Every day, through the very nature of their position, midwives play an integral role in the fascinating, and overwhelmingly joyful, process of welcoming new life into the world.

It’s hard to imagine a more rewarding experience.

But as the adage goes, with reward does come sacrifice, and midwives face many challenges as they care for new parents - before, during and after their baby’s birth.

Perhaps the most difficult though, is when a family experiences the stillbirth of their baby, or his or her death in the minutes, hours, or days after birth.

“All the skills midwives are renowned for - kindness, calmness, patience, encouragement and gentleness - are much needed when caring for these babies and their families,” says Maternity Social Worker, Deb De Wilde.

“Talking with colleagues and seeking opportunities to learn about your own emotions around life and death can be helpful in preparing for the times when we need to draw deeply on what we have inside ourselves, to help others at the most vulnerable moments of their life.”

The experience of caring for acutely bereaved families can be extremely confronting, even for midwives who have cared for families for decades, says Ms De Wilde. 

“For the length of our careers, we will all have times when we feel bewildered and helpless in the face of a family’s distress.

“Experienced midwives will help more junior staff and support them in their vulnerability.

“This sharing of practice wisdom is an essential element in caring for ourselves and our profession, and will benefit families into the future.”

Helping families through grief and despair

“Midwives are witness to much joy – the birth of a baby welcomed by its parents is a beautiful event to be part of,” says Ms De Wilde.

“Even amongst the depth of despair at the death of baby, there is still a baby to be acknowledged and welcomed, and tears of love and grief to be shed.”

When it comes to grief, the way parents express or exhibit their feelings will be as unique as their circumstances.

“Shock, disbelief, anger, anguish, and fear are the emotions that are most common.

“The death of their baby may literally be incredible to them. Some families might appear calm and contained but this often reflects a state of profound shock and shut down - a way of being able to tolerate an otherwise totally destabilising situation.”

The expression of intensely-felt emotions can be painful and frightening to witness, which is why it’s imperative for midwives to be mindful of their own mental health, as well as equipping themselves with the skills to support the bereaved. 

“It can be helpful to prepare the parents for how their baby may appear,” says Ms De Wilde.

“A baby who is stillborn or who has recently died is often warm and soft, a little pink or red, and sometimes has changes to their skin. It’s important for parents to be aware of this, and the fact that it is still their much-loved baby.

“Talking with the family about gently placing the baby on its mother’s chest, placing the limbs in a natural posture, offering a warm blanket, and modelling the sensitive and gentle handling of the baby will help to reduce the parent’s fearfulness and allow them to get to know their baby in the time they have together.”

Acknowledging death is never easy. But Ms De Wilde says it can be helpful to grieving families for midwives to express their own sadness.

“Speak to the baby if you feel more comfortable in doing so.

“These words often open a space for parents to speak with the baby as they gradually look into the baby’s face, take in her or his features, hold little feet and hands and explore its little body.

“This may offer a moment of calm in an otherwise confused and confusing space.”

Be careful of unintentionally hurtful comments, such as ‘I’m sure we’ll see you back here soon’, which may seem to diminish the significance of their baby’s birth.

“With the parents’ consent, record these moments with a camera. The quality of the photograph matters much less than the emotion you will capture.

“At times, no words will be needed. Your physical presence, your gentleness, your respect for their baby, their parenthood, for the sadness that the death of each child evokes - these are the important things to carry in your heart and mind at all times.”

Taking care of the carer 

Not only is the process of witnessing immense pain and grief traumatic for midwives, but these feelings may be exacerbated by the continuing demands of the workplace.

“It can be distressing to have to pull away to manage our responsibilities to other patients and staff,” says Ms De Wilde.

“Feeling that you could not give the care and time that a family needed and deserved is painful for all of us, and we will forever be approaching our managers to discuss the importance of time spent with families at times such as these.

“We also need to continually consider the emotional toll that caring for all families - particularly families experiencing grief and trauma - has on us as carers.”

In the days following a traumatic event or death, Ms De Wilde says midwives should connect with a support person, preferably a colleague, who will listen to your feelings without judgement.

“It is important to go home to your family whatever form that takes and let them know it has been a hard day and you need gentleness. Get in the shower and wash some of the tension, sadness, anger, and tiredness off and see it disappear down the sink.

“Be aware of your body – points of tension will alert you to emotion stuck in those familiar places - shoulders, jaw, tummy. Remember to breathe deeply. Sleep. Walk. Let the tears flow.”

Most importantly, stay connected to the heart of what you do.

“Midwives have a vital and wonderful role and their impact on the lives of families is often underestimated.

“Know that what you do truly matters. Value yourself. And keep going with an open heart.”