Background
Reflexivity
Methods
Approach
Recruitment
Participants
Participant number and pseudonym | Age (years) | Stillborn baby pseudonym | Stillborn baby’s gestation | Live baby pseudonym | Live baby age (months) | Partner/Husband pseudonym | Diagnosis history | |
---|---|---|---|---|---|---|---|---|
1 | Ruth | 35 | Emma | 41 | William | 4 | Steven | No |
2 | Sharon | 32 | Oliver | 31 | Grace | 4 | Kevin | Depression |
3 | Sarah | 34 | Joseph | 34 | Jacob | 21 | Dylan | No |
4 | Karen | 48 | Chloe | 32 | Shauna | 48 | John | PTSD |
5 | Isabel | 28 | Ella (Mia twin sister) | 25 | Amelia | 30 | Richard | Depression |
6 | Defne | 30 | Ufuk | 30 | Zeynep | 48 | Murat | No |
Procedure
Results
1. Prepared transcripts for analysis (pseudonyms were given, identifying details were taken out and line numbers inserted). (By first author) |
2. Free coding followed up by a close, line-by-line analysis, was completed to understand each participant’s concerns and claims. (By first author) |
3. Emerging themes were then established for each individual case in conjunction with regular supervisions. (By first & second author) |
4. Then, from the researcher’s own understanding of theoretical frameworks in Psychology and from reflections from her own stillbirth experience, an interpretive dialogue was established and this was also highlighted in each transcript. (By first & second author) |
5. For each case a narrative overview, summarising emerged themes and the researcher’s own interpretation and speculation for each case, along with the line by line coded transcripts, was established. (By first & second author) |
6. All participants’ identified themes were presented side by side in a table for general visual overview. This was then used towards establishing the structure of the main and sub themes. (By first & second author) |
7. Then all participants’ experiences were tabulated, this time according to the established structure and presented in a table in which the participants’ contribution was indicated. (By first author) |
8. A narrative of women’s experience, evidenced by extracts from participant’s accounts, was then developed in conjunction with the established structure. (By first author) |
9. The final analysis and interpretations were also overseen by the 3th and 4th authors, and the overall findings in relation to perinatal loss, attachment and mental health literature were assessed. |
I) Broken Canopy | The number of participants shared the experience | |
1. It cannot be true – Baby with no heart beat | (Pregnancy with a dead baby; Confronted by a dead baby; Choice and information) | 6 |
2. Questioned Self & others | a. The off script experiences of others | 6 |
b. Others failure to acknowledge the loss | 6 | |
c. Changed view of self – self is alone | 5 | |
3. It cannot be true – Baby with a heart beat | (Consolation prize/Runners’ up prize) | 6 |
4. Surreal Experiences | (Joy and grief; Creating life like other women) | 6 |
5. Anxious parenting | (Unrealistic expectations from self; Creating memories) | 5 |
6. Integrating death in life | Self-growth | 4 |
II) How did this happen? | ||
1. Why | Is the self the culprit? | 6 |
2. Emotions | Anger and despair | 5 |
III) A Continuing Bond | ||
1. My baby existed after all | They are brothers/sisters; We are a family; He/she is still my child | 6 |
2. Betrayal | 4 | |
3. Longing and need to be in touch | 6 |
Theme I - Broken canopy ‘Questioned self and the changed view of world –world may not be safe’
I think now that Chloe's death has left me with an almost constant awareness of the fragility of life, how quickly everything can change. Before Chloe died, a headache was just a reason to go to bed earlier, now I worry could it be something more serious. Now when friends are expecting babies, I feel great relief when their babies arrive safely. I don't have that blind expectation that all will be well. I don't trust doctors so much either (KAREN)
Sub subordinate theme | Quote | Shared experiences |
---|---|---|
1.1 It cannot be true - Baby with no heart beat
| I couldn't breathe. I couldn't speak. Not only did I have to start processing this horrible information, but I had to experience it while still being pregnant…couldn't run. I couldn't fall to the floor. I had to hold up this big pregnant belly (SHARON) | All participants shared their disbelief when they learnt the baby’s heart stopped and their baby was no longer alive, although, they still looked pregnant and they still gave birth to their babies. |
1.2 Questioned Self and Others
| The death of a baby is so "off script". It's just not supposed to happen. And it taps into people's individual fears and discomfort (SARAH) | This ‘off – script’ experience then translated into failure of acknowledgement of such loss by others and the person being isolated from others as a result. |
1.3 It cannot be true - baby with a heart beat
| I know it's an odd observation to make, but I was really astounded by the fact she was breathing (ISABEL) | The realisation of the broken canopy and the heightened awareness in danger and death appeared to leave the women surprised at having given birth to a living, breathing baby after all. Women collectively reported that they questioned their ability to create life and were prepared to face further adverse experiences. |
1.4 Surreal experiences
| I enjoyed seeing Grace on the screen at our many doctors' appointments. Those were the moments I focused on her… But mostly, my thoughts and focus were on letting my hopes and dreams for Oliver go, and learning how I could incorporate his absence into my life (SHARON) | A co-existence appeared to be linked with the surreal experiences and left mothers in a dilemma. All participants reported simultaneously experiencing opposite feelings – joy and grief, were reported by all the participants. |
1.5 Anxious parenting - (Unrealistic expectations from self; creating memories). | This is all after she was born -going through the labour with her was a different thing entirely! I have described the change over from being in labour to having her born as two different worlds -diving off of a cliff only to land in a foreign land (SHARON) | Heightened awareness of the imminent danger along with surreal experiences appears to influence mothers’ relationship with their infants and their parenting experiences. |
1.6 Integrating death in life | In fact, there had always been that fear of driving. It was difficult to imagine myself in traffic jam. But today I drive to work every day (DEFNE) | The awareness of fragility of life and death itself appeared to bring a new authentic way of living. Life and death are not separate entities. Four out of six participants, articulated being able to find new ways of in engaging with life. Their focus appeared to move to the ‘present’ ‘here and now’ as described by Defne. |
It cannot be true - Baby with no heart beat
She was wrapped in a towel, like any other new born baby and handed to me. She was absolutely minute. Her face was bruised and there was a tiny trickle of blood coming from her nose and mouth. Her eyes were still sealed shut and she had no hair. She was still, clearly, meant to be in my womb. I held her and cried over her for a bit, before handing her to my husband who did the same (ISABEL)
No-one had told me Chloe would be warm. I think deep inside without telling anyone I felt she was still alive. Later as she lay in the cot beside me I dozed off and when I woke I thought she had moved I screamed. The junior midwife came running in. I didn't tell her why I screamed (KAREN)
We were able to hold him and spend some time with him, then they took him … When the hospital took Oliver away , I felt empty. I wanted to know where he was going, who was going to take care of him, were they going to be careful even though he wasn't living. He was my child and I felt sick that I would never see him again. For me that was the beginning of my unyielding grief that he was no longer a physical part of me and I couldn't feel him anymore (SARAH)
We found out on Monday, 3 days later that we didn't have to leave her there so we went and brought her home. It was so lovely to hold her and hug and kiss her and have her home. She was in her coffin in our bedroom until we buried her on Wed. Having Chloe home meant the world to us. Her big sister was able to hold her too and family visited and we felt we had 48hrs to tell her we love her. We never think about the fact we were not told we could take her home. That would be so upsetting. We are just thankful we found out we could bring her home (KAREN)
We were fortunate to have a local photographer from a local charity arrived at the hospital and took pictures for us. It seemed awkward at first but we are both very thankful to have these photos as they are the only ones we will have of our darling angel daughter (RUTH)
Questioned self and others
Only one of my friends said cry Defne. No matter what I will say will lessen your pain, but express your feelings to me- offered me a shoulder to cry on. I cried a lot that day, only to her… How well she understood my only need to be able to cry (DEFNE)
Every now and then someone either a family member, friend or someone handling the burial arrangements would make a hurtful comment such as "Don't worry, you'll have another baby." or "Are you sure you felt fine? You didn't feel like anything was wrong?" or "It was God's will." None of this was helpful, because a) I don't want another baby. I want this one; b) if I didn't feel fine, I would certainly have rushed to the doctor or hospital!; and c) what little faith we had we were now questioning (SARAH)
I think it was tough, dealing with depression to be honest and my friends, the one or two I have in [Place 1], rarely showed up or text me, so they were little help sadly. My husband worked 60 hour weeks at the time, so when I did see him, he was exhausted himself (ISABEL)
It is wonderful to go to school with her everyday but I still cry when I think of my son but nobody knows it (DEFNE)
It cannot be true – baby with a heart beat
This may sound morbid, but I felt disbelief that I had actually given birth to a healthy child! (SARAH)
Other people seem to see Shauna as some kind of ‘consolation prize’ for Chloe's death. I find this so untrue and offensive. Giving birth to Shauna safely and rearing her did not heal my grief over Chloe. What it did do was give me a pressing reason to get up every morning. One child does not replace another. Each of my daughters has their own special place in my heart (KAREN)
Surreal experiences
Often I felt I had to act like I was always happy and grateful in front of everyone else for their own relief and happiness about expecting Jacob. Mind you, I was thrilled to be expecting him, but that coincided with the fact that I was still grieving. The guilt didn't last long, because we came to see Jacob as a sign from Joseph that we should love another child as well. Perhaps that sounds a bit esoteric, but we believe that (SARAH)
Anxious parenting - (Unrealistic expectations from self; creating memories)
There was so much worry. I had dreamed before she was born, of us being so relaxed and enjoying her baby time. I think now that my expectations were too high. But the worry for having Shauna did not turn out how I expected. I was surprised when one doctor commented that he couldn't understand why we worried so much about her. After Chloe died so suddenly, I felt it made perfect sense that we would be worried that something bad would happen to Shauna (KAREN)
My feeling toward my ‘importance’ to Daniel relate to my ability to provide for him in a way that no one else can. I really wanted to be able to breast feed him for at least 6 months. When this didn't happen, I felt less of a woman and almost helpless (RUTH)
With Grace, if there was something that felt right for her, I bought it with the understanding that it is hers whether she ever used it or not. In that way, I was creating physical memories of her if we lost her (SHARON)
Integrating death in life
Something beautiful that I experienced being pregnant after having a baby born still is that I treasured each moment that she was alive in me. Most people go through pregnancy anticipating the next steps - birth and life. Never having gotten to those steps with my son, I was able to build a relationship with my daughter in a unique way in utero. I was getting to know her and think about her in the moment rather than dreaming about the future (SHARON)
Theme II – How did this happen
When I am reminded of my daughter's tragedy I think to myself how lucky I am to have known her at all. I used the knowledge of her situation and took that forward with me during my pregnancy with William… Life is so precious and too many people take the ability to create life for granted ( RUTH)
Why - Am I the culprit?
So, basically, we were left with absolutely no answers. I think that has been the hardest part in our process. Doctors tell us they don't like to have answers because it's less likely to recur. We like that. But it doesn't help in our understanding of what happened to our little boy. And it certainly adds to my anxiety that maybe it was something I did ( SHARON)
Emotions - anger and despair
Everybody said if this happened later it would have been worse, what happened was better than what would have happened if this child born with disabilities. This made sense but it did not make me feel better. Even it made me angry (DEFNE)
I could have chucked a chair at his head. I pointed out to him, rather curtly, that I had buried two children and that I didn't plan on doing it again and if he'd been through what my husband and I had been through, he wouldn't be asking such a dumb-ass question (ISABEL)
I could not touch him. When asked prior to his birth, I had told everyone I was going to hold him. But when he came out I felt differently. All I kept thinking was, "That's not him" I knew the real essence, the true being who had been my little boy, was not in that body. My baby was gone. I said I had held him for eight months. I wasn't going to hold him when he wasn't there (SHARON)
I tried going to Church but gave that up quite soon as I was so angry with God (KAREN)
I spent the first few days just completely numb, like a robot, coordinating and planning her funeral services. I felt the need to make sure she received the best she could, since there wasn't anything else I could do for her (RUTH)
Theme III - A continuing bond
My baby existed after all
There is the real child, and the one we have created in our minds. Understanding this was a beautiful and helpful thing for my relationship with Oliver. It made part of him still exist for me. Accepting this allowed me to continue to know him as my child. I just had to come to terms with the fact that I would never get to see who he was as compared with my creations (SHARON)
Betrayal
It was very complicated. I felt terribly guilty, as if we were already forgetting Joseph. I'm sure others judged the fact that we conceived right away, but our doctor recommended it and I was already 33. Even when I discovered the positive pregnancy test, I remember calling Dylan and just feeling scared and nervous. It was difficult to enjoy the pregnancy and all the joys of expecting--first kicks, ultrasound photos, etc. We were constantly fearing for the baby's life (SARAH)
She presented me with a card with the footprints in and photos of her. I was very grateful for her doing that, although I think back now and wish I'd have done it myself. I was her Mum after all (SHARON)
Longing and need to acknowledge a continuing bond
‘My husband and I felt incredibly lonely in the sense that we had these empty, aching arms that should be more than filled with two babies (ISABEL)
Ok, keep the questions coming. I am glad to be purging all of this. Sometimes I go weeks without talking about Joseph (SARAH)
I just love to talk about my daughter; it helps to ‘keep her alive’ in my heart (RUTH)
I walk around thinking I should have two sons on either side of me. My husband says we are blessed with our son Jacob because we lost our first son Joseph, but I still feel that they are brothers who should be together right now, playing, getting into trouble, getting ready to start nursery school, etc. I think of myself as a mom to two boys, but no one else sees me that way (SARAH)
Coped with the guilt of devoting all my time and attention to Amelia by doing certain things. Probably sounds weird, but there are times when I can 'smell' them. All babies have a particular scent and so did Ella before she died. From time to time, I can smell her and I always say hello to both her and Mia (ISABEL)