Late-term miscarriages - in the
second trimester, and before the 24-week mark - are one of the most
heart-rending experiences a pregnant woman can endure. While most miscarriages
occur in the first trimester when the fetus is less than a couple of inches
big, the words "late-term miscarriage" don't quite capture the
gravity of the upset.
The woman has to undergo the labor process and once
delivered the baby can be buried but, despite this, the law does not recognize
it as having existed: No birth certificate, no official record of life. If a
baby dies after 24 weeks, it is called a ‘stillbirth’ because the baby has
reached the legal age of viability (the period where a baby is deemed capable
of surviving outside of the womb) and its status changes. One woman opened up
to The Independent about the emotional turmoil a late-term miscarriage caused
and the difficulty of coping with the legal status of her dead babies. Rachel
Corry, a psychologist from Sale in Greater Manchester, lost twin boys at 23 ½
weeks in a late-term miscarriage.
Already a mother of one to 3 ½ year old Adam
– who was born overdue without any complications – Rachel and her partner Steve
Wilson discovered (surprisingly) that she was pregnant with twins after having
an early miscarriage a couple of months before. Though the 20 week scan showed
all was fine and revealed the sex of the twins, at 22 weeks and three days she
noticed spotting. Doctors discovered her cervix was opening and that she could
go into labor at any time, she was scanned and they determined the babies would
probably not survive. Rachel, 42, delivered the first twin on 22 June 2013:
“Even though it’s not what you want to be doing I was having to push him out, I
had no contractions which was very difficult.
I could still feel him moving
around inside me right until the waters went just before he was born and then,
of course, there was no movement at all, he could not survive outside of the
waters,” she told The Independent. Because Rachel was in labor before the 24-week
mark, the neo-natal doctors said they would not be at the birth to intervene.
“I was on my own if you like (with the midwives), they didn’t have any
confidence they would survive.” The second baby was born two days later – where
the neonatal staff did stand by just in case as he was on the cusp of being
born at the 23-week mark. This was really difficult because they were saying to
me the first child wasn’t worth intervening for but the second one, if he makes
it to the following day, they will be there just in case…
I understand there is
a cut off but when you have the same woman and the same pregnancy, it was
really tough.” The second twin was born on at 22 weeks and six days but “didn’t
stand a chance either,” according to Rachel who says the babies looked “perfect
and tiny” with heads the size of tennis balls. “If we’d made it eight or nine
days later it would have been a stillbirth and that’s really tricky… When you
have delivered, them they are your children but there is no legal recognition
they ever existed. That’s really difficult.” Rachel and Steve decided on a
burial where they could get a stone engraved because then there would be a
record of them. “Legally they had never
existed but if there was a stone with their names it felt like they did,” she
says. They had a funeral two weeks after their death just for she and her
husband: “Planning a funeral is horrendous because you have no happy memories
to discuss, it’s awful. You’re thinking about what would have been rather than
what has been.” If you don’t make it to 24 weeks, you don’t get any maternity
pay. Some companies might provide sick pay but “it’s not like being ill and
getting better. It is something that takes such a long time to get your head
around.
That’s without telling people or bumping into people in the street who
ask how far you are getting on”. Rachel and Steve had already started
construction on an extension onto their home after deciding they needed to
enlarge their home upon discovering they were having twins. We came home to a
building site with no kitchen” Rachel says. “It felt like it was all for
nothing.”Given the perceived safety in waiting until after the 12-week mark to
tell people and start preparing, and given Rachel’s experience of a relatively
straightforward pregnancy with Adam, she told her friends and employer, bought
clothes and even a pram for the anticipation of the twins, like most expectant
parents would have. “You come home [from
the hospital] and your faced with all those things,” Rachel says. “I think it
took us 18 months to get rid of the pram just because I couldn’t bring myself
to get rid of it. Also, I think I hoped that we would get pregnant again with
another baby and I think in my mind I thought ‘it can only be twins because
that’s the fair thing’.” After the babies died, Rachel had another two early
miscarriages which is when she finally got rid of the pram. “I held it together
for a week, then various people came round – whether we wanted them to or not –
and then I hit rock bottom.
I felt like I wanted to die.” Rachel took herself
to the doctor where she was prescribed some medication. “That was the lowest I
got,” she says. “I don’t think I ever thought ‘why me?’ because why not me?”
she says. Throughout her grief, Rachel
experienced “deep sadness” at seeing heavily pregnant women which she describes
as a form of jealousy after she never made it that far along as well as
starting noticing twins everywhere she went. Another side of the cruel grieving
process left Rachel feeling guilty, firstly about initially being shocked and
anxious when learning she was carrying twins and then questioning whether she
did something to blame for the miscarriage. “I was also racking my brains
thinking ‘What did I do wrong that caused them to come early?’ The day before I
went for a walk and I think did that cause a problem?’ The things that go
through your mind of what could I do to prevent it?’” Rachel’s doctors never
found a reason as to why the twins did not survive. There can be many reasons
for a later term miscarriage including chromosomal or genetic issues,
structural problems, infections, blood clots or underlying health issues but as
with all miscarriages and stillbirths there is sometimes just no explanation,
according to the charity Tommy’s which funds research into pregnancy problems.
To help deal with the grief, Rachel and Steve attended support groups and also
made a commitment to talk about her grief “whenever possible” which she says
helps. “I feel like I’m doing [the
twins] a disservice if I don’t mention them,” she reflects.
It was lucky Rachel
and Steve could access these support groups. A spokesperson for Tommy’s told
The Independent late miscarriages are often not well supported. “I think late miscarriage is perhaps not well
supported. Until the 24 weeks’ deadline the fetus/baby is not eligible for a
birth certificate and this can have a big effect on parents. Sometimes the
hospital will issue a certificate but it is not a legal document. Funeral
arrangements will be discussed but of course this can be very difficult.
“Emotional and physical recovery can take time. By this, I mean many weeks or
months and in our society after the initial event parents can be left with very
few places to go for support. Very often there are no answers and this can
increase the distress.” In 2014, Rachel fell pregnant once more. Closely
monitored throughout her pregnancy at Wit Hens-haw hospital, at 21 weeks she was
admitted to hospital when it looked like her cervix could open again. Resting
on a downward bed to “keep gravity on our side”, she spent four weeks on the
ward before giving birth to their son Hugo at 24 weeks and six days. He was
admitted to the neonatal unit at St Mary’s hospital in Manchester, where he
stayed for seven months and underwent heart and bowel surgery, before they
could take him home. He is now a healthy and happy 18-month-old boy. While seeing,
your young baby wired up on a neonatal unit for such a long time is difficult
for any parent. Rachel says that being acutely aware of “what the alternative
was”, she was not as traumatized by Hugo's ordeal as one might expect. “The other two never made it that far so I
thought, ‘well as long as he’s here’.
That was my perspective,” she says. Each
year Rachel’s family commemorate the twin's birthdays by organizing an activity
or trip away. When people ask how many children she has, she says four. “I say,
‘I have a little boy who is six and a half, we had twins who died and then we
have Hugo.' That is the way I deal with it… it feels wrong to deny them.”
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