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Losing a baby at 20-24 weeks of pregnancy

Experiences of giving birth at 20 to 24 weeks of pregnancy

Going through labour and birth knowing that their baby had already died or would not survive was extremely difficult and emotional. Some mothers felt they were fighting their own body to stop their contractions as giving birth meant the end of their pregnancy and their baby’s life. However, despite their loss and intense sad emotions, many also described extremely powerful positive experiences during the birth.
 

Camille described how her emotions ranged from fighting against her contractions to the “magical moment” when she gave birth to her daughter.

Camille described how her emotions ranged from fighting against her contractions to the “magical moment” when she gave birth to her daughter.

Age at interview: 26
Sex: Female
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After a while I could feel that something was going on. So I had a feel down below. And I could feel her head. And that was very, very close. So I told a midwife. She laid me down. And I went on my side. My husband was there. We had decided that because he didn't want to see the baby and I did, that he was going to leave when I was close to giving birth. So, I at that point told him, "I think you need to go now." And then I started involuntarily pushing. So I shouted at him, "You need to, now!" And he sort of stood up, looked at the midwife, the midwife stepped aside as if to say, 'go'. And he sort of looked at me, and looked at the midwife, looked back at me, sat down and said, "No." Took my hand, and. It was very strange. Because it was sort of a magical moment on probably the worst day of our lives. But it was a magical moment that happened between us, when we just looked into each other's eyes and [my husband] - holding each other's hand, and I just pushed her out. A couple of pushes and she was out. I remember fighting with myself, actually, at the time. Because obviously I didn't want her to be born. And I sort of had to obviously talk to myself, in my head, saying 'she's going to be born, whether you want it or not, so you might as well make this quick, for both of us'. 
The pain of labour

Even though their baby was extremely premature, mothers had to labour and give birth to their baby. The physical pain of labour and birth was often very intense and came as a shock. Those mothers who had previously given birth were more aware of what to expect, and this helped manage their pain and emotions. For first time mothers, they had no experience to draw on. Kelly described labour as “a really horrible experience” but her midwife’s explanation of what to expect meant “I was able to manage it a lot better emotionally”.
 

Emily didn’t want to go through labour but appreciated the encouragement of her midwife to do it.

Emily didn’t want to go through labour but appreciated the encouragement of her midwife to do it.

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Emily: We had a lovely bereavement nurse that - before we left - that came to talk to us, and went through everything, which was incredible. She was so nice, wasn't she?

Mike: Yeah.

Emily: Because - Just to explain exactly what would happen. And I distinctly remember her saying about how every single woman that she has met says "You know, I don't want to go through the labour, it's horrid - I just want - can you just sort of get it out of me and get-?" You know? And she said like "There is not a single woman I've met that regrets doing that, and doesn't want to then hold their baby," and all that sort of stuff. So, but you just still don't believe it until actually, she is right [laugh]. Which you realise afterwards. But it just seems so insane, that - you know - I just wanted it to go away, and sort of be over, because I kind of knew it was.
 

Emily felt the birth was awfully hard work but was reassured by her midwife who explained it was exactly the same as giving birth later in pregnancy.

Emily felt the birth was awfully hard work but was reassured by her midwife who explained it was exactly the same as giving birth later in pregnancy.

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Emily: I still had to push and everything.

Mike: Yeah. 

Emily: Because I said to the bereavement midwife afterwards, I said something like "Gosh, that was awfully hard work - I can't imagine what it's like to really give birth." And she said, "But you did." She said, "You still had to get to -." I think I had to get to six centimetres dilated or something. And she was like, "That's the majority of the hard work, it's just the same, and you did really well. And you were - you know." And again, because she was small, you sort of think you don't, but I still had the awful contractions, I had to do the breathing, and still had to push, and all the - you know - I had to deliver the placenta afterwards. I still had to do exactly the same, it's just that she was small. 

But I don't think I was ready for that.
 

Vikki felt unprepared as she couldn’t find any information about what it might be like to give birth to a baby that had already died.

Vikki felt unprepared as she couldn’t find any information about what it might be like to give birth to a baby that had already died.

Age at interview: 33
Sex: Female
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I'd been on Google a lot [laugh] since I had found out that she'd died, and. Trying to find out what would happen next was really difficult, because nobody really puts it out there, that - you know - after twenty weeks, if you lose a baby you have to give birth. I think it's after fourteen weeks, even. But nobody ever describes a labour of a stillborn. And nobody describes how quickly it's going to happen. I mean, I know it's different with everybody, but just having a little bit of information. And there was nothing. 
Terms used such as “mini-labour” and “miscarriage” meant some mothers felt unprepared for their experience. Some mothers found the emotional distress intensified the pain. Michelle felt “it's more painful in the sense of you have fear, because you don't actually know what you're giving birth to”. For Courtney the whole process of labour and birth was a shock because she had been told she was having a miscarriage and felt “it's not going to be like this, it's going to be like, like just blood or whatever”.
 

Loretta was told she would experience a mini-labour but found it extremely painful.

Loretta was told she would experience a mini-labour but found it extremely painful.

Age at interview: 54
Sex: Female
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[Sigh] it was, it was a good few hours. And even now, I can remember what I said - because they said it was going to be a mini labour. And when it finally came, [laugh] I can remember saying "Well, if this is a mini labour, I'd hate to think what a normal one is like." Because it was painful, really was painful. So it was probably about three, four hours. It wasn't very long. But when it came, it was very sort of quick. Which obviously was helped by the fact that he was only tiny. 
 

Kerry had a very short labour and gave birth in the toilet. She resented the term ‘mini-birth’.

Kerry had a very short labour and gave birth in the toilet. She resented the term ‘mini-birth’.

Age at interview: 47
Sex: Female
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And I was actually - they, at the [name] hospital they've got a room that's called [home style birthing room]. And we were there. And I started contracting. They call it a mini birth, because it's these mini contractions that you have. And I landed up actually going to the toilet, and that's where - I delivered the baby in my hands on the toilet, at that stage. And I had to shout to [partner] to get the sister in. And she got someone in. And the cord was attached. And she was just curled up. So tiny. You know? She just fitted in my hand.

And how different did losing Noah at 23 weeks feel to the other miscarriages that you had had before?

Oh, it was - For me, a major thing compared to - I think the closest to that was probably when I was eleven weeks, and I miscarried. Because there was quite a bit of afterbirth, and the - when your miscarriage is the clots. Yeah. You don't realise how much you actually lose. But I suppose there's [sigh] - a teaspoon of blood looks like a hell of a lot. I think it's harder when you're actually delivering a baby, when it's in a foetal position. And the umbilical cord is attached. So it was so thin, and - you know - I just remember just sitting there, when I caught her. I was like - she just slid out. I was like on the toilet. And I caught her in my hands. And, yeah. To me - Having a miscarriage is a lot different to having to deliver a stillborn baby. 

How long did the labour last, do you remember?

It was quite - I think within two hours? Yeah, I delivered quite quickly. And what they did say was, you know - everyone says - they call it a mini birth, but there's nothing mini about it. And she's right. You're in just as much pain as what you are when you're delivering - you know - a full term baby.
Managing the pain

Most of the mothers we spoke to, though not all, had pain relief through labour. As the baby had already died or wasn’t expected to survive, mothers were often offered morphine to relieve their labour pains. While Emily found it helped her anxiety, others found morphine made them feel “numb” and “out of it”. Other women were given an epidural or gas and air. Michelle gave birth on a gynaecology ward where pain relief was not readily available and her husband Iain had to argue strongly to get her some gas and air.
 

Camille didn’t have time to have morphine before her baby was born but afterwards felt glad as she didn’t want to miss the experience of her baby’s birth.

Camille didn’t have time to have morphine before her baby was born but afterwards felt glad as she didn’t want to miss the experience of her baby’s birth.

Age at interview: 26
Sex: Female
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I was given gas & air, which I hated. The anaesthetist came in and offered me a PCA of morphine. Which I accepted. So he sold it to me as saying that it was going to numb the pain, but it was also going to make me feel like I wasn't quite there. And that would possibly help with the birth. And actually, reflecting back on that, I didn't have time to have the PCA, because she was born not very long after that. But reflecting back on that, I'm actually really, really glad that I didn't have it. Because as horrible as time that it was, and as hard as it was, it was the first, the birth of my first child. And I would never have wanted to miss that. I think that would have been really upsetting.
Where the birth takes place

Many maternity units have dedicated bereavement suites. These rooms are often made more homely, offer privacy and space for both parents with beds, sometimes a bathroom and a cold room for the baby. Several women we spoke to were able to labour and give birth in one of these suites. Sometimes these suites weren’t available, as they were already in use or not provided, so mothers had to give birth on a standard delivery ward. Hearing the sounds of other women giving birth and new born babies crying was painful.
 

Helen felt giving birth in a bereavement suite really helped her

Helen felt giving birth in a bereavement suite really helped her

Age at interview: 43
Sex: Female
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And, but because - Also, what that charity had done - Of course I knew my local hospital, I delivered my son there, three years before. But what I hadn't realised - the delivery suite, double-doored, you go into the delivery suite - but to the left of that was a door. Which looked like it could be a cleaner's cupboard, or an office, or - you know - it's not a door you would take any notice of, because there was no sign on it. But there, what this midwife had managed to do was set up a room. So that's where we were sent, the Wednesday that we went in to have our induced - medicine - that I was given that. We weren't sent into the delivery suite, which of course would have been awful for me, and traumatic. We were sent into this room. Which was like - set up like a bedroom. It was a sort of a halfway between a bedroom and a sitting room, a living room. So it had a bed, a comfy bed. With, with bedding that you would have at home, not hospital bedding. 

It had tables, chairs, a TV. It just - basically, we were going to have a hellish Wednesday, but we were in this room that we could lock. We were given a key to it, so if we wanted to go to the café we could. It was our stuff. It was our room while we were delivering Emily. 

And that room, really. We couldn't have done it - if that - If we hadn't have had that room, it would have been an awful day. And of course my family didn't know we were going to be in that room. They knew we were going to the hospital, they thought we were going to be dumped in a hospital delivery suite. We weren't. And so they were really pleased by the time - I think I maybe probably texted and called them from the hospital. But when I had a real chance to tell them that we had been in this really nice room, decorated beautifully, a real home from home, they were really pleased to hear that that was on offer to us.
 

Joelle explained how the bereavement suite made her feel less like a patient in hospital.

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Joelle explained how the bereavement suite made her feel less like a patient in hospital.

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So they put me in a Sands-funded room. I think quite a lot of the hospitals have them, it's like a bereavement suite, which was amazing. Going into the room was - it was like every - Like being able to have a shower. And stupid things, like they had shampoo and conditioner. And a hairdryer. And they had a bed for me but then they had - underneath, they had another pull-out bed, so that Adam could stay over. So it was more like the two of us together, rather than me being a patient in the hospital. And there was like a TV and like chairs. It was an amazing place. And also leaflets from Sands, and lots of books and CDs. And sort of - Not a home from home, but like - It was the first time I'd actually - there was information.
 

Nesta found that the layout of the bereavement suite allowed her time to prepare herself to see and hold her baby.

Nesta found that the layout of the bereavement suite allowed her time to prepare herself to see and hold her baby.

Age at interview: 39
Sex: Female
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Actually by the time things started happening, we got transferred to one of the special rooms, they'd become free. And it was when I was in that, I realised what an amazing facility they are.

You know, there was - We were much more comfortable. And they had - They had the sort of birthing room and the bathroom, and then they had a sitting area. You know, where you could make tea and coffees and things. And then there was also another little room, where you could put the baby afterwards. Which was amazing to have. 

And you stayed in there for the rest of the time?

And that's where I gave birth in the end, yeah.

Yeah. And it was special because it was just a bit more cosy, and you had that room?

It was special [sigh]. Yes, it was much more comforting, but that extra room was so useful. Because you can take your time to work up to see the baby. Because you don't know what to expect. I kept asking what to expect, and they said, "Well, it's a baby." [Laugh]. But Daniel, he was born completely in his sac, as can happen quite a lot - can happen anyway, can't it. But, so I couldn't see anything. And it was - He actually came out when I was in the toilet [laugh]. So I was in labour for a while. And the one thing I remember that you don't have with a live birth is they can give you morphine, they can give you any drugs you want. So it does make you more out of it [laugh].

And I went to the loo, and he actually came out then. And then they took him away to clean him up. And they put him in a little Moses basket in this room. And you can prepare yourself to go and see him. So I went to see him immediately.
Care during labour

Many women felt very well supported by their midwives during such a distressing time. They were understanding and empathic, providing emotional support as well as small touches such as physical contact, remembering parents’ names or bringing food. For example, Sarah’s midwife sat waiting outside the bereavement room for whenever they needed her. These little things made a real impact. But other parents had a different experience and felt abandoned. Some fathers had to call for help and sometimes even had to help their partner give birth in the absence of a midwife.
 

Kelly felt really cared for and appreciated her midwife’s commitment to stay with her until she gave birth.

Kelly felt really cared for and appreciated her midwife’s commitment to stay with her until she gave birth.

Age at interview: 39
Sex: Female
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And the midwife who was allocated to me, she - she was absolutely great. She said, "I'm due to go off duty in a couple of hours, but I'm not going to go home, I'm going to stay with you until you deliver this baby." She was, she was brilliant.

Yeah. Yeah.

Yeah. 

And did that make a real difference?

It did. It did. Because they - it - they were so caring, and - What they done, they used like lavender oil, and stuff like that, so like aromatherapy. And like used - gave me like pethidine, and like gas & air and everything, to make me more comfortable. And basically were there all the way throughout the labour. And they were absolutely brilliant. And round about five o'clock that night, I delivered the baby. And they asked me, and said, "Look, would you - would you like to hold the baby? We can - we can dress the baby for you." And I said, "Yes, please." So they, they put the little baby in a little, like a little outfit that they had made. And I held the baby. And they took photographs for me. And, and also they took footprints and handprints of the baby. And because the room that had been set up, there was - there was like a bedroom - like a room where parents could like deliver the baby, or sleep.

Yeah.

A bathroom. They also had what they called the cold room.

So that the - you could spend as long as you wanted with the baby, without worrying about like the baby[‘s appearance] deteriorating. And then there was also like a living room, as well, with a little kitchen area. And it was set away from all the other wards. On like the maternity ward. And you had like your own entrance, so that you didn't have to come across parents that were leaving with their babies, and - and things like that. 

Tell me about what impact that -

That had - That was really good, because I felt really cared for, and a lot of thought had gone into the room. And it had everything that you needed to make your - like your life as comfortable as possible. And I know like my husband found it a lot better, because he - he was able to go out without - out of the room and come back in, without having to go like through like the maternity ward. And that really helped.
 

Kareena and Raj really valued the care and support their midwife gave them.

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Kareena and Raj really valued the care and support their midwife gave them.

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Kareena: My midwife was really good and reassuring. She was really trying to help.

Raj: Yeah, she did everything she could to make us comfortable.

She brought extra little things for myself, like brought extra sheets, and brought sandwiches, You know, stuff physically that you can't really do in a bad situation. But you know, if there's food ready there, I don't have to keep walking up and asking, "Can I have a sandwich?" Or "Can I get some water?" It was just there, topped up. So it was like just in the background –

Kareena: Yeah. It helped, because it meant that Raj didn't have to leave me to then go and get some water, or anything like that. It meant that he could stay with me, and he could still have a drink, or something to eat. Because it was quite a long time that we were there, so that sort of stuff really helped. And even when she was talking to me and saying you know, "You can do this, and" - because I couldn't have the epidural because they said it might make the infection worse. So they said with the sepsis already going on, it's best not to have it. And then I couldn't have the gas and air, because it was making me feel sick. So they'd given me something else before, but that had worn off. And there was only so much that they could give me, so. She was really helpful. 
 

Michelle and Iain felt they were experiencing labour and birth with very little support.

Michelle and Iain felt they were experiencing labour and birth with very little support.

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Michelle: And we were left on our own for most of it, weren't we. 

Iain: Oh, yeah. Very isolated.

Michelle: And they just, "Going to the toilet - and always, you know, go to the toilet in a bowl. You know, one of those paper sick bowls, whatever - poo bowls. And then always check, to make sure that there's nothing in there. And then just put it on the side." So, that was your job, wasn't it. I mean, you were amazing, because you stayed by my side the whole time. And you know, I've heard stories in - since then, of women being on their own in the toilet, where they've just not known what to do with it when it's come out. And they've either flushed it down the loo, or they've put it in the sanitary thing by the side of them. And then they've had massive regrets. So, Arthur didn't come out in the bathroom.

Iain: Mmm.

Michelle: But you, you sort of lovingly kept an eye on what was coming out, didn't you.

Iain: Mmm. Mmm.

Michelle: And I remember that being quite a fearful time. And I was really ill. I got really bad diarrhoea, didn't I, from the induction. 

Iain: Mmm. Mmm.

Michelle: And then we were just on our own, weren't we. And I felt really violently sick. And I was sick. And at the same time as I was sick, the baby came out. And I didn't see it. But you did.

Iain: Yeah. I saw the umbilical cord. I guessed, because I didn't know. Because obviously the cord's a lot thinner and tinier. 

So sort of saw this thread hanging, and I thought 'right'. So I pressed the buzzer, and no one came. So I had to go out and leave you alone. I had to go out and try and get someone's attention, and ask for help.

Michelle: And that's not what you'd normally do, is it, as a person, so.

Iain: It was just irritating. You know, when you have a birth, you have several people not leaving you alone, and then when you have another birth that isn't a live baby, they're not interested. You know, for whatever - busy elsewhere, I guess. But it was hard work all day, getting any attention, really.

And then, you know, obviously at the moment of - And you know, okay I've [sigh]. I don't know how to put this. Whether it helped or not. But I'd been at every other birth. So I'd at least become an expert on how she gives birth. So at least I was confident with what she was going through, even though you'd got to go through all that, which is hard anyway with a live birth at the end. You know, that's hard work, keeping you going, supporting you, and - you know - making sure you pull through, for a live birth. Knowing at the end of it you're not going to get a baby is - you know, knowing that's what you're going through, to - It's even harder. So, but to be doing it with zero - pretty much zero support, you know, in a room on our own - you know - that was quite hard work. And then to have to go and try and grab some attention at the end, "Could you help us find out if this is what we think it is?" You know? [Laugh]. It wasn't ideal.
After giving birth mothers were often physically exhausted. For some this was made worse by complications, such as trouble delivering the placenta or needing a blood transfusion. This delayed parents’ opportunity to spend time with their baby.
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