How will my body react after a stillbirth or neonatal death?

Dealing with a stillbirth or neonatal death is a difficult and sad experience. Grief can be very intense, and you may experience physical effects such as:

• loss of appetite
• headaches
• tummy aches
• insomnia (not sleeping well)

At the same time, your body may undergo common changes that occur after giving birth, such as:

• sore breasts
• breast milk production
• vaginal bleeding
• afterpains
• weak pelvic floor

These changes may be a painful reminder of your loss. There’s support available to help you manage these changes and help you through this difficult time.

How can I manage breast soreness and lactation?

From week 16 of your pregnancy your breasts will have been getting ready to produce milk. They may:

• be large
• feel hard and sore

Your breasts might also be engorged. Engorgement means there’s more milk being made than is being discharged. This might cause your breasts to leak milk for 1 to 4 days after giving birth. If you have lost your child, this can be:

• uncomfortable
• painful
• distressing

Easing breast pain

To help relieve the discomfort of engorged breasts, you can:

• put cold or gel packs on your breasts
• ask your doctor about using a mild pain reliever
• express milk
• wear a firm bra to support your breasts
• use breast pads to collect any leaking milk

Expressing milk

You may choose to keep expressing your milk as you grieve your baby. You can express for as long as you need to, but try to express at the same time each day. This will help you avoid mastitis.

See your doctor immediately if you have signs of mastitis, which include:

• a painful or warm breast, which may have a red patch on it
• flu-like symptoms, such as a fever, aches or chills

When you decide to stop expressing, do so gradually. Reduce the number of times you express every few days.

If you only express a small amount of milk, your milk supply will gradually decrease until it stops.

This can take a few days or weeks depending on:

• how advanced your pregnancy was
• how much milk you’re expressing
• if you become pregnant again

Reducing the amount of fluids you drink won’t reduce milk production. So, it’s best to continue drinking water whenever you’re thirsty.

Donating breastmilk

You may choose to donate your breast milk to a milk bank. Donated milk can be used to help babies who are sick or premature.

How can I manage pain and bleeding?

It’s normal to have vaginal bleeding (or lochia) and pain after giving birth.

Vaginal bleeding

Vaginal bleeding will be different for each person. It can last up to 6 weeks.

In the first few days after birth the blood is usually bright red and heavy. It will seem similar to a heavy menstrual period.

Over time the bleeding will become thinner. It will change in colour to a pink or brown, before stopping.

You should seek help from your doctor or midwife if it’s more 24 hours after the birth and:

• the amount of blood suddenly increases
• you notice that you are passing large blood clots
• the blood becomes bright red
• you feel dizzy, weak, sweaty or have trouble breathing
• you have a high temperature
• you are worried that your bleeding is not normal

Pain

Pain is common after giving birth, especially if you:

• had perineal tears (tears outside your vagina) during vaginal birth
• had a caesarean section

‘Afterpains’ are also common. They feel like cramps, and may happen when you express milk.

If you’ve lost your child and are experiencing pain after giving birth, speak to your doctor. They may recommend pain relief by using:

• icepacks or heat packs on the painful area
• pain relief medicines such as paracetamol, ibuprofen or aspirin
• non-steroidal anti-inflammatory drug (NSAID) gels

Should I see my doctor?

After a stillbirth or neonatal death, you should have check-ups.

Make an appointment to see your doctor about 8 to 12 weeks after giving birth. They can:

• check your health
• talk to you about any risks with future pregnancies

How can I deal with feelings about my body?

The changes that your body goes through after giving birth can make the loss of your baby even more difficult.

You may feel guilty, or as though your body has betrayed you. Remember that you are not alone.

Grief is an intense journey, and the loss of a child is devastating. Some days will be better than others. Over time, your grief will become easier to manage. It’s very important to have support, such as from:

• family and friends
• your partner
• support groups and forums

How can I deal with a weak pelvic floor?

Giving birth can stretch your pelvic floor muscles. This can lead to bladder and bowel problems, such as incontinence.

A weak pelvic floor after birth may cause you to:

• leak urine (wee) when you cough, sneeze, laugh or exercise
• be unable to control when you pass gas (fart)
• struggle to have a bowel movement (constipation)

You can help your pelvic floor recover by:

• avoiding bouncing exercises
• doing pelvic floor exercises
• squeezing and holding your pelvic floor muscles before sneezing, coughing or lifting objects
• avoiding lifting heavy objects

These issues should get better in 6 months after giving birth.

When can I expect my periods to return?

The time to ovulation after giving birth is variable. So, it's best to consider contraception early, before you plan to have intercourse (sex) again. Your doctor or midwife will be able to advise you about this.

How should I approach future pregnancy?

Some parents want to try for a baby again soon after a stillbirth or neonatal death. However, it may be helpful to give yourself time for your body and emotions to recover first.

If you fall pregnant again before processing your grief, you may find it more difficult to:

• cope emotionally with another pregnancy
• bond with a new baby

It may be helpful for some people to have medical tests or genetic counselling before becoming pregnant again. This can check if you or your partner have any underlying medical conditions that could cause a complicated pregnancy. Your doctor will be able to refer you to the most appropriate service.

Resources and support

For support, you can speak to your doctor, midwife, maternal child health nurse or social worker. They can guide you through the process after the birth. They will also be able to advise you about who can help you if your grief becomes overwhelming.

For support and information about suppressing, expressing and donating breastmilk, call the Australian Breastfeeding Association on 1800 686 268.

You can find more information, resources and support through:

• Red Nose Grief and Loss
• Grief Australia
• Pregnancy Loss Australia

Lifeline supports anyone having a personal crisis — call 13 11 14 or chat online.

Griefline provides telephone support — call 1300 845 745, Mon to Fri, 8am to 8pm (AEST).