Experiences of giving birth at 20 to 24 weeks of pregnancy

Going through labour and birth knowing that their baby had already died or would not survive was extremely difficult and emotional. Some mothers felt they were fighting their own body to stop their contractions as giving birth meant the end of their pregnancy and their baby’s life. However, despite their loss and intense sad emotions, many also described extremely powerful positive experiences during the birth.

Camille described how her emotions ranged from fighting against her contractions to the magical moment when she gave birth to her daughter.

Age at interview 26

Gender Female

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The pain of labour

Even though their baby was extremely premature, mothers had to labour and give birth to their baby. The physical pain of labour and birth was often very intense and came as a shock. Those mothers who had previously given birth were more aware of what to expect, and this helped manage their pain and emotions. For first time mothers, they had no experience to draw on. Kelly described labour as ‘a really horrible experience’ but her midwife’s explanation of what to expect meant ‘I was able to manage it a lot better emotionally’.

Emily didn’st want to go through labour but appreciated the encouragement of her midwife to do it.

Emily felt the birth was awfully hard work but was reassured by her midwife who explained it was exactly the same as giving birth later in pregnancy.

Vikki felt unprepared as she couldn’st find any information about what it might be like to give birth to a baby that had already died.

Age at interview 33

Gender Female

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Terms used such as ‘mini-labour’ and ‘miscarriage’ meant some mothers felt unprepared for their experience. Some mothers found the emotional distress intensified the pain. Michelle felt ‘it’s more painful in the sense of you have fear, because you don’t actually know what you’re giving birth to’. For Courtney the whole process of labour and birth was a shock because she had been told she was having a miscarriage and felt ‘it’s not going to be like this, it’s going to be like, like just blood or whatever’.

Loretta was told she would experience a mini-labour but found it extremely painful.

Age at interview 54

Gender Female

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Kerry had a very short labour and gave birth in the toilet. She resented the term mini-birth’s.

Age at interview 47

Gender Female

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Managing the pain

Most of the mothers we spoke to, though not all, had pain relief through labour. As the baby had already died or wasn’t expected to survive, mothers were often offered morphine to relieve their labour pains. While Emily found it helped her anxiety, others found morphine made them feel ‘numb’ and ‘out of it’. Other women were given an epidural or gas and air. Michelle gave birth on a gynaecology ward where pain relief was not readily available and her husband Iain had to argue strongly to get her some gas and air.

Camille didn’st have time to have morphine before her baby was born but afterwards felt glad as she didn’st want to miss the experience of her baby’s birth.

Age at interview 26

Gender Female

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Where the birth takes place

Many maternity units have dedicated bereavement suites. These rooms are often made more homely, offer privacy and space for both parents with beds, sometimes a bathroom and a cold room for the baby. Several women we spoke to were able to labour and give birth in one of these suites. Sometimes these suites weren’t available, as they were already in use or not provided, so mothers had to give birth on a standard delivery ward. Hearing the sounds of other women giving birth and new born babies crying was painful.

Helen felt giving birth in a bereavement suite really helped her

Age at interview 43

Gender Female

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Joelle explained how the bereavement suite made her feel less like a patient in hospital.

Nesta found that the layout of the bereavement suite allowed her time to prepare herself to see and hold her baby.

Age at interview 39

Gender Female

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Care during labour

Many women felt very well supported by their midwives during such a distressing time. They were understanding and empathic, providing emotional support as well as small touches such as physical contact, remembering parents’ names or bringing food. For example, Sarah’s midwife sat waiting outside the bereavement room for whenever they needed her. These little things made a real impact. But other parents had a different experience and felt abandoned. Some fathers had to call for help and sometimes even had to help their partner give birth in the absence of a midwife.

Kelly felt really cared for and appreciated her midwife’s commitment to stay with her until she gave birth.

Age at interview 39

Gender Female

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Kareena and Raj really valued the care and support their midwife gave them.

Michelle and Iain felt they were experiencing labour and birth with very little support.

After giving birth mothers were often physically exhausted. For some this was made worse by complications, such as trouble delivering the placenta or needing a blood transfusion. This delayed parents’ opportunity to spend time with their baby.