It's not the same....

It's been brought the forefront of my thoughts today about the differences and similarities between miscarriage and stillbirth. So I've been reading some blogs and stories from both points of view and from people who've experienced both. 

My overwhelming opinion is that I shouldn't have to think about how my own grief is affecting someone else but I have done so quite a lot of the past few weeks because I love that person, who had a miscarriage at 10 weeks. I recognised it was hard for her about a week after having Isla and was deeply upset when I realised I hadn't heard from her for a week after I got out of hospital. I now feel like 'Fine, thanks' is the only answer I can give her to the question of how am I because I don't feel I can openly grieve with her about Isla. 

I felt I was there to support her and she has told me she recognises this. But she feels upset that June was not recognised as her due date and that she didn't get the rallying around and constant support at the time that we have had. She feels we don't remember that she was pregnant or that she needs support.

Now, I definitely feel supported. My mum came down as soon as we told her Isla had died inside me. She was distraught. Everyone visited at the hospital when Isla was born and when I had to stay in for a further week. And I've had the supportive texts since. But on the whole, to be fair, it's mostly just been Dan and I. People check in and want to see us sometimes but we've mostly been left to grieve and get on with healing. Which we appreciate. But this person says she sat on her sofa in the evenings in tears. Well, I do that too - my husband works away sometimes and I've been left alone plenty in the last 5 weeks. I don't feel any less supported by friends and family but yes, I do appreciate the 'checking in'. 

I told her that from my point of view, losing at any stage is obviously awful and distressing. But it IS different. I have scan photos galore, I was in maternity clothes, I had a crib and clothes and nappies, I had chosen the nursery design and arranged the pram and car seat. I had maternity cover in place at work, we had chosen a beautiful name and we were well into the 'safe' stage. I was seeing and feeling kicks and wriggles daily and heard her little heartbeat inside me. 

It was only at about 18 weeks that I finally started to believe that I was going to become a mummy. I was allowed to believe it because it was tangible. And then to get to the 'viable' stage at 24 weeks was a real landmark when I could finally relax. She was a proper little human being. 

I laboured, I pushed, I gave birth (during a very traumatic birth) to a beautiful little girl that we got to name, hold, cuddle, kiss, talk to and wrap up. We then had to arrange a funeral, make a burial gown, register her birth/death at the registry office and lay her to rest in the ground. 

Now that's different isn't it? I can't take away the pain of her miscarriage but I have to focus on the pain we have gone through with Isla. 

Here are the exact words from a US blog on the subject - Wide White

"...what makes stillbirth so different from miscarriage: miscarriage is a relatively common event. Many couples wait to announce a pregnancy until after the first 10 to 14 weeks gestation, knowing that their risk for a prenatal loss has significantly dropped after the first trimester.

The NCBI underscores the commonality of miscarriage with this data:

It is estimated that up to half of all fertilized eggs die and are lost (aborted) spontaneously, usually before the woman knows she is pregnant. Among those women who know they are pregnant, the miscarriage rate is about 15-20%.

By contrast, the rate of stillbirth is less than 1%. Here’s a summary from Wikipedia:

The mean stillbirth rate in the United States is approximately 1 in 115 births…. In Australia, England, Wales, and Northern Ireland, the rate is approximately 1 in every 200 births, in Scotland 1 in 167.

I should point out that a more common definition of stillbirth in other countries is any baby who weighs more than 1 pound (weight determinations vary from 350 to 500 grams). More broadly, online forums usually simply divide the two categories of prenatal loss into “miscarriages” and “2nd and 3rd trimester losses.”

So it’s well-established that miscarriage is far more common than stillbirth and that one occurrence is generally considered to be before 20 weeks gestation and the other is after. But still, a loss is a loss, right? Are the two losses really that different? Why get particular about the technical definitions?

We have friends who have had the awful experience of going through both a preterm delivery and a few miscarriages. They talk about the miscarriages as a footnote of life. By contrast, they often speak of their son who died at 28 weeks gestation. They have pictures with him on a wall in their home....

Life is no less real in the first trimester of pregnancy than it is in the second or third. However, our experience with the child certainly changes in that time and we become more attached to the baby we’re waiting to meet. Here are just a few things that make the connection to the baby so much more significant later in pregnancy:

• A baby bump develops (~12-16 weeks)
• Gender is often known (~16-20 weeks)
• Baby kicks (~16-22 weeks)
• Baby becomes viable outside the womb (~23 weeks)
• Baby is often named

These are just a few of many developments that bring us closer to the baby we’re about to welcome into the world.

Each one of us loves our children dearly from the moment we see that positive pregnancy test. Each one of us grieves our prenatal losses, the children we never got to meet here on earth.

But I’ve never seen a memorial service or a funeral for a child who was lost in the first trimester. A baby lost within the first month or two rarely has an empty nursery waiting for them. Parents of miscarried children have just begun to dream of the life they’re going to give their new babies; parents of stillborn children have often purchased the going-home outfits, built the cradles, and bought the car seats.

Of course, there are exceptions to every rule. For every 5 people who reached out to me with their stillbirth story, 1 has reached out with their story of miscarriage. Miscarriage impacts each person who goes through it differently. For some, miscarriage is a footnote of life and for others it’s one of the most significant events they’ve gone through. But while each family’s experience with stillbirth is also different, I have yet to meet a parent who has gone through a second or third trimester loss and has not been permanently and tremendously affected by it.

Stillbirth is not miscarriage. Miscarriage is not stillbirth. No parent going through either experiences wishes to be in either camp, but no grieving parent wishes their camp to be confused with the other. To understand the place in which each prenatal loss falls is to understand just a little more what each family is going through. For the sake of grieving moms and dads, the distinction is worth understanding.

Now, as one person commented after that post,  I too think that in the end, we need to remember that whether miscarriage or stillbirth, parents are going to grieve and need support and need others to remember that no matter how short the life, they did have that child. 

I am mother to one child, as is the person I write about. Nothing can change that or take it away from us.