“What’s Inside of You Now is Just Bones and Skin”: The Tension between Restorative Meaning-Making and Deliberate Detachment in Maternal Experiences of Stillbirth

Subordinate Theme 1: Forged in the Body

The participants in this study chose to share memories of pregnancy as a route to reinforcing feelings of relationship with their lost baby. For the mother of a stillborn child, to reflect on the experience of pregnancy was to relive the limited window of time which existed for the creation of bonds. Reflecting on the pregnancy promoted a sense of maternal relationship, as connection was noted via the changes which occurred within the female body, feeling the baby moving in the womb and viewing the baby during monitoring scans.

Caroline characterised her “tummy” as a place of safety and described her own body as her baby’s “home.” As she recalled her womb providing shelter for her baby, she acknowledged the live connection between her own body and that of her child: “That’s where the baby’s home is. That’s where he’s safe. In your tummy.” (Caroline.) The fact of pregnancy built a relational connection with the personhood of the baby and this shared experience of life bound mother and child in unique ways: “It’s like an actual person inside of me.” (Rachel.) The female body became the sole vessel of the child’s life, as continuing bonds came to represent something embodied and lived: “That was his life, inside of me.” (Caroline.)

The bolstering of feelings of relationship and continuing bonds could not be more concrete than when encountered via the growth scan. Three of the participants chose to share images taken during scans at their participant interviews. These pictures of grainy, foetal shapes provided vital links to the baby and were transformed into connecting objects of meaning following stillbirth. These moments of visual representation also allowed for thematic characterisations of the baby. Rachel described her experience of observing her daughter’s movements on the hospital monitor. She nicknamed her baby “Little Fish” because of her constant “flipping around.” In the excerpt below, Rachel used the pronoun “we” to denote the shared experience of viewing her child. The scan provided a point of connection which allowed Rachel and her husband to assign characteristics to their daughter. In this rare moment of shared sense-making, “Little Fish” was “hilarious” and “chilled” – a baby who flipped and yawned inside her mother’s belly, as the maternal body became the site of family memory creation: “We just called her ‘Little Fish’… She was always flipping around. She was the most hilarious baby. We were always scanning her and she’d be like yawning and totally chilled...” (Rachel).

A maternal wish to identify the moment in which the baby passed from life into death recurred in participant narratives. The noting of final movements or a sense of ominous stillness marked the cessation of life and may have served as a means of marking the importance of all that had been lost. As with the experience of mourning itself, the baby was both present and absent, still encased within the mother’s body. Aurelia described her experience of noting the cessation of movement in the excerpt below. She shared an eerie experience of stillness and “anxiety” as she became aware that something was wrong. Discomfiting “thoughts” hover darkly over the lines and the repetition of “the baby does not move” adds a hollow refrain.

I am saying: “The baby does not move today.” … And then, the evening was approaching, and I am having thoughts and a kind of anxiety. I am thinking that I am feeling weird. And the baby does not move. And that was it... Just a lack of feeling. (Aurelia.)

Subordinate Theme 2: Birth as a Route to the Construction or Deconstruction of Bonds

The birth may offer the potential for a vital bonding experience. Conversely, it may also represent a raw and devastating deconstruction of bonds. Laura described an instinctive desire to experience the physical pain of childbirth, which she interpreted as rooted in her knowledge that she was “not going to have a baby.” The excerpt below revealed her innate desire to physically “feel” the birth. She intentionally heightened her own physical experience of the delivery in order to provide herself with “memories” upon which she could draw. The experience spoke to the intentional crafting of continuing bonds in the moment of birth, as the mother elected to curate her own experiences of her child in such a way as to strengthen feelings of connectedness.

They [medical staff] asked if I wanted an epidural but I couldn’t. In my head, I just knew that I needed to be able to feel this happen… because I’m not going to have a baby… I still have very strong memories of giving birth… (Laura.)

A sense of the importance of the birth experience as a route to maternal identity seemed to arise in the analysis. Though the use of the transitive verb “forced” in the excerpt below suggests an experience of tension and perhaps coercion, Aurelia also seemed to retrospectively share feelings of gratitude and to acknowledge that the experience of birth had helped to actualise her maternal identity: “I was very grateful that they forced me to give natural birth because then I felt like I was the mother and I had given birth… As much as I didn’t want to, I was so grateful.” (Aurelia.)

Conversely, themes also appeared which related to the deconstruction of bonds. In the segment below, the birth was rendered pointless, as the pain of labour failed to bring the usual reward, and Rachel’s language was dismissive, as she repeated the refrain: “I can’t be bothered.” She juxtaposed the “ridiculous” with the “painful,” as her jarringly defeated tone clashed with an agonising physical experience.

“I was in agony. And a lot of it was like: ‘I can’t be bothered to do this anymore. This is the most ridiculous thing I’ve ever done in my life.’… I think that was the most pointless activity. It was so painful!” (Rachel.)

Elsewhere in her account, the birthing female body seemed to become the site of torture and gore, with the negated baby being perhaps interpreted as a painful void: “You’re going to be bleeding and bleeding and bleeding away because you’ve got a hole in your body.” (Rachel.)

Themes of the birth providing a potential route to the severing of bonds further highlighted a wish to excise the baby from the mind and body of the mother. Aurelia expressed a profound will to dismantle bonds and to erase the emotional pain of the loss, as well as the physical presence of the baby: “I wanted to have a C-section because I wanted to, kind of like, cut it out from my mind, my body.” (Aurelia.) While in the excerpt below, Rachel rejected the construction of meaning in her birth experience and “Little Fish” became an “it” without a name who must be “gone”: “The whole thing was just … pointless… I could have just had a Caesarean and just had it gone. I didn’t need to have this whole experience that’s meant to be so liberating and empowering.” (Rachel.)

Subordinate Theme 3: Birthing the “Dead Baby Inside” and its Impact on Continuing Bonds

Here themes of horror and fear recurred. The baby became abject, and an experience of repulsion prevented maternal connection via feelings of intimacy: “I am pushing out a dead baby.” (Rachel.) Grief itself appeared fragmented by an experience of horror which seemed to erode the personhood of the baby. Aurelia deliberately refused to experience her child: “I gave birth but I couldn’t look at the baby.” (Aurelia.) In the segment below, she shared a sense of disbelief at the impossibility of tolerating the knowledge of the “dead baby inside”: “They said: ‘Do you want to go home and wait for the birth?’ And I was like: ‘What are you talking about? You want to send me away with a dead baby inside?’” (Aurelia.)

Themes of rejection seemed to arise from this close proximity to death. In the quotation below, Rachel discounted feelings of connection with her daughter, as she refused to experience her as a person.

What’s inside of you now is just bones and skin. Totally dead! And I was like: ‘I want this out now, now, now, now!’ … The whole thing just totally grossed me out… I was like: ‘I’ve just got this whole mound… dead!’... It’s suddenly a corpse. (Rachel.)

Rachel’s language transformed “Little Fish” from beloved baby to composite human remains, as she relayed her horror at the fact that her swollen belly had suddenly become a burial “mound”. Her use of colloquial language denied the traditional vocabulary of mourning and conveyed her rejection of this “corpse” within. Language which polarised “inside” and “out” amplified the impossible relationship of intimacy and distance in this moment of maternal distress.

Subordinate Theme 1: The Beloved Baby

Continuing bonds can be interpreted as an experience by the bereaved of what it is that the loss of their loved one triggers within them, in terms of shifts in personal identity and experiences of grief and remembrance. A maternal drive to nurture and protect the stillborn was vividly present in this subordinate theme which engaged with configurations of the baby as beloved.

An instinctive will to bond appeared, as the mother experienced feelings of love and connection. Following delivery, Laura described her overwhelming instinct to physically bond: “I wanted to hold him straight away.” (Laura.) In the extract below, she shared her experience of powerful maternal affection, which was represented by the importance of visiting her stillborn baby. She articulated “the next day,” “every day,” and “for as long as we could,” in a manner which showed her desire for ongoing connection. Laura wished to stay with Hal, but he was moved into “a cold place,” which conjured the presence of death and separation.

We stayed with him for as long as possible but then they had to take the baby away and put him in a cold place. So, then we went home and came back the next day and, in fact, every day and for as long as we could … Having that time was so very important to me… I just wanted to keep holding him. (Laura.)

Themes which related to experiences of a continuing maternal love which remains consistent beyond death were present. The memory of Baby Hal endured for Laura as a beloved “son” whom she wished to protect and remember. In the segment below, Laura constructed the personhood of her child so that others could recognise and relate to her loss. Language was the vehicle which allowed Hal to become real, and Laura used the phrase “all the time” and also the negative-time adverb “never” to convey a sense of permanency.

As his mother, it’s very important for me to keep his name there and talk about him all the time and for him to be part of our family because I want to protect his memory, because he was a person. You know, because he was a person, a little boy, a little baby, that should have had a life, and sadly didn’t, and it’s really important how we never forget him. (Laura.)

Themes of ongoing connection appeared, as participants shared a sense of a continuing bond which remained undiminished by the passing of time. In the excerpt below, Rachel characterised her daughter as a permanent connecting force between herself and her husband. She immortalised her child as a beloved “daughter”, who remained forever in position as “eldest” child and was automatically absorbed into the family narrative: “She’s our daughter! She’s our child! If we have future children, she’s still going to be our eldest… It’s very straightforward… She’s part of our lives.” (Rachel.)

Subordinate Theme 2: The Rejected Baby

Experiences of deconstructing maternal bonds displayed the way in which the bereaved mother struggled with responses to her child. The following segment articulates an instinct to reject. Rachel’s use of the depersonalised pronoun “it” underscored her deliberate distancing. She denied the personhood of her baby, and, in this moment of disorientation, the baby became something undeserving of maternal contact: “They [medical staff] were like: ‘Do you want to hold her?’ And we were like: ‘No! We want nothing to do with it!’” (Rachel.)

In these moments of detachment the participant’s language altered, and the child was veiled by the impersonal. Aurelia’s use of language seemed to distance her from her child. She explained that she could not speak her son’s name and chose to refer to him as “the baby.” She used the impersonal pronoun “it” to distance herself from the personhood of her son: “Every time … I am calling it ‘the baby.’ I never call it by the name.” (Aurelia.) She also described the way in which she did not wish to “look at” her child or to “hear” about him.

I didn’t want to have anything to do with it... I couldn’t look at the baby. I asked them [medical staff]: ‘I don’t want to look at the baby.’ Then one of the doctors, I heard: ‘Your baby is perfect.’ And, I was like: ‘I don’t want to hear it! (Aurelia)

Subordinate Theme 3: The “Empty-handed” Mother

The simultaneous presence and absence of the baby seemed to be a recurrent theme in the analysis. In the aftermath of her delivery, Rachel articulated a sense that the physical presence of her daughter alleviated frozen feelings of detachment. In the segment below, she shared feelings of disorientation, which abated with physical contact with her child. In this moment, it seemed that the child held the mother, as the baby’s physical body helped to contain the mother’s experience of disorientation: “I was just numb – just numb. When I held her [the baby], I was in-touch and I could cry... But, the rest of the time, I was just confused and dazed.” (Rachel.)

Themes which related to experiences of a lack of recognition of the personhood of the baby by family and medical staff were present. Experiences of continuing bonds were seemingly challenged by attempts by others at erasing the existence of the lost baby. In the segment below, the anonymous “they” of the medical staff proved obstructive in Rachel’s meaningful constructions of her daughter.

So they [medical staff] ended up taking her out of our room and putting her in a storage cupboard. … My husband had to go look for her. And then he was like: “I found her in the storage cupboard!”. And I was just like: “Just keep her. Just keep her with us!” (Rachel.)

Subordinate Theme 1: An Altered World: “I Was That Person”

The world may appear irrevocably altered by the stillbirth experience, and perceived changes to close relationships and altered sense-making relating to existential purpose may be experienced by the bereaved mother. Aurelia shared the way in which she was affected by unfeeling social responses to her bereavement. Sharing meaningful memories of the baby, which might reinforce continuing bonds, became risky for the mother, as she became increasingly aware that others may fail to appropriately respond to the loss: “You are angry because somebody said something … insensitive... They try and be supportive but, even now, if I would talk to somebody, I could be upset... It’s a fragile subject.” (Aurelia.)

There appeared a sense that memories of the baby must be sanitised in order to be safely shared with others. A lack of recognition of meaningful anniversaries further served to promote feelings of isolation. Rachel’s language in the excerpt below reinforces an experience of disenfranchised loss, as the lines reverberate with the lonely repetition of “no one”: “The anniversary of her death was 2 weeks ago. No one remembered. Zero remembered. I called my parents. I called my siblings. No one remembered!” (Rachel.)

Laura described a desire to safeguard baby Hal’s position in the wider family. Here, the use of a more socially acceptable “birthday” cake-baking event appeared better received than Rachel’s “anniversary of death.” The repetition of “birthday,” “know,” and “everyone” underscored Laura’s desire for the outside word to acknowledge Hal’s personhood. There was a sense that Laura must advocate for Hal in order to keep his memory alive.

He is very much a part of my whole family… they know when his birthday is and it’s marked… The first year, we did a massive cake-baking... And I do push it a lot... It’s so important to me that people are acknowledging him. (Laura.)

But themes of a desire to deny memorial also arose in the analysis. In this regard, Aurelia shared a profound wish to forget anniversaries. In the excerpt below she described her strong dislike of the seasonal reminders which painfully triggered the unbidden pain of remembrance: “Sometimes, I hate the spring because, you know, I remember having a stillbirth and I remember the smell of the spring.” (Aurelia.)

Subordinate Theme 2: Holding On, Letting Go

The positive impact of bereavement support groups allowed some participants to encounter a community of loss which validated and fostered their experiences of continuing bonds. In the following excerpt, Laura described locating a sense of fellowship, which allowed her to experience her perceptions of a continuing bond with her lost child as being understood by others: “We [members of the support group] try and see each other, especially when we know it’s each other’s anniversaries [of stillbirth]. Just having that kind of unified relationship – just somebody that gets it …” (Laura.)

With the passing of time, the bereaved mother may gradually feel better able to personally encounter and publicly share her memories with others: “Time definitely does help… And you can talk about it easier to strangers.” (Caroline.) For some, it seemed more possible to treasure precious memories of the lost child and to simultaneously background feelings of regret: “I’m not sorry that it happened… I’m so grateful for the time that I had.” (Caroline.) It seemed that the passage of time may somewhat lighten the grief in a manner which allowed for more contained experiences of loss: “I think I’ve come a long way. It doesn’t feel as dark. I can sit and cry for a bit but then I can get up and do something else. It’s painful but it has eased...” (Laura.)

In time, the bereaved mother may become more able to remain connected to the positive aspects of continuing bonds and less inclined to pursue detachment: “Most of the time, you don’t have the painful loss but you remember the nice things.” (Caroline.)

Subordinate Theme 3: Ways of Relating to the Stillborn Baby via Subsequent Children

At point of interview, two of the participants had gone on to have children following their stillbirth and themes of subsequent children providing routes both towards and away from continuing bonds with the lost baby could be identified in the analysis. Subsequent children may offer a pathway to hope and continued sense-making for the bereaved mother: “It [having a subsequent child] helped give me life.” (Laura.)

However, themes of a deep longing for “another baby” who might eclipse the stillborn child also arose. Aurelia shared her experience of a powerful desire for another child to hold in her arms. This imagined replacement child served both to soothe her longing and also suggested a wish to efface the painful knowledge of the existence of the stillborn boy.

The most important thing was to have another baby. I didn’t want to tread on the past because I knew it will not bring the baby back ... The most important thing, for me, was I want to have a baby … I need to hold a baby in my arms. (Aurelia.)

Ways of relating to subsequent children which might also serve to erase the stillborn child appear in the segment below. Aurelia shared the way in which she constructed the gender of her second child, a daughter, in relation to the gender of her stillborn son. Her language was permeated with concepts of rewriting or deleting the past and framed her living daughter via the metaphor of a “new chapter.” She seemed – in this moment – to wish for a blank page upon which to rewrite her maternal experience in such a way as to deny the existence of her stillborn baby.

I was little bit sad that we had a girl … We thought, if we would have a boy, then it was kind of like it [the stillbirth] never happened. If a boy to come, then we start from beginning. But then, thinking, maybe having a girl is better? Because it is not just replacing one with another. It is different – a new chapter… (Aurelia.)

A desire for the stillborn baby to be hidden or segregated from subsequent living children could also be identified:

I don’t have time, or I don’t have energy, to lose on grieving because I need to live for the kids. They don’t know yet about the stillbirth. I have said to my husband that they are too young. I do not want to put any burden on them. I don’t want to make them guilty or in any way confused. (Aurelia.)

Conversely, in the excerpt below, Laura explained the way in which she valued the familial conduit between her stillborn baby and her two subsequent children and suggested that her subsequent children were able to “give” her “something” of Baby Hal. Here, the subsequent children seemed to re-animate the stillborn Hal, as they were translated into a lived embodiment of what could have been.

We didn’t know if he [subsequent child] was going to be a boy or a girl… If he looked like Hal when he was born, does that mean there’s a similarity to what Hal could have looked like? It’s important – that blood connection between the boys. And it gives me something of what Hal might have looked like… It helps. (Laura.)

Elsewhere, Laura shared the way in which she talked to her living sons about their stillborn brother. She and her children appeared to create a shared narrative relating to Hal. The existence of a continuing bond, passed from mother to child, seemed evident. The family unit constructed Hal as a beloved family member, who remained permanently present, though irrevocably distant: “My sons talk about Hal a lot. We talk about him being in the stars. I heard one of them saying to a friend the other week: ‘I’ve got a brother, another brother, he’s up in the stars.’” (Laura.)