What is maternal-fetal medicine?
Maternal-fetal medicine, also called perinatology, is the specialty of obstetrics devoted to managing high-risk, complicated pregnancies.
Baptist Health Medical Center-Little Rock has a seven bed, high-risk antenatal unit staffed by labor and delivery registered nurses certified in fetal heart rate monitoring and newborn resuscitation, a dietician, certified lactation consultants and a Maternal Transport Team available 24-hours a day to transport high-risk obstetrical patients to Baptist Health by ambulance or MedFlight.
Why might I need a maternal-fetal medicine physician?
Women may be referred to a maternal-fetal medicine physician (or perinatologist) early in their pregnancy if they have a medical condition that puts them at risk for complications such as a history of premature delivery, pregnancy loss or multiple gestation (expecting two or more babies). They may also be seen for help with conditions such as high blood pressure, diabetes, lupus or another medical condition that would be affected by pregnancy or that may affect the pregnancy. A perinatologist may provide consultation to your obstetrician or may manage your pregnancy.
What support is offered?
SHARE Support Group
SHARE is the largest perinatal bereavement support group in the country. Meetings are free and open to parents who have experienced a miscarriage, stillbirth, ectopic pregnancy, or neonatal death. Parents and caring staff members meet monthly at Baptist Health Medical Center-Little Rock to share their concerns and experiences with other parents who have also experienced a loss. For more information, call the Women’s Center education center at (501) 202-1717.
Bereavement is the period of grief and mourning after a death. Grief is a normal, healthy response to loss, and the repression of that grief is unnatural. We want you to know that you are not alone in your grief. We have prepared the following information to help our patients learn how to deal with the loss of a child.
As you are saying goodbye to your baby, we encourage you, whenever possible, to touch or hold the baby. It is also helpful to name the baby as this may help you to say goodbye. We may take footprints and pictures of your baby as remembrances for you, which you may take home.
However, mourning an unsuccessful pregnancy does not end when you are discharged from the hospital. You may find it comforting to have some form of remembrance dedicated to your baby such as planting a tree, engraving a plaque or symbol of your baby with his or her name, or planning a special service or memorial.
Dealing with Grief
There are different phases of grieving and phases can come in any order, length and degree. No two people grieve the same. Even when you think you have come to a full acceptance of your situation, these feelings can reoccur reminding you that grieving is a continuous process.
Four Phases of Grieving Characteristics
Your first feelings after your loss will probably be ones of disbelief, perhaps a numbness or haziness as if the whole thing happened to someone else. It may seem that you are in the middle of a bad dream and cannot wake up. Denial can take the form of feeling or pretending that everything is just fine. When you are back in familiar surroundings, the sense of loss will be more real; the reminders that the baby is missing will be more obvious. You may find it difficult to settle back into your usual routine. Don't worry about this. The adjustment will take time and it usually isn't helpful to busy yourself in an effort to forget the baby.
Other characteristics of this phase include a short attention span, concentration difficulties, impaired decision-making, time confusion and failure to accept reality.
Whether or not there is a satisfactory medical reason for the death, you will still feel angry and hurt. You may pass your anger onto your spouse or family just because they are there. You may be angry at the medical community because they seemed to lack effective methods of preventing or "fixing" the situation. You may be angry at God and feel that He is punishing you. Feeling angry can be healthy and normal at this time. Sharing your anger is healing, and you may even discover a new perspective to your feelings when you put them into words.
Another common feeling in this phase of grief is guilt. Both parents may go over every detail of the pregnancy and birth to find real or imagined causes for the tragedy. You can spend hours, days or even years thinking of reasons why you are to blame. When these feelings occur, it is comforting to some parents to be realistic and say to themselves, "I know I would have done anything in the world, gone to any length or trouble or pain to have made this child be healthy."
You may even feel guilty for grieving over the loss of your newborn as compared to another person whose loss seems greater. The fact is that grief cannot be measured or compared. What you feel is your own. There is no such thing as a "wrong" feeling. It is not wrong to feel guilty, but it can be unproductive if you stay stuck on guilt and self-punishment. This uses energy that you need for other things right now. Use your guilt in a positive, constructive manner to ask questions and find realities.
Physical characteristics during this phase can include blurred vision, palpitation, lack of strength, headaches and aching arms.
You may feel an overwhelming sense of sadness and depression, which could last for weeks or months. The reality of postpartum depression is often forgotten in this context. There is no baby, no happy visitors with gifts and attention, no approval and no fuss. Your excitement and hopes have been crushed. You may feel that you have failed or that you are a disappointment to yourself, your mate, your friends, and your family. You may feel a terrible sense of loneliness, isolation and emptiness.
Tears honor both yourself and your baby. You may be afraid to cry because you feel it will make others uncomfortable or that if you start crying you may not be able to stop. Give yourself permission to cry. Tears can be a soothing release. No one else has ever felt exactly the way you do, and no one else could possibly understand how you feel. However, this sense of emotional loss is universal, normal and expected following the loss of a baby.
Other characteristics of this phase include social withdrawal, weight gain/loss, difficulty concentrating, disorganization, forgetfulness, lack of energy, insomnia and thoughts like “I’m going crazy.”
Reorganization and Resolution
This phase of grieving is characterized by a sense of release. You begin to have renewed energy, you’re better able to make decisions, your eating and sleeping habits are re-established and you’re even able to laugh and smile again.
If you have other children
Although your initial instinct may be to "protect" or "shelter" your children from the sadness of life, most professionals agree that you should be open and honest with children about death. A simple statement about the baby being dead, as soon as possible after it happens, may be difficult to say, but allowing your own sadness to show and sharing these feelings with your children can be a meaningful experience for all of you. No matter how young your other children are, they need to know about this loss.
If your children are quite young, they may not know what "dead" is; they may not have seen anyone or anything that they defined as dead. Reminding them of fading flowers, a dead animal seen in the yard or road, or another experience with death may help them understand what dead means. One can also remind them what living means, such as breathing, talking, walking, eating, etc., and tell them that dead means the absence of these signs of life. Death should not be referred to as sleeping since this may lead to sleep disturbances in the child. Death should not be linked too strongly with illness, as this may lead to fearfulness or panic if a minor illness develops in the child or another family member. The child may indeed need reassuring that he/she is well. The first illness following the death may be especially stressful. Many children may need to know or will ask about what will happen to the body of the infant. If a funeral is planned, explain the need for burial or cremation because of the decomposition.
Many children will want to know why the death occurred. Again, simple honest statements will be helpful to your child. But if the reasons are unclear, be cautious in telling children that "God took the baby to Heaven because He loved and/or needed the baby more than we did." This can cause resentment against God or a conflict in the child's mind about being loved by God.
Another point that should be stressed is that no family member could have caused or prevented the death by their actions, thoughts or wishes. This is especially important if the infant was unplanned or unwanted by any family member. Young children believe that wishes are powerful and may believe that they or another family member caused this infant's death.
The reaction of your child to the death will depend to some extent on his/her age. A wide range of responses is normal, from incessantly talking about the death to a refusal to speak of it at all. Preschoolers will view death as temporary because the concept of permanent is quite sophisticated. Gently indicating that the baby will not come back is sufficient; when the child is older, understanding will come. Preschool and younger school-aged children may develop fears, which grow out of fantasies about their own or their parent's death. Because openly dealing with strong emotions is difficult for this age group, they may deal with them piecemeal over a long time through their questions, in dreams and in their play. You should let them set the pace, listen lovingly to what they have to say, and answer all questions simply and honestly.
Pre-teens and teenagers will have a somewhat more adult view of death and grieve much the way you will. They understand the permanence of death, but they may need to deal with issues of why it happened. Children of all ages will grieve and must be allowed to do so to relieve the feelings generated by the loss of a family member. Because of their stage of psychological development, adolescent girls may have an especially difficult time dealing with the death of the infant. They may feel a considerable amount of anxiety and/or anger about this happening.
Months or years after the death, children may need to re-think the event through and begin again to question you regarding their brother’s or sister's death. Any major event in a young person’s life is commonly reworked in adolescence. Later questioning and reworking these issues is part of growth and development and should be viewed as normal.