Postpartum support after loss

STILLBIRTH SUPPORT

Returning home...

Eventually, there will come a time when you are discharged and have to return home. For some, this is exactly where they want to be but for others, it can feel triggering as there are reminders of our pregnancy/baby everywhere. Below are some considerations as you are discharged and returning home after loss:

Ask for help/find a support person

While all of this feels lonely, you don’t have to do it alone. Ask a trusted friend to be your “support person” as you make this transition. All they need to do is listen. This person’s support can look like:

Prepping the home – This will ensure potential triggers are moved out of sight for the time being upon your arrival home (do not throw anything away or return any gifts!).
Letting people know – They can help remove the burden of notifying mutual friends about what has happened, and let them know you need some time and space before reaching out. They can also encourage them to send you texts or messages of love and support.
Phone calls - They can help make phone calls to situate insurance billing, finding counselors or therapists, making appointments, arranging meals or finding disposition providers.
Manage quiet time – They can arrange for childcare/play dates for other children at home to provide periods of rest for both parents.
Managing meals - They can coordinate a meal train/schedule or help with routine household chores which can become unusually overwhelming.
Holding space - Be someone who can be shoulder to lean on when you can’t express how you are feeling.

Ask your care team questions

Upon discharge, your care team will meet with you to discuss the next steps in your physical, emotional and mental well being, as well as any medications you are prescribed and temporary restrictions you may have. We encourage you to retain all documentation and paperwork regarding your post-discharge instructions, post-partum follow up needs and mental health resources. Create a list of questions to discuss with your care team prior to discharge and, if possible, have your partner or support person present so they can answer any questions when you get home and help you get situated. Remember, there are no dumb, wrong or unusual questions. Common questions include:

What happens next regarding burial/cremation?
What postmortem testing options do we have?
How do I dry up my milk supply?
What resources are available for mental health support?

Leaving the hospital

Leaving the hospital without your baby is one of the most difficult parts of the journey. Many parents will carry bears so their arms feel less empty. You can request to be escorted out a separate entrance or certain time of day to avoid crowds, strangers and the public. It is important to remember, while you are leaving them behind, as their parent you are taking them and their love with you wherever you go.

Lactation support

After the loss of your baby, you may begin to make breast milk. It can be a painful reminder that while you are no longer pregnant, your body does not quite realize there is no baby in your arms. Lactation support for post-partum loss moms is virtually non-existent and leaves many suffering in silence.

Most women will choose to dry up their supply, as quickly (and painlessly) as possible. Others will decide to pump and donate their milk for use by NICU's and moms who cannot breastfeed for whatever their circumstance. Whatever you decide, your decision is what is right for you and your situation, and we support you.

Drying up your milk supply - Chilled cabbage leaves can be a great first step in this process. Placing a leaf in each cup of your bra will help with the pain and swelling from engorgement. Some say the enzymes found in cabbage can help dry up your milk, but more studies need to be done on that specifically. Other suggestions include small ice packs in your bra for short periods of time, nursing pads, specialty tea that can aid in drying and gentle breast massages. Read more here about drying up your milk supply.
Donate your milk supply - Research in the United States shows that donating breast milk to a Human Milk Bank has helped some bereaved women identify as a mother, while grieving the loss of that motherhood. Donating your breast milk can be beneficial; not only through helping hospitalized premature infants, but also to help with your own personal grief. Some say that donating breast milk to other infants helps find some positive meaning in the death of their own baby. It is important to understand, the process is a little more complex than pumping/expressing and dropping off your milk. Milk Banks require a criteria screening, as well as testing your blood. Read more here about the process to donate and eligibility requirements.

Understanding the emotionality of breastfeeding

Expressing breastmilk for a baby who will not be nourished by it is physically, emotionally and spiritually exhausting for the parent. We encourage reaching out to a lactation professional to support you through either option Most provider accept insurance and it is a benefit you already may have. While some may find the presence of milk is upsetting and want to eliminate it as quickly as possible, other mothers find the milk to be a comforting reminder of their body’s ability to care for the baby they so love and had wished to care for and reserve some milk to create customized jewelry.. There is no right or wrong way to feel. It is their choice to follow.

Meaningful keepsakes

Breastmilk jewelry - DIY kids available or keepsakes can be created by lactation consultant or doula with the grieving parent’s milk
Can purchase meaningful jewelry to honor loss made from other’s donated breastmilk
Other support items can be produced from ashes, hair, placenta or meaningful flowers

Other postpartum considerations...

Unfortunately, there are several options and considerations that need to be discussed prior to discharge regarding the next steps with your baby. Below are details on some options you have:

Postmortem pathology and testing options

Your care team should discuss options for postmortem testing that they believe can help in determining a cause for your loss and its impact on your future family building journey. This can include an autopsy, pathology or specific tests for you as the parent to complete. Each bit of detail that can be discovered and tested has the potential to provide a cause of death. The specific tests, their process and your personal thoughts and feelings need to be discussed. Ultimately, it is up to you if you have these tests completed. Often, they come at an expense not covered by insurance or there are not laboratories or providers nearby that can complete these tests. Additionally, these tests can delay laying your baby to rest and regrettably, the results may not offer any answers or insight as to a cause.

Post-partum appointments and follow ups

Despite your birth method or outcome, your OBGYN should schedule you for a follow up within six to eight weeks from discharge. You should also be provided contact information for postpartum support provided by the healthcare system. Please retain this information in the event you are in need of mental health support. When making an appointment for this follow up, be sure to let them know you experienced a loss, this is your first postpartum appointment and you may need the following considerations:

Scheduling appointments - Consider taking the first or last appointment of the day to avoid a busy waiting room
Special requests – It is absolutely ok for you to request special accommodations such as a separate entrance/waiting area if possible to avoid being triggered by others, extra time in your appointment to ask questions or request resources. They should have no issues meeting your request.
Advocate for yourself – Tell the office how you would like you and your baby addressed or if you would prefer one doctor over another.
Be honest with your feelings – They cannot help you if you do not tell them how you are feeling. The postpartum period is sensitive regardless of birth outcome. They will not judge you.

Disability/time off

Short-term disability may be available to you based on your personal medical experience, laws in the State you reside, or through other benefits available to you with supplemental insurances, FMLA or union benefits. Specific details can be requested from representatives from each of these organizations.

Finding support

Three Little Birds offers peer-led support to the perinatal loss community in Philadelphia and Southern New Jersey through various virtual and in-person support groups and events. Since our founding, we have supported more than 400 families walking similar journeys at no cost. When the time is right for you, please know there is a community of other parents who want to support you and hear about your baby. Be sure to add your email to our distribution list for our monthly email with our support schedule.

Avoiding baby-related mailings

Unfortunately, the coupons, catalogs and mailings for baby products do not stop if your baby passes away. To remove your name from other baby-related mailing lists, phone call lists, and email lists, please contact the DMA's Mail Preference Service by writing to the following address to stop many unwanted junk mailings from coming to your house which may help decrease the amount of baby-related mail parents get the first year after their loss. Writing to the address below will take you off many national mailing lists, for awhile. However, if you would still want to receive certain (non-baby related) catalogs, it might work best to just write to the specific companies sending the baby-related stuff.

Mail Preference Service
Direct Marketing Association
P.O. Box 9008
Farmingdale, NY 11735-9008

Navigating social media after loss

Social media has become such a large part of society and how we communicate that we often forget that we have the choice as to how we use it and when. Many families will reduce or cease social media usage after loss to avoid unforeseen triggers like pregnancy announcements, photos of babies/children, reminders of their pregnancy before loss as well as the unsolicited comments from people who have not had similar experiences.

There is, however, value in connection and community through social media in dealing with loss. There are established baby loss private groups for loss parents to connect and share their stories. It is a place to find information and articles written by others but sometimes it can be too much.

Three Little Birds recommends setting boundaries with social media in ways that make sense to you. We are in control of what we engage in or view on these platforms, so it is ok to alter settings so that you are only seeing information with a specific purpose. It is ok to take breaks with social media, particularly during holidays or anniversaries. You can always return when you are ready.

Many families find healing in sharing their stories and photos with other to help #shatterthestigma of pregnancy and infant loss. If/when you are ready, we would love to help you tell your story and honor your special baby.

Obtaining a Stillbirth Certificate

In New Jersey - Parents can request a certified copy of a Certificate of Birth Resulting in Stillbirth by submitting a completed the REG-68 form. Acceptable Forms of Identification and the appropriate (minimal) fees directly to the Office of Vital Statistics and Registry or to a licensed health care professional for signature, who is then responsible for submitting the documents. The form and above items are to be submitted to New Jersey Office of Vital Statistics and Registration, Attn: Stillbirth Certificate Processing, PO Box 370, Trenton, NJ 08625-0370. Additional information is provided on the REG-68 form or can be obtained at 1-866-649-8726 extension 506 (Monday through Friday, 8:30am - 4:00pm EST) excluding State Holidays.
In Pennsylvania - Residents can download the application for stillborn birth certificate from health.pa.gov. The first stillborn birth certificate issued is free. The cost for each subsequent stillborn birth certificate is $20 each regardless of the quantity that you order.