Hey Friends,
It’s Pregnancy and Infant Loss Awareness Month, in case you didn’t know. Truthfully, I didn’t know that until I started looking up ways to help my friend grieve her miscarriage recently. I really have to confess; I can’t keep up with all the special weeks and months for things. It’s not really something I have time to think about a lot. I have, however, been thinking about death a lot lately. It’s morbid-sounding, I know. It’s just that I’ve been to more funerals and memorials this season than I’d normally care for. And, at those celebrations of life, there is something very cathartic and uncomfortably necessary that happens. People feel…less alone. They laugh at uncomfortable memories. They listen to music. They pray. They listen to a sermon. There are flowers. Food. There are probably some unsolicited, trite phrases that hurt more than they help, or fall flat, empty and hollow. There are hugs. There is maybe a casket. Maybe the smell of earth. Maybe a weird funeral home smell. The smell of lilies. Notes written, thrown into the water to be carried away. Lanterns lit and let go. It’s all messy and beautiful and important. Like birth. And, regardless of how people go about saying goodbye, there is some sort of ceremonial closure. A proverbial “bookend.” A cleansing breath. The heart needs this tangible ritual to begin letting go. I actually just got home from a memorial. My friend lost her daughter, and it was, of course, heartbreaking. Parents weren’t meant to bury their children. And we aren’t made to grieve alone. Family and friends were all in attendance at the memorial. There was even a choir. It was beautiful. I didn’t do much. Just provided some food and some coffee cups. And it is raining…a gentle, continuous blanket of heavy mist. It’s healing and perfect.
So, then, of course, this memorial, and this weather, has me thinking of all sorts of sweet/sad thoughts. Losses I’ve witnessed as a doula. Little sparkles of life that are here one minute and gone the next. One of my first baptisms into early loss came when I was supporting a client as their birth doula. We knew her baby had some heart issues via an ultrasound and was on the small side. We didn’t, however, know her precious baby girl had trisomy 18 until she was born. I was unsure how to support them through a transport to a higher NICU, or in the weeks to follow during palliative care. All I really knew was to be present and show up where I could and cry and laugh. And that was enough. Their story is found at the links below, and one theme you’ll notice is…they aren’t alone in it. They let people walk with them.
https://www.desiringgod.org/articles/brooklyns-bridge
https://abchull.wordpress.com/brooklyns-bridge-scholarship-fund/
Later that year, I attended a twin birth, where one twin had already passed. Ugh. The tension and balance of grief and joy, and contemplative stillness and honor for the one lost, and pressing forward and fighting for milk for the one that lived. I remember marveling at how resilient and strong the human heart is when I watched those parents navigate cooling beds, memento pictures, and a memory box.
Then my sweet sister-in-law had miscarriage after miscarriage. You know, when you read up on miscarriages, it’s actually pretty rare for a website to describe it appropriately. I was shocked at how little information my sil was sent home with. “You may bleed a little more than normal. You may pass some “tissues of conception” or some clots.” No one told her she would labor. She would have honest-to-goodness contractions for hours and hours. Her back would hurt. No one told her she would pass a tiny fetus, and to watch out, because it may go into the toilet, because that’s where you will be, because you feel like pooping, because that’s what happens when your body has a baby. And maybe you would like to do something special for that little baby…and here are some ideas. Nope. Just, “No heartbeat…it’ll pass…if not…dnc…”
So, with one of these miscarriages, I had the honor to be with her. Rub her back. Keep her nourished. Watch her blood loss to make sure it didn’t cross that threshold of too much. Reassure. Be present. Grieve and honor the body’s hard work at the same time. Pray. Sing: “He gives and takes away. And still my heart will choose to say, ‘Blessed be the name of the Lord.’” I remember thinking, “How do women do this and then just go back to work?” and “How do women do this alone?”
Rituals to mark meaning
Sacred rituals connect the spiritual to the temporal and give meaning to something that feels meaningless. In Jewish culture, after loss, one tradition is to allow for 7 days (Shiva) of grief and visiting, soooo no going back to work right away. This feels like a must, at the very least. And maybe a care calendar. And paper plates. I also read how some Jewish women prefer to partake in mikveh after a miscarriage or stillbirth. This is a ritual of cleansing, a washing to prepare a body for death, or baptismal cleansing of a body after touching death. In Christianity, baptism is an outward symbol of death to your old self, cleansing through Christ’s blood, and being raised up to walk in newness of life. This ritual is usually saved for after someone converts to Christianity, but I absolutely can see how any kind of ceremonial water immersion can feel like a highly appropriate concrete ritual for someone who just had to walk through a portal of death and grieve a life lost, and needs that season washed away, as they must still get up and walk in the land of the living again.
Miscarriages and pregnancy loss can feel like such a socially and culturally nebulous portal into grief, especially when a lot of people weren’t even told that the pregnancy even existed. In Japan, however, a common cultural pathway of grief exists for early pregnancy losses. Small stone guardian statues called Jizo Bosatsu are dressed in warm red clothes and hats and bibs. Trinkets and candies are left at their feet. According to the Japanese Buddhist belief, the Jizo hides these fragile, miscarried or stillborn souls called mizuko (or water child) within the sleeves of his robes to protect them from demons and smuggle them safely to paradise. (They have to be smuggled in because they did not live long enough to accrue good karma.) Families perform mizuko kuyō (“water child memorial service”) to honor them, engage their feelings of grief, and ensure the safety of their lost child’s spirit in the afterlife. The yard at the temple where all the statues are situated is designed to be a place where families come and grieve together, and children of the family play on nearby swings. There is a feeling of “I’m not alone in this, and others have felt the same thing” while there.
The intentional creation of a safe space to grieve and even connecting a physical object to that grief, where one can revisit and reflect on that loss when needed, can be an important part of the process of letting go. Some people choose to create a safe space together with others with similar loss stories. I distinctly remember one afternoon, when my friends and I all started having babies, we were just sitting around, nursing, and eating and, almost organically, one by one, we all started sharing our miscarriage stories, stories of actual dreams of children in heaven with names, stories of pain, stories of hope. It was cathartic and so good to not feel alone. Some people, however, need more intimate privacy and create these sweet little places of remembrance in their garden at home. There is something so healing about getting into the dirt and planting life. Planting a tree to honor the life of your baby and watching it grow, year after year. Similarly, planting perennial flowers in a flowerpot that come out each year to remind you of the life that was and the new life that is, and the one to come, is especially symbolic and meaningful. There also exist special infant loss sections in public and private cemeteries worldwide. Even here in Austin, the Austin Milk Bank has a “Teardrops and Milkdrops” Memorial Garden featuring etched stones commemorating the babies of participating families. Additionally, the milk bank helps grieving mothers easily donate their expressed milk as a way to honor the baby they lost and help other fragile newborns.
How else does one grieve a loss that they haven’t officially held, or maybe even seen? Or how else can one honor a tiny twinkle of a life that existed for a few weeks or months or moments, in utero or out? Creating a ritual of remembrance creates space for the heart to acknowledge the loss, validate its reality, and grieve. One of my favorite rituals of remembrance is lighting a candle on special days, like the due date, the birthday, the day you found out you were pregnant. Other ideas include heartbeat recordings, weighted memory bears, memory boxes, and scrapbooks. I personally know some people who have Christmas ornaments with the birth date and the baby’s name on it. And every Christmas, the siblings are told of their little baby brother or sister who is with Jesus as all the ornaments are put on the tree. Oh! And of course, there is beautiful, engravable memorial jewelry and charm bracelets on Etsy and Amazon complete with birth stones that serve as a tangible visual remembrance of one’s baby.
A few quick stats
As to why we should care about this as women and doulas…. Miscarriages happen in about 10 to 20% of known pregnancies. They occur before 20 weeks. If it is after 20 weeks, it is classified as a stillbirth. 1 in 175 pregnancies will end in stillbirth in the US. 1 in 6 women will be diagnosed with PTSD after a stillbirth.
Whether it is called stillbirth, pregnancy loss, miscarriage, or abortion, the bond between parent and child often begins early in pregnancy, and losing a baby, no matter the gestation, can be deeply painful for both parents. This is especially true when there is no established cultural tradition for mourning such an early loss. Grief needs to be expressed in order to be worked through, and a ceremony or ritual provides a structure for doing so. It honors the reality of what the heart feels, validating those emotions and giving the person permission to mourn.
Research supports this. Michael I. Norton and Francesca Gino, faculty at Harvard Business School, conducted experiments on the effects of mourning rituals and found that rituals are highly effective at reducing grief. They help mourners regain a sense of control at a time when their world feels completely out of their hands (Cozen-Heral, Forward). Unfortunately, in the Western World, there really aren’t a lot of culturally ingrained ways to come alongside and grieve with someone who has had a miscarriage or stillbirth. Marking the loss is important, and keeping the memory of your baby alive is a real need a lot of parents have. As doulas and educators, we have a unique privilege to walk alongside parents who experience such losses. Even though miscarriages are more common than we like to discuss, there is no reason why anyone should ever feel alone in this. To that point, recently I was talking with yet another birth doula client due soon with her rainbow baby. We were chatting about her previous miscarriage. She was expressing how it was so hard to allow her body to miscarry and to relax in the process when she was so mad and in so much pain. Unlike in birth, where there are soothing affirmations, reminding mom to trust her body and stay soft and allow the powerful waves to bring her baby, in miscarriage there was nothing but sadness and confusion and fear. “I just wish I had some affirmations for what I was going through in the moment.” I asked her if she would be willing to write some and record it. She did, and we put music behind it. You can listen to them below.
Ending on a history note
On October 25, 1988, President Reagan designated the entire month of October as Pregnancy and Infant Loss Awareness Month. On that day, he said: “When a child loses his parent, they are called an orphan. When a spouse loses her or his partner, they are called a widow or widower. When parents lose their child, there isn’t a word to describe them. This month recognizes the loss so many parents experience across the United States and around the world. It is also meant to inform and provide resources for parents who have lost children due to miscarriage, ectopic pregnancy, molar pregnancy, stillbirths, birth defects, SIDS, and other causes. Now, therefore, I, Ronald Reagan, President of the United States of America, do hereby proclaim the month of October as Pregnancy and Infant Loss Awareness Month. I call upon the people of the United States to observe this month with appropriate programs, ceremonies, and activities.”
The initiative was deeply personal for President Reagan and his first wife, Jane Wyman, who had experienced the devastating loss of their newborn daughter, Christine, in 1947. Today, all 50 states have a yearly proclamation in honor of those who have lost a child during pregnancy or during infancy.
https://www.reaganlibrary.gov/archives/speech/proclamation-5890-pregnancy-and-infant-loss-awareness-month-1988
In 2002, October 15th became universally designated as Pregnancy and Infant Loss Remembrance Day and is marked annually by the global “Wave of Light” candle-lighting campaign. [1, 2, 3, 4, 5]. At 7 pm, people across the US are invited to light a candle in remembrance of a little life lost and in a show of communal solidarity. This year I will be lighting a candle of remembrance, and I invite you, my fellow birth workers, to do it, too.
https://nationaldaycalendar.com/celebrations/national-pregnancy-and-infant-loss-awareness-month-october
A parent’s heart is not made to bury their child. But if one must honor a life lost too soon, then there are ways to do it intentionally. Just don’t do it alone.
And to adapt a quote from Dr. Seuss, “A loss is a loss. No matter how small.”
If you would like to listen to one of my sister-in-law’s miscarriage stories and some of her live birth stories, check out the video below.
Keep up the good work! What you do matters more than you know.
Warmly,
Amy Nevland ICCE, ICBD, CLC, IAT
www.planetchildbirth.com
“Those who sow in tears, will reap in joy[6]”. Psalm 125:5
Resources
https://www.nationalshare.org/find-support-in-your-state
https://ritualwell.org/ritual/and-she-laughed-kitchen-ritual-healing-miscarriage/
https://www.mybabysheartbeatbear.com/blogs/pregnancy/miscarriage-traditions-that-may-help-you-heal
https://Beceremonial.com
https://www.starlegacyfoundation.org
https://fertilityresilience.com/12-rituals-of-miscarriage/
https://www.talkdeath.com/mizuko-kuyo-grieving-for-the-unborn/
https://www.amusingplanet.com/2019/08/mizuko-kuyo-japanese-ritual-of-mourning.html
https://www.npr.org/2015/08/15/429761386/adopting-a-buddhist-ritual-to-mourn-miscarriage-abortion
https://forward.com/life/433663/how-jewish-rituals-helped-me-mourn-my-miscarriage/
https://pinkelephants.org.au
