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Sister to Sister (and Brother): Pregnancy & Newborn Loss

By Saraji Umm Zaid

The loss of a baby -- whether in the first trimester of gestation or minutes after birth -- is one of the hardest things that a human being can endure. In the United States, it's estimated that around 900,000 pregnancies end in miscarriage or stillbirth every year. That's around 20% of pregnancies each year, or one out of five. It's heart-breakingly common enough, but it's something that's rarely approached in the general society, let alone among Muslims.

So as Muslims, what do we do when faced with a pregnancy loss or the loss of a newborn child (or stillbirth)? How can mothers (and fathers) deal with their grief? How can Muslim friends and relatives approach the parents and offer support?

Many women and men find themselves feeling alone and without support after the loss of a pregnancy or newborn child. This is especially true when a child is lost in the first or second trimester, when the child was "real" only to the mother whose body was most affected and the father who saw the changes occurring day after day. It is common for the mother to feel the loss more acutely than the father, but that doesn't mean that fathers don't grieve as well.

American society in general does not deal well with death. We're a youth oriented, optimistic culture, notes Kim Kluger-Bell in her book Unspeakable Losses. People don't know how to deal with death, especially the death of a young one. Feeling awkward and uncomfortable, well meaning relatives and friends say things like, "It was for the best," or "You can always try again." Friends and relatives also tend to get impatient with those -- especially mothers -- who are viewed as mourning their loss "too long," and will urge them to "get over it." Some may unwittingly hurt the parents by saying things like "But it was a first trimester loss."

Questioning

It is also common for mothers to feel that something they did -- arguing with the husband, or going to work -- caused the miscarriage to happen. Although medical evidence shows otherwise (that there is almost nothing you can do to prevent the miscarriage), it's natural for mothers to feel that they did something wrong. After all, motherhood is about protecting and nurturing a child. Although it seems irrational, many women feel as though they or their bodies betrayed the child and harmed him or her.

For Muslims, these feelings of guilt, shame, and imposed silence can be compounded. Ignorance about scientific facts, coupled with Old World cultural superstitions means some people often place the "blame" for the miscarriage solely on the shoulders of the woman. "She should not have been working." "She should not have been walking." "If only she didn't argue with her husband." In addition, there is a significant amount of pressure on Muslim women to procreate, and "blame" for infertility and miscarriages are often heaped at the feet of the mother (even if the "fault" is with the father). Worse, the Gloom and Doom segment of the Muslim population will often come up with things like "If she was a better Muslim..." or "She's being punished by Allah for some reason." Subhan'Allah.

While it is true that we, as Muslims, view suffering as a purification and expiation for sins, it is beyond insensitive to suggest to a Muslim woman that the loss of her child was the result of her own past sins. Or that it was due to "weak iman." At the end of the day, says Hajj Gibril Haddad in his article about miscarriage, it's about the Qadr of Allah. Science shows that miscarriages are often due to genetic abnormalities, or illnesses or infections in the mother's body. However, the reason for almost 50% of miscarriages are unknown. As Muslims, the only thing we can say is that all 100% of them are due to the Qadr of Allah. There is nothing more fitting to say "Allahu 'Alim" or "God knows best" about than a miscarriage. The key task is to believe it -- that God Knows Best. It's important for you, the mother or father of a lost child, to internalize the reality that it is not your fault that the child is gone, and that his or her death is the Qadr of Allah. As Muslims, we need to strengthen our certainty and our feelings of reliance on God (tawassul) and our trust in His Judgement, even though it can be incredibly difficult at times like this.

Although Allah is strong enough to withstand our anger and questioning, it's important that you don't get mired down in questions of "Why me?" It's true that there are many women out there who do drugs and have healthy babies, who get pregnant from fornication and adultery, who neglect and abuse their children, who use abortion as a means of birth control, and so on. And it's natural to feel some anger and jealousy towards them. However, as a Muslim, you can not question the Qadr of Allah on this matter. He Knows Best, truly, why your child was destined for Jennah at such an early age while a crack addict bears healthy child after healthy child that she doesn't care for. As difficult as it can be, it's important for you to focus on your own situation and your own soul. I especially recommend that you read the article by our esteemed teacher, Hajj Gibril Haddad, about pregnancy loss, which includes many ayat and hadith about patience, qadr, and the fate of the lost child.

Grieving

A major struggle for Muslim moms and dads is to deal with the grief and mourn without going to extremes. It's natural to cry, not shameful. The Prophet (peace be upon him) cried when his children, including the infant Ibrahim, died. Islamic law says that children who died after 4 mos gestation (16 weeks), or were stillborn should be buried. However, we only pray Janaza for children who lived outside of the womb. It is permissible to put up a headstone at your child's gravesite, so that you and your relatives will know where to go to pray for him or her. It is permissible for you to name your child, in honor of him or her being a child of Adam (peace be upon him) (although some people discourage this). If it helps you deal with the loss of your child, take on the kunya of this lost one -- Abu so and so or Umm so and so. For other mothers and fathers, it may be too painful to name the child or carry a kunya in his or her honor.

It's okay if you want to talk about your loss and your feelings surrounding it with a sympathetic friend or relative. Keeping a journal of your feelings might also be helpful. Another suggestion is to write a letter or poem to your lost child. You can then keep it, burn it, bury it, toss it out to sea, or do whatever feels right with it. You can also plant a tree or flower bush or something else in honor of your child, or as a personal remembrance of the child. If you find that your husband, friends, and / or family are unable or unwilling to listen to you, seek out a counselor or therapist through your midwife or physician.

Some hospitals will offer parents of children lost in the second or third trimester, or after birth, the opportunity to hold and photograph your child. Many therapists, doctors, and psychologists do recommend that the mother and father hold the child and say good-bye to him or her, as a means of achieving a sense of closure. You might also experience a great deal of guilt and regret and an additional feeling of loss later on if you do not. Trust yourself -- you know what you can and can not tolerate.

It's natural to feel depressed after the loss of a child. Nightmares and insomnia are two common reactions to the loss of a child. Although it might be tempting, try to avoid using pain killers and sleep medications to deal with the emotional pain and turmoil you're feeling. These things could lead to greater troubles down the road. If you feel that your depression is affecting your ability to sleep, eat, or do regular physical activity, or if you are having suicidal thoughts or planning a suicide, please call your physician / midwife or contact a post-partum depression group for help.

It is also normal and acceptable for some parents to not feel a great deal of grief or go through a mourning process, especially if it was a first trimester loss. It does not mean that you are a cruel and uncaring person. For whatever reason, some men and women are simply able to pick up their lives where they left off, and do not have to struggle with prolonged grief and / or depression. Just be sure that you have truly dealt with the loss emotionally and spiritually, in order to prevent suppressed grief from coming back to haunt you in a subsequent pregnancy or crisis.

Healing

After a miscarriage or newborn loss, you should not feel pressured to get "back into the swing of things" in order to prove that you're "over it." At the same time, you should not let yourself get swallowed up in grief and mourning. Try to establish a routine of sorts -- get out of bed, and get dressed. Take care of yourself, and of your body. Make sure you're drinking plenty of water and eating good things like fruits and fresh vegetables. Sleep when your body tells you to. Go out for walks or long drives if it makes you feel better. Your doctor will tell you what you can and can't do (physically) afterwards. Don't feel obligated to attend baby showers or 'aqiqas just because people tell you you should. Again, you know what you can and can not handle. The sight of people happily preparing for or welcoming a newborn may be too much for you to tolerate, especially if your loss was relatively recent.

Look to the Qur'an, especially Surat al Rahman, for guidance and comfort. Increase your dhikr and du'a, especially if you're not praying salah because of bleeding. It is said that Allah Loves to hear His servants calling upon Him. Putting a regular dhikr or wird (litany) in your schedule when you're not praying (and when you are) will help you maintain a sense of balance and purpose in the day.

Many, many Muslims find a great deal of comfort in Islamic teachings on the loss of a child. We believe that a child lost before the age of accountability goes to Jennah (Heaven). There are numerous hadiths of the Prophet (peace be upon him) confirming this. The Prophet (peace be upon him) also gave us the comforting news that the stillborn or miscarried child will be the one to bring his or her parents into Jennah. Although it often sounds trite and insensitive to say that the child's "in a better place," as Muslims, we struggle to detach from the dunya (earthly life) and try to focus on the akhira. For reasons that will remain unknown to you in this life, Allah Wrote that your child would be one of these blessed children. It can be a struggle to find the good in this at first, but you may find that it becomes a source of comfort and happiness for you later on.

Husbands and Wives: Healing Together and Apart

Miscarriages, stillbirths, and the death of a newborn child can put untold strain on a marriage, especially if it was already troubled. They can also bring a couple closer together than they have ever been. The crisis of a miscarriage, stillbirth, or infant loss is one that couples often experience together in the hospital. It's when you get home that many husbands and wives feel alienated and awkward with one another.

Wives, if you feel that your husband isn't responding to your grief, or if it seems to you that he is not grieving, keep in mind that our American culture and Muslim mores often encourage men to be outwardly strong. American culture in particular pressures men to keep their emotions, especially sadness and grief, hidden from anyone else. It may be that your husband feels that the best way to support and protect you is to be the one to deal with the insurance company, the doctors, the funeral directors, and so on. It may be that he feels that if you see him angry, upset, or crying, you will feel let down or guilty. If you feel that your husband is not dealing with his grief and / or that it is interfering with his practice of Islam, encourage him to talk to you, or to a trustworthy male relative or friend. Some men will find relief and comfort knowing that other men have also experienced the loss of a child, and in knowing that it is not an uncommon event. It's important for men to know that they did not fail in their duty as the protector of their wife and child, but to rely on Allah and trust in His Judgement.

Husbands, you may find yourself bewildered and confused by your wife's reactions to the loss. Because your wife was physically and emotionally closer to the child than you were, her reactions will likely be much stronger than yours. It's important to be a source of strength and support for her. Hold her when she cries, and listen to her when she wants to talk. In the first weeks, she may be physically, mentally, and / or emotionally unable to clean the house, cook, or take care of other children. Go easy on her. If you think that getting her back into her normal routine will help her heal, then by all means encourage her to do her everyday tasks, just don't push her. She may find it helpful if you set up a list of tasks for her to accomplish, even if it is only one or two things a day. It's important for you to let her know that the loss of the child does not mean she is a failure as a wife, mother, or woman. If your parents or hers have a particularly "old world" mentality, it's important for you to take them aside and talk to them about not pressuring her to have another child right away, or placing guilt and blame upon her for the loss of the child. If, after a period of several weeks or a month, you find that your wife's grief is interfering with her ability to perform everyday activities, contact her midwife or physician for help.

In the first few weeks after a miscarriage, stillbirth, or loss of a newborn, you may find yourselves physically or emotionally unable to engage in intimacy. This feeling can be greater if the loss of the child occurred shortly after intercourse. Some women (and men) feel guilty experiencing any happiness or pleasure knowing that their child has died. Other couples find that intimacy after a tragedy is a way of sharing their love and comfort for one another. You should not engage in intercourse while the woman is still bleeding, and until her midwife or doctor says it is okay. Follow the your caregiver's directions on this matter, as intercourse before healing can cause painful cramping and infection.

Trying Again

It's important for you to follow your midwife or doctor's instructions when it comes to trying to conceive after the loss of a child. If this was a recurrent miscarriage (second time or more), you may be encouraged to go through genetic counseling and testing, to determine if a biological or genetic factor played a part in the loss of the children.

Healthcare providers generally recommend that you wait one to three cycles before trying to conceive again. This gives your uterus time to heal, and gives your body time to re-establish normal cycles of ovulation and menstruation. Don't feel pressured by parents (in law or otherwise), or the community to try and conceive right away, especially if your physician doesn't recommend it. Your uterus and body will need time to heal just as your heart, mind, and soul do.

You may find that you feel jealous or angry when you see other sisters (or women in general) with babies, and this is natural. You may find that you are unable to hold the child or even look at him or her. The best thing to do in this situation is take refuge in Allah from your jealousies and to recite Surat al Falaq in your heart or on your tongue. Don't let the Shaytan get a hold of you and exploit your sadness or jealousy.

It's important to feel that you have come to terms with your loss and grief before a new pregnancy. Going through the physical and emotional trials of pregnancy and birth before you've dealt with your loss can cause you to feel a great deal of anxiety, stress, and fair during the pregnancy.

Some couples find out after a pregnancy loss or high-risk pregnancy that ended in stillbirth that they will be unable to have more children, or that doing so will present dangers to the health of the mother and child. It's important for you, as Muslims, to deal with this "loss of promise." You may want to talk to a trusted scholar or Muslim counselor to deal with issues of infertility. It's important that you stand together as a couple during this time, as many people view infertility as a good reason to divorce, the strength of the marriage and love of the couple notwithstanding. Some people may encourage the husband to take on a new wife, "one who can give you children." Psychologists and health care professionals generally recommend that couples take a long period of time to think before making any major life decisions after the loss of a child -- such as moving, changing jobs, or, in our case, marrying a second wife.

It's important for you to grieve and heal at your own pace. If it means that you focus inward for a few months, so be it. Don't be surprised if a fresh wave of grief hits you on the baby's due date, during holidays, or on the anniversary of the miscarriage or death. Find whatever gives you comfort or a measure of joy (walking, gardening, sewing, reading, etc) and grab hold of it. Time, combined with your faith in God, will help you heal, insha'Allah.

Tips for Friends and Family

1. Don't allow yourself to speculate on what the mother (or father) could have "done wrong" to cause the miscarriage or stillbirth. It's tacky and disgusting and un Islamic. If you hear other people doing it, ask them to stop and remind them to have taqwa.

By the same token, it's beyond insensitive to tell an infertile mother or father that "he can just take another wife." It makes the wife feel inconsequential, and less than a woman, and makes the man feel pressure to do something he may not want to do. It's none of your business what the husband and wife decide to do.

2. A mother who miscarries may be in physical pain for about a week. A mother who has a stillborn child at term or who loses a child just after delivery may be physically weakened and in pain for two weeks, especially if she had a c-section. Offer to help clean the house, take care of other children, run errands, etc. so that she can sleep and rest.

3. Even after she's physically "okay," it may be hard for the mother to return to such tasks as cooking on a regular basis. She may also not feel like eating. Why not cook some meals for her family and freeze them? Or offer to come over and fix lunch for her? This is also especially important if the mother is on bed rest to prevent pre-term labor in a high-risk pregnancy.

4. Try to stay away from offering platitudes or giving pat answers. "Your baby is in Jennah now" may be true, but when the loss is fresh, all the parents know is that they wish the baby were here with them. If you have to say something try, "What can I do to help you?" and "I'm so sorry. I may not always have answers or know the right things to say, but I'm here to listen to you." Sometimes, people just want to know that they have a shoulder to cry on and that someone's willing to listen to them.

5. Offer to make dhikr or recite a wird (litany) with the mother (or father). Offer to read Qur'an to the mother.

6. If the mother has a hobby (scrap booking, quilting, etc.) give her a small gift to encourage her to return to it.

A Few Resources

A Silent Sorrow, by Ingrid Kohn, MSW and Perry-Lynn Moffitt is a wonderful, sensitive resource for men and women who have lost a child through miscarriage, stillbirth, or abortion after a grave diagnosis. Has a small section on grief in Islam, and examines issues like grief and grandparents, siblings and pregnancy loss, the impact on your career, infertility, and subsequent pregnancy.

Unspeakable Losses, by Kim Kugler-Bell gives insight into the psychological impact of pregnancy loss, stillbirth, and abortion, written by a woman who has been there herself.

As I come across more books, or receive recommendations from other Muslims, I'll include them here, insha'Allah. Please check out Modern Muslima's internet resource page for support pages and information on pregnancy loss, stillbirth, high-risk pregnancy, and infertility.