What to expect when you're expecting (220 page)

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Authors: Heidi Murkoff,Sharon Mazel

Tags: #Health & Fitness, #Postnatal care, #General, #Family & Relationships, #Pregnancy & Childbirth, #Pregnancy, #Childbirth, #Prenatal care

BOOK: What to expect when you're expecting
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Save a photo or other mementos (a lock of hair, a footprint), so you’ll have some tangible reminders to cherish when you think about your lost baby in the future. Try to focus on the details you’ll want to remember later—big eyes and long lashes, beautiful hands and delicate fingers, a headful of hair.

Postpartum Depression and Pregnancy Loss

Every parent who loses a baby has reason to feel sad. But for some, the sadness can be deepened by postpartum depression and/or anxiety. Untreated, postpartum depression can prevent you from experiencing the stages of grief that are essential to healing. Though it might be hard to distinguish postpartum depression from the depression brought on by the tragic loss of a baby, any kind of depression requires help. If you’re exhibiting signs of depression (loss of interest in everyday activities, inability to sleep, loss of appetite, extreme sadness that interferes with your ability to function), don’t hesitate to get the help you need. Speak to your prenatal practitioner or your regular doctor, and ask to be referred to a mental health professional. Therapy—and, if necessary, medication—can help you feel better.

Lactation Suppression When a Baby Dies

If you’ve suffered the devastating loss of your baby, the last thing you need is another reminder of what would have been. Sadly, nature can deliver that reminder when the end of pregnancy (even when it has ended tragically) automatically signals the beginning of lactation, and your breasts fill with the milk that was intended to feed your baby. This can be incredibly painful to cope with, both physically and emotionally—as can handling milk production that has already been fully initiated (because your baby died after you started nursing or pumping in the NICU).

If your baby died in utero or at birth, and you never had a chance to nurse, you’ll have to deal with breast engorgement. Ice packs, mild pain relievers, and a supportive bra can help minimize the physical discomfort you’ll feel. Avoiding hot showers, nipple stimulation, and expressing milk from your breasts will help avoid further milk production. The engorgement will pass within a few days.

If your baby died after you already began nursing or pumping (as might happen with a baby in the NICU), ask the nurses in the hospital or a lactation consultant for help. You’ll likely be advised to remove enough milk (using a pump, or manually if you prefer) to reduce the pressure in your breasts but not enough to empty them and encourage more production. The frequency and duration of pumping varies from one woman to another, depending on the amount of milk you’ve been producing, the frequency of feedings, and the length of time since the birth of your baby, but, in general, you should gradually go longer between expressions and pump for a shorter period of time. Be aware that it’s normal for drops of milk to be present in your breasts for weeks or even months after breastfeeding and/or pumping is discontinued.

If you have a large amount of milk, either in storage or in production (if you’re producing a lot of milk or if you were pumping for twins, for instance), you might want to consider donating your breast milk to a milk bank. Donation of the milk may help you find some meaning in the death of your baby. But, as always, do what helps you most.

Discuss autopsy findings and other medical reports with your practitioner to help you accept the reality of what happened and to help you in the grieving process. You may have been given a lot of details in the delivery room, but medications, your hormonal status, and the shock you were feeling probably prevented you from fully understanding them.

Ask friends or relatives to leave the preparations you made for baby at home. Coming home to a house that looks as though a baby was never expected will only make it more difficult to accept what has happened.

Keep in mind that the grieving process usually has many steps, including denial and isolation, anger, depression, and acceptance. Don’t be surprised if you feel these emotions, though not necessarily in this order. And don’t be surprised if you don’t feel all of them or if you experience other emotions instead or in addition. Everyone is different and everyone reacts differently, even in a similar situation—especially such a personal one.

Expect a difficult time. For a while, you may be depressed, very anxious, or just deeply sad and have trouble sleeping, eating, or focusing at work. You may be short-tempered with your spouse and with your other children, if you have any. You may feel lonely—even if you’re surrounded with people who love you—and empty, and you may even imagine you hear your baby crying in the middle of the night. You will probably feel the need to be a child yourself, to be loved, coddled, and cared for. All this is normal.

Cry—for as long and as often as you feel you need to.

Recognize that fathers grieve, too. His grief may seem less intense or more short-lived—partly because, unlike you, he didn’t carry the baby inside him for so many months. But that doesn’t make the pain he’s feeling any less real or the process of mourning any less vital to healing. Sometimes, fathers may have a harder time expressing their grief, or they may bottle up their emotions in an effort to be strong for their partners. If you sense that’s the case with your spouse, you may both find comforting release in talking the pain out. Encourage him to share with you, with a counselor, or with another father who’s been through such a loss.

Take care of each other. Grief can be very self-absorbing. You and your spouse may find yourselves so consumed by your own pain that you don’t have the emotional reserves left to comfort each other. Unfortunately, relationship problems can sometimes result when partners shut each other out that way, making recovering even more difficult. Although there will almost certainly be times when you’ll want to be alone with your thoughts, also make time for sharing them with your spouse. Consider seeking grief counseling together, too, or joining a couples support group. It may not only help you both find comfort but also help preserve—and even deepen—your relationship.

Don’t face the world alone. If you’re dreading the friendly faces asking, “So, did you have your baby?” take a friend who can field the questions for you on the first several trips to the supermarket, dry cleaners, and so on. Be sure that those at work, at your place of worship, at other organizations in which you’re active, are informed before you return, so you don’t have to do any more difficult explaining than is absolutely necessary.

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