Parents urged to remember children lost at birth

Parents urged to remember children lost at birth

December 4th, 2011 by Joan Garrett McClane in News

The Never Forgotten room is on a back hallway of the neonatal intensive care unit at Erlanger hospital, just far enough away from where the living newborns are being nursed and crying.

On the wall, a brown bear floats on blue-sky clouds. White cabinets are filled with boxes of knit hats, some small enough to cover a thumb. Doll-sized gowns go on the right. Hand-painted boxes on the left hide mementos abandoned by parents who weren't ready to take them home.

The hospital will keep them here for 10 years, just in case someone comes back to remember the baby she lost.

Between 25 and 30 babies are born dead every month at Erlanger. People come from far beyond Hamilton County to deliver here because Erlanger has the region's only high-risk labor and delivery unit.

One-third of the deaths are mysterious, but the rest can be linked to pregnancy-related forms of high blood pressure, pregnancy-induced hypertension, chromosomal abnormalities, a lack of oxygen, bacterial infections, umbilical cord accidents or maternal diabetes.

Some mothers know when they start labor that they will never know their children. Others find out in the last minutes. Some want the babies more than anything. Others are negligent and drug addicted.

And all those babies come to the Never Forgotten room. Nurses wash them and dress them and press their feet in molds. They collect fingerprints and locks of hair and make bracelets for them if they are given a name.

Local photographers from a nonprofit called Now I Lay Me Down to Sleep come to the hospital to capture some of the births, the looks on the parents' faces when they hold the baby. Funeral homes provide miniature caskets for free.

Nurses will tell the parents how beautiful the child is, how much the baby looks like them. When they do their best work, a parent will believe, at least for a few moments, that their baby is just sleeping.

Thirty years ago, rooms like this didn't exist. Doctors and nurses took a sterile approach to stillbirth. The little bodies were ushered off, given over for burial, thrown out or tested.

Doctors heavily sedated women during delivery. No one held the baby or dressed the baby.

"This was the time when it was the Lord's fate. Whatever happened happened," said Dr. David Adair, CEO of Regional Obstetrical Consultants. "You might bring it home to do a burial, but tomorrow was a new day."

But grieving over a baby is complicated, hospitals now know. Mothers and fathers need to cry over them and cradle them. And in the end, seeing the baby, even if it is disfigured or discolored, is freeing rather than scarring, said Adair.

The doctors tell the parents they might need counseling in the months to come, and that some days -- the woman's first menstrual cycle, the due date, even the birth of the next child -- will feel like reliving the loss.

"You think you get over it. That is another chop-your-legs-out-from-under-you [moment] and you've got to get them back up again," Adair said. "Physically you look at [the parents] and they look normal, but they are hurting deep inside, and it doesn't go away unless we address it properly."

The grief associated with a stillborn is different than most. Bereavement experts call it disenfranchised grief because it isn't a loss fully accepted by society. If a young child dies, sympathy pours in for the family, but when babies die in the womb, there can be a strange silence.

People don't know what to say. Or they tell the parents not to worry, they are young, they can have more children.

Both scenarios are hurtful, said Susan Latta, the perinatal bereavement counselor at Hospice of Chattanooga.

"It is as much of a death when it is in utero as when an adult dies," said Latta. "These dreams and these feelings of parenthood are just shattered."

The experiences of grieving parents have fueled much of the change in the way hospitals and the state deal with stillbirths. Bereavement programs are more common now than not.

At Erlanger, the germ of the Never Forgotten program started when a nurse at the hospital named Laura Apyan wrote a book called "On the Wings of Angels" in 1991 to give to parents leaving the hospital without their baby.

It was meant to be a keepsake of the birth. There were places to put ultrasound images and pictures of the delivery, a page for footprints, locks of hair, hospital bracelets and letters from loved ones.

Apyan, now 54, knew what it felt like to leave the hospital with nothing. She lost her second child, a boy, in 1984. Her memory of the delivery is foggy because of the drugs given to her before delivery. She never saw her baby or named it.

"When I lost my child that was the norm at that time, but it was an impetus for me to understand the need for a different form of closure for other people," she said. "You have to say hello before you get to say goodbye."