Wednesday, June 26, 2013

Response to Reader's March 18 blog comments

(On June 18, a reader shared her story with us. Since my reply was too lengthy and wouldn't be accepted for posting, I have elected to maintain the length and add my response as an additional post. The regularly scheduled post covering grieving appeared this past Monday, June 24. If you would like to read her comments, go to the March 18 blog and click on the "Comments.")

First, please forgive me for this late reply. Travel, illness and not wanting to just send out a perfunctory response prevented me from writing.

Thank you for sharing your story, as well as some of the intimate details, with all of us. I wept when I read it and am weeping again as I re-read it and reply to you. I can't begin to tell you how sorry I am that you are experiencing so much loss and pain.

Your story does sound so similar to mine. Close to the same gestational time; a devastating complication of pregnancy; a three-year old excitedly anticipating a sibling. After doing a little research on placenta percreta, I can appreciate how severe your condition was and just how fortunate you are to be alive! And I can appreciate the fear your husband must have experienced, although I know my husband can more deeply appreciate it than I. It really is much harder, I think, to sit anxiously in an emotionally cold room, awaiting news of a a loved one's response to surgery, particularly when it's a potentially fatal emergency. Knowing that one of the patients—the littlest one—will definitely not make it only adds to that pain and distress.

Knowing there wasn't a choice between you and your baby and feeling it are two different things. I understand and appreciate your guilt; identical thoughts have run rampant through my mind on many occasions and still do, even after twenty years. It's often stunning for us to realize—usually through grievous events—just what little control we have over our lives and the lives of others, including our children who we desire and feel obligated to protect.

And I am so sorry that the hope of future babies carried in your womb are no longer an option for you. That, indeed, does compound your grief: future dreams and hopes decisively swept away. You have been dealt an extra wound. While I was able to have another baby, that pregnancy ended up being complicated and nearly ended in my son's death during a premature birth. Soon after, and following much prayer and discussion with my husband, I elected to have a tubal ligation. Surprisingly, I experienced another round of grief over being unable to bear more children. And that grief lingered with me for years. Simultaneously I felt if I attempted another pregnancy, I'd be foolish and presumptive, putting God to the test; but if I had the ligation, I wouldn't be trusting Him or displaying enough faith. 

Yet I came to realize that nothing is ever a given, and even having everything intact physically didn't allow me to take anything about childbearing for granted. Sitting in the NICU day after day with my son, watching stunned parents leaning over full-term, healthy-looking babies drove that point home for me. I could read their eyes and overhear their distressed comments to the staff: "How could this happen? To us? Our baby was full-term, and now he's in here. Everything seemed to be going right. What happened?" And they all looked utterly helpless. 

I won't toss you any well-meaning, pious platitudes. Your loss and pain are terribly fresh, and you're still healing physically from the surgery. That latter fact adds a burden to your emotional and spiritual recovery.

I will say, however, that while the pain is likely to get worse before it gets better, it will get better. It really will! I know you can't see it or feel it now, (and may not want to), while you're thrashing around in the middle of it, but it will. Take your time. Reading some of the recent posts on grieving may help you anticipate the obstacles you'll encounter in this valley. I wish I'd known more of what to expect. I think it would have helped me, and my husband, heal better, more quickly and more completely from Victoria's death. But healing takes time. No one else can walk this road for you. Set your own pace and don't expect too much of yourself at this stage.  

Please know that I, as well as many reading this blog, (I'm sure), are now praying for you in your recovery, or recovering right alongside you. Readers from over 50 countries are following along, all with their own unique stories or stories of friends and family. Although you often feel like it, you are not alone. We're members of a little "club" we didn't, and don't, want to be a member of. I just wish I could sit with you, hold your hand and weep with you, listen to your heart as you express your pain. Having someone in your presence, with "skin on them" (as one little girl so aptly put it), is often so much nicer.

What did you name your little girl? (If you don't mind sharing that with all of us.)



Monday, June 24, 2013

What Does Grief Look Like? (Part 4) Anger, Guilt, Blame, Yearning and Jealousy

“I had a lot of hostility. I felt deprived of my baby and fatherhood. Looking at other people who had what I didn’t have made me wonder, ‘Why can this idiot have a family and children and I can’t?’ This was a question I asked myself a lot.”

Ever feel like this heartbroken father who lost his baby? If so, you’re experiencing the natural reaction of anger. It's a way for us to attempt to justify or make sense out of what we perceive to be a senseless tragedy. And your particular situation may, like mine, fall into the “senseless” category, with my medical group’s poor medical care and the misdiagnosis of my placenta previa condition. You might also want to blame somebody.

You’ll be confronted with stories of neglected children, unfit parents, parents who seem indifferent to their children (or even hostile to them) and oblivious to the blessing and gift they’ve been given. After all, children are a heritage of the LORD. Happy is the man who has filled his quiver with them. (Psalm 127) And you deserve that, don’t you? A heritage and full quiver. It’s just not “fair” is it?

Juxtaposed with these thoughts of anger are likely to be thoughts of guilt: you worry that you are in some way responsible for your baby’s death. Maybe you felt only ambivalence instead of excitement and joy about your pregnancy diagnosis; perhaps you didn’t feel it was “the right time” to have a baby or it was too soon after the last birth, the pregnancy was “unplanned” or you didn’t know how you’d care for another child financially or emotionally, or ____________ (you fill in the blank). The nagging doubts, questions and self-chastisement can go on endlessly. You can, and will, find (or possibly manufacture) any number of faults to berate yourself for having during the pregnancy. If I had a dollar for every “what if” I’ve let rattle through my brain the last twenty years I’d be a wealthy woman. Not happier, just wealthy. The thoughts—if I entertained them too much—sometimes made me sleepless, agitated. They left me exhausted and depressed.

Or you may feel so strongly about being at fault that you convince yourself you need to be punished. Consider this couple’s story, shared by the father:
            “The labor took a long time, even with Pitocin, and Sally was in a lot of pain.
            The doctor said, ‘Don’t be a hero, take something for the pain,’ but she refused.
            Later she told me she felt she had to punish herself. If I had known that, I
            would have demanded she take some medication. It seemed so unfair for her
            to be blaming herself for that.”

If you have feelings of guilt, share them with others and certainly with your doctor. Having your doctor clarify the medical facts—in a gentle, empathetic way—can help you through this part of the grieving process. Just having a counselor or friend listen to your concerns and fears goes a long way in releasing fear and guilt. At least someone else is “sharing” your burden with you.
Sometimes you may have a medical condition you didn’t know about so you and your doctor were unable to prevent the loss by taking steps to prevent it. This was the case with a personal friend who had three children in a row die in utero. Her doctor was finally able to diagnosis the problem and treated her for it during the subsequent pregnancy, which resulted in a full-term pregnancy and birth of her healthy son.

This friend had joyfully experienced three full-term pregnancies prior to her three losses, so anticipating a problem hadn’t even been considered. My first son was born after a relatively “easy” (aside from ghastly morning sickness and a third-term blood pressure elevation) pregnancy, so no one was expecting the incompetent cervix I presented both during Victoria’s and my last pregnancy. After Victoria, my doctor was looking diligently for another placenta previa, but when that was officially ruled out, he—and Chris and I—breathed a collective sigh of relief. Our relief was short-lived, as you’ll read in the rest of my story. An incompetent cervix and premature labor in the next pregnancy shocked and demoralized all three of us.

And now the difficult consideration: Certainly there are behaviors that may lead to the death of a child in utero or premature delivery, and your feelings of guilt may be justifiable. Your self-accusations may have some ring of truth to them. (As in my case, one of my self-accusations was: Why didn’t I change doctors when I had the chance?) In that case, do what you can to correct the situation in any subsequent pregnancy and go through the process of seeking forgiveness from the Lord and forgiving yourself. This is really another topic all together, but let me say that sometimes we return to the Lord over and over again to ask Him to forgive us for the same sin because we haven’t really forgiven ourselves for it, or we’re still suffering the ramifications of it, or because spiritual forces or other people repeatedly beat us up over it. (I think I could have a blog dedicated solely to this issue alone!) We let these situations rob us of our joy and our future! Don’t let that happen. Seek the counsel of a wise and godly friend; seek therapy from a trusted biblical counselor or pastor. Confront the issue, repent, let it go and move forward. (Did I say let it go? And don’t return to pick it up again!)

If someone else has contributed to your loss then you will eventually need to forgive them so you aren’t allowing theme to rob you of your joy and future!

The bottom line is that you must fight against letting your guilt paralyze you emotionally and block your grieving. (Yes, it is a battle.)

Then there is the searching and yearning for your baby that is so common. Hilary had this to say about her twins who died due to a premature delivery:
            “For a long time I would fantasize about the babies, putting them into
            situations. I would go into a grocery store and think, ‘I couldn’t fit a double
            stroller in here.’ When driving I could think the twins should be in the backseat.

            “Once on a business trip I told a fellow passenger I had twins. I’m really
            embarrassed about this. I engaged in this fantasy and pretended they had
            lived. It was so nice. The man was kind and I knew I would never see him

Sound familiar? Honestly, I don’t know if these feelings ever truly disappear. I still walk by the baby sections in department stores and wonder what Victoria might look like dressed in the flouncy, girly dresses and hats; I sometimes allow myself to “guess” what she’d look like or be doing at this stage of her life. What boyfriends she’d be bringing home for her dad to assess, what she’d be pursuing in college. How I would have raised her differently from my boys. How they would have interacted with or protected her.

And yearning for your baby can cause you to desperately crave becoming pregnant again, right away. This was Chris’s immediate reaction in the hospital, before he thought about it and realized that wasn’t a good idea. He recognized that he really just ached to replace Victoria. Yearning is a natural response to the void you’re feeling, or the feeling of having failed and wanting to try again to make it right the next time. To fix it. But doing so will severely hamper your ability to grieve the baby you lost. As the authors of A Silent Sorrow state: “…mourning your loss and bonding with a new pregnancy are demanding and opposite emotional tasks, difficult to do at the same time.”

Giving yourself time will help you understand that you'll never be able to replace this special, unique baby you lost. Another baby will be just as unique and new. (In my subsequent pregnancy and birth of my son, this was a tremendous issue for both Chris and me, one we struggled with, and one I was shocked to discover had not really resolved even after I spent a year grieving Victoria’s death and seventh months struggling physically and emotionally through another pregnancy.)  

Finally, don’t be surprised if you're assailed with jealousy, even if this feeling is normally anathema to you and your personality. Following your loss, pregnant women and new babies will appear to be everywhere. You’ll feel overwhelmed with jealousy and hurt. It is a normal aspect of your loss and the grieving process. Experts say it is temporary, but I’m not convinced of that. I’m ashamed to admit that I’m still sometimes assailed with jealousy at the vision of a new, pink baby girl. (Not a boy, just a girl.) But that could just be a vestige of my competitive nature kicking in. Thankfully, these events are now rare, but they do happen and render me internally embarrassed and disgusted at my abhorred character weakness.

If it’s all too much for you to process, don’t feel guilty about explaining to your friends and relatives, who may be oozing a pregnant tummy or gushing over their new arrivals, that you’re unable to see them or their new offspring at this time because of your loss. If they are truly friends, they’ll deal well with it and open their arms wide to socialize with you again, when you’re ready.   

NEXT WEEK: How Mothers Grieve the Loss of Their Baby. I’ll also include a short discussion on the type of grief one might experience when choosing to undergo an abortion following prenatal testing revealing a congenital problem.

Until next week.

Thanks for joining me!



(Reference: A Silent Sorrow: Pregnancy Loss by Kohn, Moffitt and Wilkins, 1992.)

Hi everyone! Or, I could say, Aloha! Just returned from a two week holiday back in my "home" state of Hawaii. It was glorious on O'ahu, but I ended up in the emergency room last Tuesday on Kaua'i with severe pelvic/abdominal pain, which still lingers on, so my week on that island was a bit rough. We arrived home today, a day later than I originally planned (mentally) because we flew out on the "red eye" (LATE EVENING) flight and didn't get home until today. Then I had to work tonight, Sunday, June 23. So, given all of that, I am behind on getting my post out at the scheduled time. I promise to have my next post added by the end of Monday, June 24, California time (which is what we are on here in Tucson now, since we rengade South Westerners don't change our clocks. The other half of the year, we're on Mountain Time!). 

I plan to have the post released by 1:00 PM, Monday, June 24. Please join me then!


(Anakalia in Anglicized Hawaiian!) 

Monday, June 17, 2013

What Does Grief Look Like (Part 3)

Answer me speedily, O LORD;
My spirit fails!
Do not hide your face from me, …
Psalm 143:7

“Ellen was in the ninth week of her first pregnancy when she awoke in the middle of the night, bleeding profusely. As her husband searched the early-morning streets for a taxi to take her to the hospital, she waited alone in the lobby of their apartment building:
            ‘At this point I was just astounded by what was happening. Even the ride to
            the hospital, with cabdriver rushing through red lights, seemed surreal. It
            wasn’t until the next morning, after the miscarriage was over, that I fully
            realized we were not going to be parents.’"

Ellen was in shock, (a phase I’ve addressed previously but which warrants this additional discussion), where you feel numb and possibly detached from the unfolding reality. It’s most likely a “self-protective response” that helps you deal with the disaster, allowing you to avoid experiencing an immediate emotional and physical breakdown. Shock may extend hours, days or come in waves over weeks.

You think you might awaken from your nightmare; you go through the motions. While you might be able to relay every detail surrounding the immediate event, it’s possible you won’t remember conversations or events that occurred during this time. No matter what stage of your pregnancy when your baby died, you may experience this stunning, slap-in-the-face, numbing feeling.

You might also develop unusual, “disturbing” feelings, imagining that you hear the wails of your hungry baby, or feel phantom baby kicks. (For those who have been with me since the beginning, remember the phantom baby kicks I talked about?) You may feel as though you’re becoming psychologically unbalanced.

“Dr. Kenneth Kellner, an obstetrician who has researched the needs of bereaved parents, found that mothers who heard phantom crying or imagined the baby kicking usually stopped having these sensations when they were allowed to see, hold, and say good-bye to their babies…or when she can at least see her baby’s photograph.”

Being able to grieve your loss openly helps to alleviate the symptoms of shock and denial.

Anticipatory grief is yet another type of grief parents may experience, especially if they learn their baby has died in the womb. Part of you begins to mourn while the other part of your brain holds out hope, thinking it really isn’t over yet. Maybe there’s a chance. Not until the baby has been delivered from your womb do you confront the reality in all of its finality.

This grief can also be true for women who have elected to have an abortion after learning that their baby has a genetic disease or abnormality incompatible with life. When the pregnancy finally ends, you may then experience some measure of relief that the questions clouding your mind are finally answered, but sadness becomes a reality. Doubt about having had an abortion can also creep in and delay, hamper or arrest the complete healing process. While you might be able to fully mourn your loss, you may never recover from the negative effects of your decision. ‘What ifs’ and nagging guilt may plague you for decades.

When the profound horror of your loss slams into you with full, unrelenting force, knocking the emotional and physical wind out of you, you are experiencing acute grief. Your pain consumes every part of you. Nightmares and uncontrollable crying may leave you frightened and exhausted. Insomnia, extreme fatigue, digestive problems, panic attacks, throat tightness, low stress level, and difficult breathing are common complaints and occurrences.

Concentrating on even the simplest tasks may seem impossible. Energy—for doing anything, including getting out of bed—will be in short supply. You may accuse yourself of being a complete failure, particularly if you’ve experienced more than one pregnancy ending in the death of your baby, wondering why you can’t have children like other women.  

Wanting to die to escape your pain and join your baby in heaven can sneak into your mind in this stage too. That seems so much simpler and more appealing than staying here and dying emotionally. Share your thoughts with friends; join a grief group. Get counseling. It helps just to talk and let someone else know how you’re feeling. Keeping your painful thoughts buried can hamper the healing process and exacerbate these feelings.

This is also the stage where you find yourself becoming more protective of your family and other children, disallowing their participation in activities you feel are unsafe. You have become acutely aware of life’s fragility and entered an overprotective state. You may become increasingly anxious about being away from your other children or letting them do ‘normal’ activities without you. You may need to battle this tendency for years, or the rest of your life. Your heart knows how paralyzing, debilitating and gut-wrenching death and loss can be, and you are terrified of going there again. In fact, you’ll do everything possible to make sure you don’t have to walk that dark path another time.

When I learned that my cousin was diagnosed with Stage 4 ovarian cancer several years ago, I sat down and wept, both for her and for my aunt. But, honestly, I think I wept more for my aunt since she’d probably be walking the same dark, painful path of losing a child—one more time. Her oldest son died in a tragic car accident almost thirty years earlier, while in college. It was devastating for the entire family. My aunt had a difficult time grieving and healing. How would she handle another loss? Miraculously, both she and my cousin came to a saving knowledge of the Lord Jesus Christ during that time. While my aunt’s pain after my cousin’s death was deep and somewhat debilitating, her new faith—and a godly neighbor—sustained her and continue to sustain her.

At this point you need to remember Who is in control, of your life and everyone else’s. You need to pray without ceasing for extra measures of faith. You need to remind yourself of your ultimate, eternal hope, that this life is not the end of the road, and that, if you are a believer in Christ, the best is yet to come.

There are still times when I hold the urn containing Victoria’s remains and allow not only my heart and mind, but also my entire body to be transported back to that horrible day and time of grief. I cry and relive the agony, guilt, and blame again. To wrestle myself from that, I remind myself that God loved Victoria, and loves my husband and children, more than I ever could; and that I will one day be reunited with my precious girl. I look forward to and rejoice over that future time: when I will spend eternity with her in a place void of tears, fears or pain. It quiets my heart and mind and brings renewed joy to my soul. And while it may seem like a very long time before that happens for me, it really isn’t. Knowing and reminding myself of that puts this present life and age in perspective. I’ll get to spend eternity getting to know Victoria! And eternity is an awfully long time.


There are several other unique stages to pregnancy loss that I want to expound upon or cover: guilt and blame, searching and yearning for your baby, and jealousy. We’ll look at those next week.

Until then, thanks for joining me!  



(Reference: A Silent Sorrow: Pregnancy Loss, by Ingrid Kohn, MSW and Perry-Lynn Moffitt, with Isabelle A. Wilkins, MD; 1992.)

Monday, June 10, 2013

What Does Grief Look Like (Part 2)

My heart is severely pained within me,
And the terrors of death have fallen upon me.
Fearfulness and trembling have come upon me,
And horror has overwhelmed me.
So I said, “Oh, that I had wings like a dove!
I would fly away and be at rest.
Psalm 55:4-6

You and your husband were thrilled with the news of your pregnancy, and you shared that happy news with family, friends and even acquaintances. You visited all of your local stores and shopped on line for just the perfect new baby items. You decided you needed a bigger place, so you moved from your tiny apartment to a house and lovingly prepared the room you selected for a nursery. You learned your baby’s sex and poured through and agonized over baby names. You bought What to Expect When You’re Expecting and What to Expect the First Year so you were prepared. You relished every doctor’s visit, to hear your baby’s heartbeat and see your miracle wriggling on the ultrasound monitor. It’s your first baby, and you are thrilled and expectant.

Then one day you prepare for another doctor’s visit. You’re within three weeks of the due date, and you’re tired, stretched and sore. But something’s nagging you: you haven’t felt the baby move in the last twenty-four hours. You’ve made it so far. What could possibly go wrong now?

But something has gone wrong. Terribly wrong. The heart monitor remains silent as the nurse presses it onto your swollen belly. She moves it to another location, then moves it again, and again. She can’t make eye contact with you and pats your shoulder and leaves the room to get the doctor. He returns to the room with a serious look on his face and wheels in his ultrasound machine; (or, if your doctor no longer maintains one in his office, you have to listen in shock to his diatribe about having to schedule you for an ultrasound and see what the results show). After smearing contact gel on your tummy, he flicks on the machine and begins to rub the head over your baby’s location in your womb. You and your nervous husband are terrified of looking at the ultrasound monitor, but your husband stares at it, eyebrows knit together, concern inflaming his eyes. You stare at him, looking for any kind of hopeful sign. But that hopeful sign doesn’t come.

The doctor turns to look at you, sighs, and says, “I’m sorry, but your baby has died. The umbilical cord is wrapped around his neck. There’s nothing we can do. I’m so sorry.” A scream chokes your throat. Your heart pounds, tears flood your eyes as you listen, vaguely, to his instructions and explanation about what will happen in the next thirty-six to forty-eight hours: medicine to induce labor, scheduling the hospital delivery, what to expect during the delivery. On and on it goes, and you feel yourself growing numb. Your brain screams that this can’t be happening, that’s it’s all a nightmare from which you’ll soon awaken. You want to go back forty-eight hours to relieve the time when things were perfect—when you could feel the baby kick and wriggle—and somehow change this hideous outcome. The doctor pats your shoulder again as he leaves the room. You and your husband make wordless eye contact. He doesn’t know what to do; after all, he’s supposed to take care of his family, his unborn baby. And he’s failed. What went wrong? You hold each other, cry and pray.

Then you quietly dress, go home to your new house, walk into the empty nursery, collapse into the rocking chair your husband recently surprised you with, and you cry like you’ve never cried before.

Whether the above scenario sounds like yours, or your baby died soon after birth, or in delivery you miscarried your child early in the pregnancy, or the pregnancy was planned or unplanned, you probably feel as though your world. Instead of receiving new life, you encountered cold, heartless death. Your hopes and plans have collapsed on you, and you feel buried—suffocating—in the rubble.

You feel failure, lost, hopeless, out-of-control. Nothing seems normal; you drag—like a pre-programmed robot—through your day in a fog, unable to get your mind completely wrapped around what’s happened. Reminders of your agony confront you every place you go. The baby gifts from the last shower line the nursery. Instead of happy announcement cards, you need to send out death announcements and maybe plan a funeral or memorial service. You might need to purchase a cemetery plot. Every new baby you see in the grocery store, bank, shopping mall, or church reminds you of your loss, and jealousy may infiltrate every fiber of your being. You feel physically ill and emotionally crushed when you return to your obstetrician’s office for a checkup: the waiting room is packed with women whose swollen abdomens signal healthy pregnancies and impending birth, and arms tenderly hold newborn infants who would be your daughter’s age. Your thoughts race ridiculously with uncontrollable or shocking thoughts: Why did this happen to me? Why do these women get to be happy while I grieve? Why did their babies survive and mine didn’t? I’m angry at them for their joy! Oh, why did I take this baby and pregnancy for granted, assuming everything would turn out perfectly? Just as oddly, you may then be swamped with overwhelming compassion and love for them, hoping they don’t have to suffer the grief you’re bearing. Or if your pregnancy was unplanned, you might experience overwhelming guilt and berate yourself for having cared so little or for having regarded your pregnancy, and this baby, as a inconvenient nuisance or untimely problem.

You’re completely unprepared for the agony you now feel, and most family members and friends will be unprepared to understand or appreciate it, unless they have walked in your shoes.

As Ingrid Kohn and Perry-Lynn Moffitt write in A Silent Sorrow: Pregnancy Loss, “No matter what your career orientation may be, your womanhood or manhood can be powerfully affirmed by bearing or fathering a child. Pregnancy and parenthood are passages into adulthood that bestow a special status on you, within both your family and your community. Pregnancy even represents a chance to overcome mortality, as you contemplate the continuation of your family line.”

In the 1970s, pediatricians John Kennell and Marshall Klause performed research that indicated parents’ emotional attachment and bonding to their baby begins early in the pregnancy. This is important for people to understand: the baby that you or your friend or family member lost was probably deeply loved, surrounded by expectations, hopes and dreams.

Indeed, the pain of loss can be overwhelming, frightening and earthshaking. Some parents actually develop Post Traumatic Stress Disorder Syndrome following the death of their baby. “They respond to their tragedy with the same intense traumas such as fires, plane crashes, or rapes. Parents suffering from this disorder may display such disparate symptoms as reliving the events in great detail, or forming a kind of amnesia about the loss of their child.”

Mothers and fathers may experience pregnancy loss grief in varying ways from one another, and it’s important for the couple to recognize and appreciate these differences. This is something Chris and I had great difficulty understanding. Each of us thought the other would, and should, grieve in the same way. Consequently, our relationship suffered immeasurably the first year following Victoria’s death, and our ability to really come to a sense of understanding, resolution and healing as a couple didn’t occur until April 13 of this year, twenty years later.

But before I delve into the mother’s and father’s unique grieving experiences, I’ll talk next week about shock and denial, acute grief and anticipatory grief, specific stages or reactions I haven’t yet addressed.

So, thanks again for joining me.

Until next week!



Reference: A Silent Sorrow: Pregnancy Loss, by Ingrid Kohn, MSW and Perry-Lynn Moffitt, with Isabelle A. Wilkins, MD; 1992.