A stillbirth is defined as; ‘a fetal death prior to birth of a baby born at 20 weeks’ gestation or more, and/or weighing 400 grams or more. This is the standard definition used for stillbirths in Australia’.
Stillbirth in Australia
The incidence of stillbirths in Australia is between 6.7 and 7.7 per 1000 births (between 2003-2021). This sadly translates to 6 babies delivered stillborn each day in Australia.
Real Men’s Health is giving voice to men who have experienced emotional and psychological distress during or following a pregnancy. The experiences of men following a stillbirth is largely unexplored and rarely discussed.
Content warning– the information discussed within this article is highly descriptive and may cause distress in people who have experienced a stillbirth.
Men & Stillbirth research study
Research exploring the experiences of fathers following a stillbirth were published in the Journal of Reproductive and Infant Psychology.
In this study, 30 men were interviewed, with most of the men sharing their story for the first time. The specifics of these 30 men were as follows,
- Median age of 39.9 years age
- 29 were married
- The pregnancy week of loss was between 22-40 weeks’ gestation.
- The time (of these interviews) from loss was varied, less than 1 year (23%), 1-2 years (23%), 2-5 years (27%) and greater than 5 years from loss (27%).
During the five months of interviews with these men, 4 major themes emerged which are discussed here. All quotes have been taken verbatim from the original study.
Theme 1: Men’ s emotional distress & perceived hierarchy of loss.
These men described their loss in terms of ‘trauma’ and of ‘being post traumatic’. Most described flashbacks of these traumatic feelings, sometimes when seeing a pregnant women or a child in a stroller.
The absence of personal acknowledgement by hospital staff was frequently reported, as one man explained,
‘I called the social worker to speak with us; I felt we needed her help to adjust. She came, and we started walking towards the room [where my wife was, and she left me standing out in the hospital hallway. Of all the things we’d been through, this was the most annoying, upsetting and humiliating experience. I felt left out, isolated and irrelevant’.
The majority of men acknowledged that their partners experience was ‘more profound then their own’,
“My wife really did experience a greater trauma than I had, because for her it was also physical. It wasn’t only the delivery itself . . . her trauma was bigger”
Theme 2: Men’s role as supporters
Initial support within the hospital setting was often found lacking for the fathers involved. A lack of empathy and acknowledgment was mentioned by many of the men interviewed,
“At the hospital, they don’t look at the fathers at all, they see you merely as the patient’s companion”.
Men often assumed the role of ‘supporter’ often at the exclusion of acknowledging their own trauma in the moment. Confounding this situation was the expectations of others on how the men ought to perform the supporter role,
“Everyone said I need to take care of her [my wife], and that in fact she is the one facing a crisis . . . and I was marginalised. People were taking me aside and saying: “You need to take care of her . . . and be there for her”. I didn’t know what to do; just like she didn’t know what to do”.
Responsibilities as the primary supporter extended to informing close friends and relatives of the baby’s death and also attending to hospital administrative tasks which were often traumatic,
“I was sent to bring the pathology report. Obviously, they didn’t ask the physicians to get it and explain it to us. I opened it up and realised that our daughter had been cut into pieces . . . that were weighed one by one . . . do you really give such a document to the parents to read?”
Theme 3: Perceived lack of support from parents and family
Most men described how a distinct lack of support from friends and importantly; family members, produced deep disappointment and loneliness,
“Just after the delivery, my brother texted me. He wrote “this is the time to acknowledge what you have, and to move forward”. The (dead) newborn was still in my arms when he texted me! Why would someone say such a thing?! While I was still holding my dead baby?”.
Another man described the hurt he felt when discussing his parents’ reaction,
“I used to think that whenever we’d need support, we’d always have our parents. . .[But] they were unable to understand, there was tension between us. I really wanted my parents to feel like they had lost a grandchild . . . that the anniversary of the loss would be a day they would remember, but they showed no empathy. Come to visit! Show some recognition of our loss! That’s all we need”.
Many men in this study (19 out of 30) returned to paid employment early following their loss. For some men, work colleagues were significant in their support,
“All I remember from that time is my workplace and my boss. . . I will never forget how attentive and thoughtful they were. I remember one of the moments that moved me the most that month when I stayed home with [my wife] . . . [My boss] called me and said he would pay me a full salary, for the whole month, and that I should be calm and be with my wife as much as we needed. When I talk about it now, it makes me cry more than anything else. It is so simple and moving. That is the workplace and that boss I cherish most – on an emotional and social level’
Theme 4: Perceived lack of recognition from society & healthcare personnel.
In total, 28 of the 30 men in this study reported they received ‘no support or too little support regarding their grief’.
The fathers stated that they wished healthcare services had reached out and offered counselling and support. Five men stated that hospital staff had personally contacted them, however in most cases it was to enquire only of the partner.
“’I wanted attention. It may sound childish, but I felt that all the attention was given to [my wife][. . .] I understand that dealing with the fathers is a great effort, but I think it should be an integral part of the process – to give me a call and ask me how I’m doing, and not only how [my wife] is doing. This happened so many times’.
In only 2 cases, were positive experiences of empathy from hospital staff reported. In these situations, the acknowledgment from clinicians about the individual grief experienced was profound,
“After the birth, the male midwife came and hugged me, and I felt so grateful. I didn’t feel transparent or like a fly on the wall. I was being noticed”.
Societal recognition was also seen as a foundational need for these fathers,
“I needed the recognition. At the cemetery, someone addressed me as “the father”. He said that the decision regarding what to call the baby was mine . . . and that [recognition] was all I needed”.
Men & Stillbirth research conclusions
The researchers concluded their research into the lived experiences of men following stillbirth by stating, ‘most participants mentioned a lack of formal support and recognition of their pain, agony and lost fatherhood from hospital personnel and from their parents, family, friends and work colleagues’.
They recommended that ‘clinicians provide them with guidance about the legitimacy to grieve and to receive social support during bereavement, and to encourage them to spend more time with their partners and to engage in meaningful experiences’.
Expert Opinion: Associate Professor Sean Seeho, Chair, Stillbirth Foundation Australia, Specialist Obstetrician and Academic, University of Sydney
It is particularly saddening for me to hear the stories of fathers/partners who report that they received little to no support following the loss of their baby, especially from healthcare professionals. Following the loss of their baby, men experience significant and persistent grief. We know that the loss of a baby can be associated with self-blame for the baby’s death, stigma and misperceptions, and feelings of failure, shame, anger, guilt, and isolation. We also know the importance of acknowledging and validating differences in grieving between parents, which can greatly impact communication and relationships.
All fathers/partners need to be offered support immediately after the loss of their baby, and in the longer term. Thankfully, in Australia, there is a strong commitment to improving the care and support of fathers who have been impacted by the tragedy of stillbirth. The 2024 national Care Around Stillbirth and Neonatal Death guideline provides fantastic advice for healthcare professionals to support fathers, including the importance of acknowledging their experience of loss and their identity as a parent, and providing tailored support services including formal and informal support options and referral to parent support organisations as required. I am confident that efforts in Australia will make stories of men not being supported a thing of the past.
Support
If the conversations featured in this article have caused distress or triggered traumatic memories, please reach out to the MensLine (1300 78 99 78) or Beyond Blue (1300 22 4636).
SANDS/Red Nose provide support for parents, including fathers who have suffered the loss of a baby, please see https://rednosegriefandloss.org.au/fathers-of-loss>.
Stillbirth Foundation Australia founded in 2005, provides advocacy, education and research into stillbirths. They also have online resources for parents, family members and colleagues. https://stillbirthfoundation.org.au
Stillbirth Foundation Australia contains a baby registry where parents can mark the birth of their child and record their baby’s name and memory.
