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Coping with pregnancy loss

ultrasounds on woman's stomach
Credit: iStock.com/Pablo_K

Sadly, not all pregnancies go to plan and this can be a difficult experience for parents. Some women may have to face a miscarriage, an ectopic pregnancy or the death of the baby. If your pregnancy ends in this way, you will need both information and support1 .

Talk to the people close to you about how you feel, and to your midwife or doctor about what's happened and why.

Sometimes it is easier to talk to someone outside your family and friends. There are lots of organisations offering information and support, including Sands.

Sands is the miscarriage, stillbirth and neonatal death charity operating across Australia, supporting anyone affected by the death of a baby.

Ectopic pregnancy

This is when a fertilised egg implants outside the womb, usually in a fallopian tube. The fertilised egg can’t develop properly and your health may be at serious risk if the pregnancy continues.

The egg has to be removed – this can be through an operation or medicines. The warning signs of an ectopic pregnancy can start soon after a missed period, but occasionally there are no noticeable symptoms.

Miscarriage and stillbirth

A miscarriage refers to the loss of your baby before 20 weeks of pregnancy. A stillbirth refers to the birth of a baby who has died prior to delivery when the pregnancy has progressed beyond 20 weeks.

Legally, if the length of the pregnancy is not known, a baby born with no signs of life but weighing less than 400 grams is considered a miscarriage.

The physical experience of miscarriage can vary greatly between an early miscarriage and late miscarriage. An early miscarriage is the loss of a pregnancy before the 12th week of pregnancy (the first trimester).

A late miscarriage is one that has occurred between 12 to 20 weeks of pregnancy (the second trimester).

Common signs of miscarriage include:

  • cramping abdominal pain, similar to period pain
  • vaginal bleeding

See your doctor or go to your local emergency department if you think you are having a miscarriage.

Losing a baby 

It is an enormous shock to lose a baby in this way. You and your partner are likely to experience a range of emotions that come and go unpredictably.

These can include disbelief, anger, guilt and grief.

Some women think they can hear their baby crying, and it's not uncommon for mothers to think they can still feel their baby kicking inside. The grief is usually most intense in the few months after the loss. 

Some parents find it helpful to create memories of their baby – for example, by seeing and holding the baby and giving him or her a name.

You may also like to have a photograph of your baby and keep mementos such as a lock of hair, hand and footprints, or the baby's shawl.

All this can help you and your family to remember your baby as a real person and can, in time, help you come to terms with your loss. 

You may also find it helpful to talk to your GP or to other parents who have lost a baby. 

Termination for fetal abnormality

In some pregnancies, tests will detect a serious abnormality in the baby. You will probably be very shocked if you’re told this diagnosis, and will need to take time to think things through.

In this situation, some couples decide to terminate the pregnancy.

Abortion law in Australia varies across state and territory jurisdictions.

Some states and territories have reformed or decriminalised abortion, while others continue to restrict women’s access to abortion.

Approximately 2% of the 100,000 abortions performed each year in Australia are for fetal abnormality.

Learning why a baby has died

Sometimes the reason a baby has died is obvious, but at other times an investigation is needed to understand the reason. 

A post mortem examination aims to understand why, but it cannot be done without parental consent.

The only exception is when the baby’s death has been reported to the Coroner. Sometimes a live-born baby’s death has to be reported to the State Coroner for further investigation, particularly if a doctor is unable to record a cause of death.

The examination by a specialist pathologist may or may not involve surgery and like any operation is carried out with respect and care.

Parents decide how detailed a post mortem will be, but the examination may reveal the impact of any genetic or physical problems, any complications due to obstetric or paediatric care and provide important medical knowledge for the parents as they consider future pregnancies. 

Birth and Death Certificates

Births are registered with the Birth, Deaths and Marriages Registry in the state that that the baby was born. When a baby dies, their birth can only be registered if they meet certain criteria.

Check with your state or territory for variations, however the following criteria is similar: 

Register the birth if:

  • when the baby was born she showed signs of life 
  • when the baby was born he did not show signs of life, but gestation was 20 weeks or more
  • If gestation is less than 20 weeks and the baby showed no signs of life at birth, the birth cannot be registered. If there is no registration of birth, then there can also be no registration of death.

Depending on where your baby was born, you will may have several options:

  • you can take your baby home to be buried. (Burials on private land come with strict regulations)
  • the hospital may offer communal cremations
  • a hospital-arranged funeral service where your baby can either be buried or cremated
  • you can organise a private funeral

1 Contains public sector information licensed under the Open Government Licence v3.0

2 De Crespigny LJ and Savulescu J. Abortion: time to clarify Australia's confusing laws. Med J Aust 2004, 181(4): 201-3.

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