She could become in Moscow an alternative to a gift box from the mayor, which women in labor receive.

The idea is not new, it is widely practiced in the West. Usually two soft toys are placed in such boxes - one is buried with a child, the second is left as a keepsake. Carbon paper or special clay to make a cast or print of a hand and foot. Photo frame. A postcard on which a mother can write words of love to a child. A small blanket that covers the baby when they are buried.

Unfortunately, we have not yet found the head physicians who are ready to take part and support the distribution of such boxes to mothers. Today, maternity hospitals give out brochures developed by our foundation with information for mothers and their loved ones who are experiencing loss. Thank you anyway. Not so long ago, it didn't even exist."

There are also difficulties with the farewell ceremony. It happens that heartbroken parents do not even have time to realize what they really want, how they plan to spend their child, and no one simply provides them with information and possible options.

“There should be an opportunity to say goodbye to a dead child and bury him, because this is an important part of living and experiencing grief and loss,” explains Natalia Perevoznyuk, a psychologist at the House with a Lighthouse Children's Hospice .

- Alas, avoiding feelings and grief is one of the communication strategies with parents adopted in Russian society. Meanwhile, the woman and her family are alarmed by the "suddenness" of the stillbirth, they are in shock and cannot immediately "figure out" what they would like or what else they could do for their dead child.

If parents initially refuse to pick up and bury their child, they should be able to do so later.