Caring for Yourself After Your Loss
The First Month
Sometimes love is for a moment
Sometimes love is for a lifetime
Sometimes a moment is a lifetime
-Pamela S. Adams
CEAC 0732
April 2017
Caring For Yourself After Your Loss
In the Hospital
The loss of a child is an important life event. You were getting ready to welcome your new baby into the
family circle, but now your baby will not be going home with you. Now you have to make plans to say
goodbye. You may feel withdrawn from everything that is going on around you. The hospital is a difficult
place to feel at home, but we want this time to be as comfortable for you as possible.
You may experience a range of emotions. Sometimes it is hard to discuss these feelings with others, but
hospital staff members are willing to listen. There will be a team of health care professionals caring for you
while you are in the hospital. There will be doctors, nurses, and social workers. There may be additional
health care providers involved in your care such as Native Services or Spiritual Services. Please feel free to
ask questions about your hospital stay, this booklet, or any health issues. We are here to help.
In hospital, staff will place a “purple leaf” card on your door. This helps staff to identify that you are
experiencing a loss and assists the staff in discussing your care with you.
Creating a Memory
Memories and mementos are important during the journey of pregnancy loss. There are various ways to
acknowledge your pregnancy or baby; collecting and keeping mementos may assist you and your family to
remember your loss, assist with healing, and provide comfort in this difficult situation.
Your nurses will do their best to make memories and obtain mementos of your baby. There will be private
time to be with the baby and your family, holding the baby, seeing the baby, or touching the baby may be
offered.
If desired, photos, measurements of the baby, a lock of hair, hand or foot prints, crib cards, small objects as a
reminder, and hats, clothes or blankets that your baby wore may be collected and offered to you. You and
your family are encouraged to take the items home with you, even though it may be painful to think about
them or ever look at these mementos. They are memories that are created to assist you and your family.
Although you may be too tired, overwhelmed, or just not ready to look at the mementos now, it is common
to find such items comforting at a later time.
If you want mementoes but cannot bring yourself to take these items home now, they will be stored securely
until such a time that you do want to see them. You would need to contact the RQHR Medical Social Worker
if you or your family decided you would like to receive the mementos at a later date.
Emotions and Grieving
As a woman who is experiencing a loss, you have hormonal changes and strong emotional feelings. Each
person will grieve differently and each may experience anger, sadness, guilt, concern, anxiety, loneliness,
disbelief, loss, and numbness. These feelings are normal. They are part of the grieving process. We grieve
when we are separated from someone important in our lives. The time following your baby’s birth and death
is one of ups and downs. Feelings can remain strong for several months or longer. If you feel like crying, do
not hold back, it may help you.
Stages of Grief
There are 6 stages of grieving. Not everyone experiences them in this order or goes through all the stages.
There is no set pattern for everyone; not even within each person. Each grief is unique, as each loss is
unique. These stages are meant to help normalize and validate what you might experience or feel during this
time of loss and grief.
Shock
Shock is the reaction that forms out of a feeling of disbelief, leaving a feeling of being numb. It is a natural
reaction that serves to protect you from being overwhelmed by emotions. At this point the loss has not “sunk
in” and things feel unreal. You may feel detached or dazed, and have trouble experiencing emotions.
Denial
Denial is a period where you want to deny that the loss has actually happened. In effect, you close your mind
to what has occurred. You know something has happened but you do not want to believe it. It is hard to go
from being pregnant and expecting a baby to losing a baby. Sometimes when people are in denial they push
away everything connected with the baby they have lost. To keep uncomfortable feelings away, some turn to
drugs, alcohol, or plan a non-stop social schedule. All of these things cover up the pain for a while but they
do not get rid of the pain.
Anger
Anger typically occurs after denial in the grief phase, although it may occur at any point during the grieving
process. Anger might be directed at yourself, your family, or at a specific person. You may experience a
spiritual crisis, feeling anger towards a Higher Power. Emotions that have been pent-up tend to erupt, and
frustration at having little or no control over the situation leads to feelings of anger. You may feel
short-tempered or feel that little things make you angry. Try to express your anger in healthy ways such as
talking, exercising, punching pillows, or writing out your angry feelings. It is important to let your anger out
in a healthy way. Bottled-up anger and frustration hurts your body, spirit, and mind.
Guilt and Bargaining
Whenever a major life event occurs we usually wonder “what if.” You may find yourself questioning your
decisions or feeling guilty for the choices you have made. When people feel guilt, they sometimes try to
resolve the situation by bargaining with a higher power. Bargaining is a form of desperation in which you try
to make deals to regain what you have lost. In this stage, people try their best to cling to what they have lost,
even though they know they can never get it back.
Depression/Sadness
When you realize that your efforts of avoidance and bargaining are futile, a period of depression generally
sets in. You finally realize that you had no control in preventing the loss. You may turn away from loved
ones, believing that there is no one who can understand what you are going through, or no one who can help
you feel better.
You may cry frequently, feel despair, sadness, and exhaustion.
Acceptance
Acceptance occurs as you learn to deal with the reality of your loss. As you reach acceptance, you regain
some of your normal energy levels. You start to feel interested in life again, and may take action to seek
closure with what has happened. Coping with loss is ultimately a deeply personal experience. No one can
help you go through it more easily or understand all the emotions that you’re going through, but others can
be there for you and help comfort you through this process. The best thing you can do is to allow yourself to
feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.
Dealing with Grief
There are many ways to deal with grief. Here are some suggestions:
 Take time for your partner and family.
 Talk to others. Let your friends know how you feel. Tell them what you need.
 Seek out others who have had an experience similar to your own.
 Talk with a counsellor, social worker or support group. Look in the Community Resources and websites
at the back of the booklet.
 Take time to grieve. Do not avoid thinking about your loss. Spend some time working through your
feelings.
 Stay away from stressful situations. For example, put off major decisions until you feel certain that you
have really come to terms with your grief.
 Keep a journal.
 Write down your thoughts and feelings in a story or poem.
 Eat a balanced diet. Get enough sleep. Exercise.
 Avoid numbing the emotional pain with drugs and alcohol because it may lead to further problems.
 Do not expect yourself to “just get over it”. Give yourself time and space to grieve.
 Spend time with friends and family members who support you.
 Hold a private ceremony or have a personal ritual each year on your child’s birthday.
 You may want to look at the momentos if you have them: pictures, hand/foot prints, blankets, and
keepsakes.
 Set realistic goals for yourself, some that are easily within reach and some that will be more challenging.
Working towards your goals helps you to move ahead.
 As you heal, share your experiences. You can help others.
 Give yourself time before considering getting pregnant again. It may be difficult to say hello to your next
baby until you have said goodbye to this baby, and saying goodbye takes time.
 Get lots of rest.
Maternal Mental Health
Being aware of your mental health following your pregnancy loss is important. According to MotherFirst
(2010) Saskatchewan’s Maternal Mental Health strategy, 20% of women may have severe depression or
anxiety with pregnancy or childbirth.
The “Blues”
After giving birth, there is a change in your hormones. This can contribute to feelings of sadness, crying, mood
swings, and anxiety. Although, you may be sad with grief of your loss some of the changes can be part of the
body’s change in hormones. You may feel tired and unable to think clearly. Your feelings of grief and sadness
caused by the loss of your baby cannot be diminished or expected to pass however, even as your hormones
normalize.
Depression
Although depression is an expected part of the grieving process, it is important to recognize that women who
experience a pregnancy loss are also at risk for postpartum depression. Postpartum depression is more serious
than the “blues” or the depression you may feel as you grieve. It is considered an emotional illness. Postpartum
depression after the loss of a baby is more complicated by the fact that, in addition to the normal postpartum
changes, you are faced with a devastating loss.
Postpartum depression can start right after the birth and up to one year following. It can affect you in many
different ways. Feeling tired and listless, having sleeping problems, always eating or not eating at all, losing
interest in the things you used to enjoy, and feeling sad and hopeless are all parts of depression. Experiencing
anxiety can also be a symptom of depression.
Women with postpartum depression feel lost and anxious - like they cannot cope. They have trouble sleeping
and eating. They feel overwhelmed with guilt, shame, isolation, fatigue, and a sense of loss. They may have
very scary thoughts.
If you think you have postpartum depression, you are not alone and you can get better. Postpartum depression
can have negative effects on you and your family. Talk to your partner and your friends about how you are
feeling. Remember – postpartum depression is common and can be treated. Some women may need medical
treatment. There are various, helpful ways to treat postpartum depression.
If you feel you are not coping well and/or thinking of hurting yourself, or others call your health care provider.
Postpartum depression can be treated. The most important thing is to seek help.
Anxiety
Anxiety can occur during pregnancy and following a loss. Women may experience feelings of worry,
irritability, or restlessness. The symptoms may also be physical with tiredness, headaches, or muscle tension.
It is important to surround yourself with support. For more information on postpartum support call:
YMCA - Postpartum Support Group
2400 - 13th Avenue, Regina
(306) 757- 9622 ext. 242
Reaction of Friends and Family
Your friends and relatives have emotions surrounding the death of your baby. If the important people in your
life are supportive, spend time with them. Being with people who care about you can be very helpful at this
time. They want to extend their sympathy and comfort you. Do not be surprised to find a wide variety of
reactions from friends and loved ones. Even though others mean well, they may not know how to express their
concern and care. Some of your close friends may avoid you, or if they do see you, they may never mention
the loss of your baby. Sometimes their own discomfort causes people to make insensitive remarks. They are
trying to help, but may not know what to say. If this happens it may be helpful to share your feelings about
these remarks with someone who cares about you and who you trust.
As time goes by, you may find that your grief is forgotten by others. Friends and loved ones become involved
in their own lives, and often do not realize your continued need for support. Do not be afraid to ask others for
help. Your friends and loved ones cannot read your mind. Tell others what you need so that they can help and
support you.
Another Pregnancy
In the future, if you start to consider getting pregnant again, you may receive advice from friends, family, or
health care providers. Only you can make the decision and know when the time is right. Here are some general
guidelines may be helpful in your decision making process:
There are 4 main areas to consider:
1. Take time to recover from your current pregnancy. Let your body return to its non-pregnant state. Taking
care of your physical well-being will support your recovery.
2. Take time for emotional healing and grieve your loss. The information in this booklet helps you
understand your feelings over the next few months. It helps you to understand that being pregnant and
grieving at the same time can be very stressful.
3. Take time to seek medical advice. Do not be afraid to ask your healthcare provider.
4. Put off making major decisions. You will be more satisfied with your decisions if you wait until you feel
that your thoughts and emotions have begun to stabilize.
Postpartum
There are different services that provide support for you after the delivery. The Regina Qu’Appelle Health
Region (RQHR) has the Maternity Visiting Program and Population and Public Health Services which
provide follow up telephone calls and care at home for families in and around Regina. Outside of the RQHR
Public Health or the nurses within the community health centre are available to talk to you about your health
and wellbeing.
During your telephone call or home visit, your nurse provides you with health information, and answers any
questions that you may have. Your nurse checks your physical and emotional recovery. This nurse is available
5 days a week, excluding statutory holidays from 8:00 a.m. to 4:45 p.m.
If you require additional information refer to the Community Resource and Websites at the back of this booklet for contact information.
Your health care provider checks that your:
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Physical healing progress has been normal.
Uterus is returning to normal size.
Surgical incisions or tears are healing.
Breasts are healthy.
Your health care provider may:
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Go over the details of your pregnancy. Reports should be available for review and may give you more
information.
Help you select the most suitable method of birth control.
Ensure that you have started the normal grief process. If the process has been delayed, your health care
provider can assist you.
Warning Signs After Delivery
If you have any questions or think you may require medical attention, you can call Healthline at 811 or go to
the nearest emergency.
If you get 1 or more of these symptoms after you are discharged from hospital, call your health care provider
right away or go to the Emergency Department:
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fever over 38.5° C or 101.3° F
sudden, very heavy bleeding or discharge, soaking more than 1 pad in an hour, and/or clots bigger than a
toonie
you cannot catch your breath for any clear reason
fainting or dizziness
painful, reddened breasts and flu like aches, fever, and chills
vaginal discharge that smells bad
burning, stinging or difficulties when you urinate
vaginal bleeding that lasts longer than 6 weeks
red, uncomfortable, or swollen legs
headaches
problems seeing, such as blurred vision or spots in front of your eyes
a caesarean incision that is hot and swollen or that becomes more painful, reddened, separates, or starts to
drain
an increase in pain around your vagina, perineum, or lower stomach
bad cramps or a sore abdomen that never goes away
not coping well and thinking of hurting yourself or others.
After Care and Healing
Vaginal Bleeding
After delivery, bleeding and discharge from the vagina is normal. It is usually small to moderate in amount
and can last for 2 to 6 weeks.
Do not use tampons during this time. Change your pad frequently.
In the first 3 days your bleeding is bright to dark red. You may notice that your flow increases when you
stand up or increase activity. You may pass small loonie-sized blood clots during this time. As your uterus
heals, the colour of your flow changes to pink or brown tinged and become lighter.
Vaginal Discomfort and Perineal Care
The perineum is the part of your body between your vagina and your bum. After a vaginal birth, your
perineum and vagina may be sore, bruised and swollen. The perineum may have torn or been cut by your
doctor during the delivery. When the doctor has stitched the tear or cut, the stitches may be painful at first,
but will dissolve within a few weeks.
Perineal Care means rinsing your perineum with clean, warm water every time you urinate, have a bowel
movement, or change your pad. Continue this routine until your bleeding stops or your perineum has healed.
To clean the area, use the plastic squirt bottle you got in the hospital, or take a bath in a clean tub.
For Pain or Discomfort:
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Cool the area with crushed ice. This helps to reduce swelling and gives you some short-term relief.
Never put ice directly against the skin. Place the ice in a towel then place the towel against the skin.
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Soak in a warm bath daily.
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Use pain-relief medication as needed.
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Sit on a soft cushion.
Recovering From a Cesarean Section Surgery
As well as recovering from childbirth, women who have had a surgery recover in additional ways.
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You will have some pain from the surgical incision. Your doctor may recommend medication to help
with this pain.
Stitches dissolve and do not need to be removed unless ordered by your doctor.
You may have steri-strips or small plastic tapes on your incision. Leave them alone and let them fall off
on their own.
Keep the area clean and dry. Wash the area gently in the shower and pat dry. You can bathe in the tub
again when the surgical incision is healed.
Do not lift anything heavier than 10 pounds (4.5 kg) for 6 weeks.
Check your surgical incision for any openings, redness, swelling, drainage, or pain. Talk to your health
care provider if you have any of these symptoms or if you have a fever.
Ask your health care provider about the best way to return to regular exercise.
After Pains
After pains are cramp-like pains felt in the abdomen. These cramps are the result of the uterus returning to its
normal size. They are more common and often more painful for women who have had previous pregnancies.
After-pains should go away in 4 to 7 days. Talk to your health care provider if you need some medication to
help with the pain.
Return of Your Period
It is hard to predict exactly when you will get your period back. Your first period may be heavier and last
longer than normal, and there may be some clots. Periods may be irregular for a few months as your body gets
back to normal.
Urinating
For the first 24 hours after birth, women may find it difficult to urinate or feel stinging when they urinate.
Some women cannot tell when their bladder is full. It may help to rinse your perineum with warm water while
you urinate.
It is important for women to urinate often – about every 2 to 3 hours. This helps prevent infection and reduces
bleeding problems. It is normal to urinate large amounts as your body gets rid of extra fluids.
You may experience some leakage of urine for a few weeks or months after delivery. A cough, sneeze, or
laugh can cause may cause this to happen. For most women, this gets better. You can help to control urine
leakage by doing Kegel exercises.
Bowel Movements
You may not have a bowel movement (BM) for up to 3 days after the birth. You may be anxious about this
process, especially if you have stiches, but your stitches will not break. If you have stitches, you may find it
comforting to support the area with a cool, clean, wet sanitary pad while having a BM.
To help promote regular BMs:
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Drink lots of fluids.
Get some exercise.
Eat foods with lots of fibre – fruit, vegetables, cereal, and whole grains.
If the above suggestions do not work, talk to your pharmacist about using stool softeners that can be bought at
the drug store.
Breasts
Depending on your stage in pregnancy there will be differences in your breasts, in early pregnancy there is
generally not significant changes but in later pregnancy you may notice differences. A few days after delivery, you may notice that your breasts become heavy, swollen, and tender.
Do not express any milk or pump your breasts. This causes your breasts to produce more milk. The milk in
your breasts is reabsorbed by your body and the fullness decreases in 3 to 5 days. To relieve discomfort, you
may find it helpful to wrap an ice pack in a cloth and apply it to your breasts. Wear a proper fitting bra without under wire. Limiting your fluid intake does not slow down the milk production any faster.
Hemorrhoids
Hemorrhoids are swollen veins that bulge out of your bum. Pregnancy, pressure from the delivery, and
constipation may cause them. They are often itchy, painful, and sometimes they bleed. Hemorrhoids usually
shrink and disappear a few weeks after the birth. They may come back from time to time.
To get relief from your hemorrhoid discomfort:
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Perform good perineal care.
Sit or soak in a warm bath tub.
Apply hemorrhoid cream to the area. Talk to your pharmacist about using hemorrhoid medications that can
be bought at the drug store.
Rest on your side when possible. Do not sit or stand for long periods of time.
Follow the guidelines above to promote regular, soft BM’s. Avoid straining when having a BM.
Talk with your health care provider if you do not get relief.
Sex and Birth Control
You can have sex again when you are physically healed and emotionally ready. Grieving the loss of your baby
can affect your readiness. It is important that you talk about sex and birth control with your partner. Talk with
your health care provider if you have questions.
Please refer to CEAC 1198 Contraception Methods for more information on birth control.
Health and Wellness
Nutrition
It is important to eat well. The right food choices give you energy, prevent constipation, and help you maintain
good health.
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Follow “Eating Well with Canada’s Food Guide”.
Drink 6 to 8 glasses (250 mL or 8 oz) of fluid every day.
After delivery it takes time for your body to return to its pre-pregnancy weight. Healthy eating combined with
regular activity helps you lose extra weight.
Rest and Sleep
Rest is important for a woman’s physical health and emotional wellbeing. Your body needs rest and proper
care to restore strength and energy.
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Rest as much as possible.
Accept help from others and ask for help when you need it.
Let unimportant household tasks wait.
Try not to take on extra tasks.
Exercise - Basic Guidelines
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Exercise to help reduce stress, to have more energy, and to feel better.
Exercise to tone your muscles and promote healing.
Make regular exercise a part of your life. Walking is a great way to exercise. Start out slowly and increase
the length of your walks as you regain your energy.
Ask your health care provider about the best way to get back to regular exercise. Stay away from heavy
exercise until 6 weeks after the birth.
All women should do pelvic floor exercises called Kegel exercises every day throughout life, but after delivery
it is especially important. Vaginal delivery stretches perineal muscles and pelvic floor muscles can stretch,
weaken and tear. Regaining the strength of the pelvic floor muscles is important for bladder and bowel control
and for support of the pelvic organs. Kegel exercises help heal these muscles and make them strong again.
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Lie, sit, or stand.
Tighten the muscles of your perineum - imagine you are urinate and you try to stop the flow.
Hold for 3 to 5 seconds. Relax.
Work up to doing these 5 times in a row, 3 times a day.
Where to Find Help
Getting your life back in order after your loss is not easy. You may be overwhelmed with the physical and
emotional reactions you have experienced. You may lack the motivation it takes to work through your grief or
you just might not know where to start. You are not alone. There are professional people available to help you
understand and cope with your feelings. See below for a list of community resources and websites.
Community Resources and Websites
Bereavement / Loss Supports
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Regina Qu’Appelle Health Region Bearing Loss Program
(306) 766-2384 Bereavement Coordinator
Bearing Loss is a support group for families grieving perinatal loss. This group is for parents who have
experienced pregnancy loss in any form: miscarriage, ectopic pregnancy, termination, still birth, or
neonatal death.
www.rqhealth.ca/womens-and-childrens-health/bearing-loss-support-group
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The Compassionate Friends
(306) 761-0974
A non-profit, non-denominational, self-help organization, offering friendship, understanding, grief
education and HOPE for the future to all families who have experienced the death of a child at any age,
from any cause.
www.tcfcanada.net/chapters/saskatchewan
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Greystone Bereavement Centre
(306) 523-2781
Provide grief and bereavement services in a safe environment for people to share in the experience of
journeying through their grief. www.rpci.org/greystone-bereavement-centre
Crisis Services/Emergency Numbers
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Family Services Regina
(306) 757-6675
Working with individuals, families and communities in all their forms, who are currently in distress or at
risk.
http://familyserviceregina.com/
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Mobile Crisis Service
(306) 757-0127
Professional Crisis Counselors are available to help you with any problem that you are having difficulty
coping with. People of all ages are welcome to call from youth to seniors. Crisis Counselors will listen,
provide support, direction and help you get connected to community resources. Offers 24-hour assistance.
www.mobilecrisis.ca
Family Planning
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Planned Parenthood
(306) 522-0902 1431 Victoria Ave, Regina
For birth control, family planning information.
www.plannedparenthoodregina.com
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Regina Crisis Suicide Line
(306) 525-5333
If you are considering suicide or know someone who is, immediate help is available. Any talk of suicide
should be taken seriously as this is a cry for help. If you are suicidal, call and give yourself the opportunity
to see what help is available. Offers 24-hour assistance.
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Sexuality and U
(The Society of Obstetricians and Gynecologists of Canada)
Information about birth control, sexually transmitted infections, and sexual health.
www.sexualityandu.ca
Health Services
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Health Canada Food and Nutrition
Eating Well with Canada’s Food Guide
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/myguide-monguide/index-eng.php
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HealthLine 811
24-hour professional health advice and information line:
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RQHR Public Health Services
Regina and Rural Public Health Services…………….(306) 766-7500
Four Directions Health Centre.………………............ (306) 766-7540
Mental Health Services/ Postpartum
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The Caring Place (Regina)
(306) 347-2273
Offers counselling for parenting, marriage, addictions, depression, low self-esteem, stress, and abuse.
www.thecaringplace.ca
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Employee Family Assistance Programs (EFAP)
Offers counselling services through your employer. Ask about this at your workplace.
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Regina Qu’Appelle Health Region Mental Health Clinic
(306) 766-7800
Counselling is available for adults who are experiencing distress.
http://www.rqhealth.ca/mental-health-and-addictions/adult-mental-health-clinics
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Women of the Dawn Counselling Centre
(306) 522-6040
Offers postpartum counseling for First Nations women.
www.reginacity.com/fnac/contact.htm
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Regina Qu’Appelle Health Region Al Ritchie Health Action Centre
The Al Ritchie Health Action Centre is a community health centre within the RQHR. They provide
various programs to underserved and vulnerable population.
Offers community services, as well as health promotion and prevention.
(306) 766-7660
www.rqhealth.ca/facilities/al-ritchie-health-action-centre
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Catholic Family Services Regina
(306) 525-0521
Offers counselling services and parenting classes.
www.cfsregina.ca
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Regina Qu’Appelle Health Region Four Directions Community Health Centre
The goals of Four Directions is to support community residents, particularly Aboriginal people, in taking
greater control over their own health, and in striving for balance of their physical, emotional, mental and
spiritual well-being. They address personal needs and the cultural, social and economic realities that
determine health with a collaborative relationship with community individuals, groups, and various
agencies.
Offers supportive and nurturing health services; working with the changing needs of a diverse population
to achieve health and wellness for individuals, families and the community.
(306) 766-7540
http://www.rqhealth.ca/facilities/four-directions-community-health-centre
Other Resources
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Health Care Provider
If you require health care services or are feeling depressed, talk to your family doctor or other health care
provider.
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Regina Qu’Appelle Health Region Medical Social Worker
(306) 766– 4444 ask for the social work on call
A social worker, psychologist, and/or family counselor may be helpful if you feel the need for additional
counselling. The medical social worker can refer you to one of these professionals in the community and
provide information about groups that can help you.
CEAC 0732
April 2017