Photo by Kulli Kittus via Unsplash
Given that the pregnancy was unfolding in the midst of a pandemic, everything was going fine for New Kent residents Karley Engelhart and Tim Rufenacht.
But in June, their daughter, Landry Reese, was stillborn. She was full term (more than 37 weeks into the pregnancy). With COVID-19 precautions in place, Englehart was literally in the dark in an ultrasound room, waiting for her husband to join her. “It felt like years,” she says.
Stillbirths account for about 1 in 160 births in the United States, according to the U.S. Centers for Disease Control and Prevention. A loss is considered a miscarriage before 20 weeks into a pregnancy and a stillbirth after that point. Stillbirths are most common in the first trimester. “It is more common than people realize,” says Dr. Frances Casey, an obstetrician and gynecologist with VCU Health and an associate professor with the VCU School of Medicine. (Casey has recorded a podcast on navigating pregnancy loss.)
Often, nothing the parents did or could do could have changed the outcome. Parents are caught unaware. “We had a healthy pregnancy,” Englehart says. “We had no idea. Everything was really good.”
Possible contributing factors include birth or genetic defects or placenta or umbilical cord problems, according to Casey. It can happen to anyone, but potential risk factors include obesity, high blood pressure, diabetes and substance abuse; if the mother is in her mid-30s or older; whether she has had previous complications such as miscarriages; and whether she experienced a condition such as preeclampsia in a previous pregnancy or premature birth. Socioeconomic and racial disparities are seen in stillbirth rates. African Americans, Native Americans and Hispanic populations experience higher rates of stillbirths in the United States than white or Asian populations, according to the nonprofit Star Legacy Foundation’s 2017 stillbirth scorecard. The national average stood at 5.9 stillbirths per 1,000 that year; Virginia’s rate was 4.8 per 1,000.
Listening and communicating are crucial in helping parents cope. Casey notes that many parents who experience loss are struck by the silence around the time when there is no heartbeat detected. She says health care workers need to communicate with the parents what’s going on with care and compassion.
The health care team is also a part of the healing process. They, like family members, friends and others, should convey their care and support. Say the name of the lost infant; honor the baby’s legacy, Casey says. The parents are given hope each time you say the baby’s name. “It’s important we take that to heart,” she adds.
Remember that this loss is not something they will simply get over, that it stays with them forever. They are not taking the baby home with them, but the infant stays in their hearts. Memories and emotions will be triggered by key dates, birthdays and anniversaries.
Casey says you can honor the child’s legacy with an act of kindness, or symbolically by planting a tree or flowers in their honor.
Resources for parents who have lost a child include Full Circle Grief Center in Richmond and the MISS Foundation.
Staying informed also helps, Casey notes, urging families to find trusted sources (she recommends The New York Times’ stillbirth library) and to be aware of misinformation readily found online.
Pregnancies that follow the loss of an infant are fraught with fear and anxiety. The parents are in need of support and reassurance and to know that what happened was no fault of their own, Casey says. The pandemic has compounded the feelings of social isolation and stigma of child loss, she says.
Englehart says that she and Rufenacht were helped in the process by being able to spend more time with Landry Reese because the hospital had a Flexmort CuddleCot, a device with a cooling mattress to regulate the infant’s body temperature and prevent color change. The device gives parents more time to bond and to begin to process the grief of the loss.
“We were able to still snuggle her,” Englehart says. The cot gave them almost two days with Landry Reese.
Earlier in March, they donated one of the devices to Bon Secours Southside Medical Center in Petersburg, in honor of Landry Reese and to help other parents. The devices are now at the health care system’s labor and delivery units in the metro Richmond market.
“I told Tim, we had to do this, we had to give back,” Englehart says.
The couple also has honored Landry Reese with random acts of kindness, such as picking up restaurant tabs for strangers, providing birthday boxes for foster children and providing a Thanksgiving meal to a family in need.
