Planning a Stillbirth Delivery

Warning: Baby Loss/Stillbirth

After my 20-week ultrasound/anatomy scan we had found out that our baby had an anencephaly, and was unlikely to live after being born. We were briefly told by my OB that the baby would likely be stillborn, but there was a small chance that it may live for a few minutes, in which case they would do their best to make him/her comfortable until they passed away. Oddly at that time I desperately hoped that the baby would live even for a few seconds, but that wasn't the case for us and in hindsight I think our son being stillborn is more comforting to me. 

My OB who had followed me for my first pregnancy and up until 20 weeks with my son had informed us that our care would be transferred to another OB, but one that focused on fetal maternal medicine. I was nervous to see another Dr, but I knew that they were the experts and also how lucky we were to have this particular unit at the same hospital I was already visiting for my prenatal care. When I went to the waiting room a few days after my scan I quickly realized a lot of women there had been referred to the clinic from hours away, so I did realize my privilege but at the time I just felt heartbroken for myself and my baby. 

Before we met with all of the doctors and nurses we waited in a small room and the main OB who was handling our case briefly discussed what we were getting into. After he left, another doctor came in who worked with preterm and premature babies and was an expert in cases like ours. She discussed what we can expect, and said that if our baby did live that she or a member of her team would be on call to ensure the comfort of the baby. We then were moved to a room for what was essentially a conference with lots of doctors, nurses, and general professionals for this sort of delivery. We were told we had three options, the first being a DNE, or Dilation and Extraction, which is essentially an abortion procedure for women in their second trimester. Linked here is a description of the procedure from Health Link BC. The next option we had was to be induced and deliver our baby before 24 weeks gestation, and at this point I was in my 21st week. It meant we would be in the same labour and delivery suites where I had given birth to our daughter, but a more hidden room at the back of the unit that meant we had a more private entrance and exit to avoid new mothers, pregnant women and of course, babies. It would be a regular induction process, I would be offered all of the same pain medication and resources offered in a normal labour and delivery and the only difference would be that it was preterm, and that they knew the outcome for the baby was that it would not live. The third option was the same as the second, except waiting to deliver at full-term, or anytime after 37 weeks. 

Of course between those three options there are many pro's and con's for each, but for us we decided that option two would be best. After seeing a few pictures of what we could expect our baby to look like, scheduling an appointment with a grief counsellor who specialized in infants, and overall booking a date for our induction the process was finished. All we had to do was meet with the social worker/grief counsellor and begin making plans for the birth of our baby. 

Most things seemed to be very similar to going in to be induced for a full-term, healthy labour and delivery. They wanted to make sure we packed everything we needed, we discussed what kind of pain medications I was open to using, and also discussing the risk of a C-Section as I had a caesarean with my daughter, and regular guidelines suggest waiting more than 18 months before attempting a VBAC delivery due to the incisions strength and also the risk of uterine rupture. I was exactly 18 months and 1 week postpartum from my daughters delivery, and we were told that because our baby would be small (around 1lb) the risk of rupture was very minimal, so that's what we planned to do. 

The things we had to plan which I suppose I was aware of but not completely sure where to start were the discussions of funeral plans, and what we wanted to do with our baby once he was born. My mind jumped to organ donation immediately, as the anatomy scan revealed that our baby had a healthy heart and other organs. Unfortunately our son was just too small to be a candidate for organ donation, which felt hugely disappointing to me. Eventually we decided that rather than have our son buried or cremated we would instead try donating his body to the local University Hospital. To our surprise this hadn't been done before, and the social worker we were chatting too (along with a wonderful Mother-in-law) did all they could to arrange an ethics meeting before our delivery, and then heard back that they would, in fact, take his body and use it for the study of anencephaly and premature birth research. This was all completed within a couple of days with the impending induction date, and I am incredibly grateful that all the people involved worked so quickly to accommodate us and our son. One thing we did not expect was having to contact a funeral home to transport our baby to the university. I realized that they typically sign death certificates, but in our case we didn't ever receive one. This is something I really want to write more on at a later date. 

We had to write that we intended to bequeath our sons body to the university, and in turn that meant that we couldn't access him again. We very gratefully received a letter shortly after he was born from a professor at the university thanking us for our sons body, and what they intended to study from him, what a unique and uncommonly donated body they had received in him, and that they would always be respectful and ethical in their studies. Part of me is so desperately heartbroken that I will never be able to see or visit him again, and the other part is so proud of the changes he will make in medicine, and who knows, maybe one day studying our son will prevent babies like him from dying at all. 

Overall, planning a stillbirth delivery was a very sudden and scary thing to do, but we were lucky that in every step there was a staff member making it much easier for us, and mostly we just had to tell them what we wanted and they did the work. While it will never be an enjoyable experience, it was made easier by being surrounded by experts, social workers and really just being told step-by-step what had to be done when your baby dies. We were put on the induction list and told to wait for a phone call to come in, and that was that. A few short days later our son, Jack, was born.