Transforming stillbirth care: Four steps hospitals must take for grieving mothers - opinion

I can still vividly remember every heart-shattering detail of a birth I experienced 33 years ago. As an obstetrician, I was near the end of a busy day examining pregnant patients when I realized it had been several hours since my own baby had moved around inside me.

I remember desperately trying, and failing, to stimulate my swollen belly, hoping for a movement in response. I remember rushing to the empty ultrasound room and sitting alone as I dragged the wand over my stretched skin and saw the screen stay still and silent. My baby’s heart had stopped. A short time later, I delivered a stillborn son. My world was shattered – and the next day it got worse when my milk came in to feed a child that wasn’t there. The emotional and physical pain was searing.

Even though I have healthy adult children now, that grief left an indelible mark on me, as it does on the nearly 2 million women who experience stillbirth each year –  one every 16 seconds. While other mothers cradle their newborns and return home with bundles of joy, those who have lost a baby are often left to grieve in isolation. Their physical recovery may be addressed, but healthcare systems around the world too often overlook the long-lasting emotional and psychological toll of such as loss. Despite the magnitude and frequency of loss, stillbirth remains a largely silent tragedy shielded from broader public awareness.

In many places, women are discharged from hospitals within hours of losing their babies, without any plan for emotional follow-up or physical rehabilitation. This cannot continue.

Just as we have created systems for new mothers, with lactation consultants, postpartum checkups, and community support, we must also create systems of care for mothers who do not take a baby home.

Grief never goes away, but aftercare makes a difference

As we mark Pregnancy and Infant Loss Remembrance Month, we honor the babies lost and the mothers who carried them physically and will always carry them in their hearts. This is also an important time to raise awareness of the mental health challenges these women face. It is worth taking a deeper look at what these mothers need – and how healthcare systems and professionals can better meet those needs. The grief of these forgotten mothers will never go away, but providing appropriate care from the moment the tragedy begins can make a big difference.

This is something I see now in my daily work as a clinical adviser at the Center for Wellness and Respite for women and couples after stillbirth in Jerusalem, a facility that has no parallel anywhere else, as far as I know. Situated within a fully operational hotel, the center is operated by local social care NGO Yad Sarah and offers holistic care that addresses both the emotional and physical needs of grieving mothers following stillbirth.

We provide psychological counseling, emotional support groups, and physical rehabilitation services, along with massage and aromatherapy treatments. Bereaved mothers, who can stay along with their partners, are served three healthy gourmet meals per day, allowing them to focus all of their energy on healing. Our center is not just a medical facility, it is a sanctuary – a place for mothers and their families to heal. It is open to anyone in need and heavily subsidized by private donations in order to remain affordable.

Essential components for recovery

While this center is the ideal, I am aware it is not possible to recreate everywhere, nor is it available to everyone who experiences a stillbirth. However, after working with over 500 couples since the opening of the center in July 2023, I have identified four specific steps that hospitals, healthcare providers, and communities should undertake to ensure that no mother faces this journey alone.

First, we must acknowledge that mental health services are an essential component of care for mothers who experience stillbirth. These mothers are more than four times as likely to develop post-traumatic stress disorder (PTSD) compared to those with live births, and they also face heightened risks of depression, anxiety, and prolonged grief disorders.

To address these needs, hospitals and healthcare providers must offer individualized mental health services tailored to this unique grief. Cognitive Behavioral Therapy (CBT) has been shown to reduce symptoms of PTSD and anxiety in bereaved mothers, while group therapy provides a space for shared healing. Early intervention, especially within the first six months after stillbirth, is crucial for the prevention of long-term psychological damage.

Partners and family members are also critical to the recovery process and should be offered counseling or support group access as well. Studies show that when partners are involved in the healing journey, both the mother and family have better mental health outcomes. By fostering an open dialogue and providing resources for the entire family, healthcare providers can help lift the burden of grief from these women and enable them to recover in a supportive and understanding environment.

In addition to emotional support, physical recovery plays a key role in the healing process after stillbirth. Mothers who deliver stillborn babies often endure the same physical effects as those with live births – without the reward of taking home a baby. Postnatal physiotherapy can assist in alleviating common post-pregnancy conditions such as pelvic floor dysfunction and abdominal separation (diastasis recti). Massage therapy has also proven effective in aiding recovery, particularly for mothers suffering from breast engorgement or mastitis due to milk production. Massage not only helps alleviate physical pain but also reduces stress hormones and promotes relaxation, both of which are critical during such a difficult time.

Public awareness campaigns can also play a vital role in breaking the stigma and silence associated with stillbirth.

Healthcare providers should lead the way by fostering open discussions about stillbirth during prenatal care and community outreach programs, ensuring that families feel empowered to speak about their experiences. Safe spaces for dialogue can help remove the shame that often accompanies this loss. Additionally, community-driven initiatives such as educational workshops, remembrance events, and media campaigns can encourage society to be more vocal about the reality of stillbirth and its impact. When communities acknowledge and validate this pain, it becomes easier for mothers and their families to find the support they need.

The journey to healing after a stillbirth takes a lifetime; I am still very much on my own path of healing. But being able to help other women who have experienced stillbirths, providing them with the support I never really received, and seeing how this support helps, has been a source of healing for me as well. I know it’s possible to go on, and I know now that I am not alone. More women deserve to feel this way.

The writer is a gynecologist and fertility specialist.