Disclaimer: On today's podcast, we'll be discussing the topic of pregnancy and infant loss, which can be a very sensitive and difficult subject for many people. If you're currently pregnant or have experienced a pregnancy or infant loss in the past, please be aware that this podcast may trigger difficult emotions. This podcast is not intended to be a substitute for professional medical or mental health advice. If you have any questions about your pregnancy or mental health, please consult with a qualified healthcare professional.

Scott Webb (Host): It's to wrap my mind around the statistics related to pregnancy and infant loss, but in 2020, almost 20,000 infants died in the U.S. according to the CDC. And according to the March of Dimes, 10-20% of pregnancies end in miscarriage. Needless to say, I'm glad to be joined today by Wendy Rickerd. She's an advanced practice provider, Program Coordinator for Inpatient Women's Health Services at Summa Health. And I'm also joined today by Shannon Blower. He's the Director of Pastoral Care Services and Education and Grief Recovery specialist at Summa Health.

This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. So, I want to thank you both for joining me today. We're going to talk about pregnancy and infant loss. It's a serious topic and one that I'm sure listeners will be interested in and want to have your expertise and compassion and all of that. So Wendy, I'll start with you. How common is loss during pregnancy or during childbirth?

Wendy Rickerd: According to the CDC, stillbirth, which is a loss after 20 weeks' gestation affects about 1 in 175 births. And as you already mentioned the statistics on miscarriage, miscarriage is the most common type of pregnancy loss. What is not common though is how individuals and families react to or experience loss. It's really different for everyone.

Host: Yeah, I imagine that it is regardless of how the loss occurred or why the loss occurred. And maybe before we get too far into the conversation, Wendy, maybe you can define some of the ways that loss can be experienced just so we have, unfortunately, that whole list to reference during our conversation.

Wendy Rickerd: Sure. There's many experiences that people can face with regards to loss, and some of which would be a loss of a child shortly after birth. An example of which would be an extremely prematurely born baby or perhaps a baby with anomalies. Another experience people might face is sudden infant death syndrome, where they've taken their child home and then something happened and child passes or any sort of type of accident that was not anticipated or illness that was not expected. Ectopic pregnancy is another pregnancy loss that affects people and they experience a loss associated with that.

Shannon Blower: Yeah, there's a couple other that are often not considered. We have around infant and birth and life, we have surrogacy. And so, there are these cultural expectations that are infused and a sort of boundaries for everyone, even though their experience is different, the way in which it is culturally expected to be, what's proper and what isn't, is kind of a pressure. And so, I also like to remember that surrogacy, there is certainly a loss for the caring mother, and what she does with it is her own journey. Even in adoption there is the loss of giving a child up. And in both cases, I've never seen one where the child didn't grow older and say, "I want a different birth story," or "I want my birth story to be unique or different," right?

When these sorts of things are going on, infused is the regret of what ifs, and also the child's sense of identity. And then, you have the family who is hosting the child, has made space in their lives, their sense of inferiority or "Did I do enough?" Right? So, there's just so many different ways in which around infant loss that we can experience. And so much of it is continued to be hushed-hushed and quieted away. And so, again, I just want to say thank you for allowing us the opportunity to talk about some of this stuff.

Host: Yeah, as you say, some of this stuff is sort of hidden away and locked away and not discussed, so I'm glad we're doing that today, having just an open and frank conversation, trying to educate folks as best we can. And Wendy, maybe you can talk about some of the training that the staff on maternity units go through in order to help patients.

Wendy Rickerd: Part of the training for our nurses includes a course on loss and we utilize the Resolved Through Sharing care model. We support the patient by educating and empowering the nurse to meet the patient where they're at and determine what the loss means for that patient and family. Did the patient have a name for the pregnancy or a name for the baby? This allows the nurse to be able to provide really individualized and respectful care. We encourage allowing patients to share their feelings and what they hoped for, which offers insight to the nurse on how to care for the patient and family. We discuss support materials that can be provided to patients and we review some of the legalese that often accompany loss and help patients through that process.

There are certain physiologic changes that occur after a loss that patients need to be educated on and we review those with the nurses as well. We foster this supportive environment and atmosphere for our nurses. So, they, in turn, can deliver the same to our patients and families who are experiencing a loss. And finally, we also encourage and promote self-care in our nurses.

Host: Yeah, we don't want to forget about the caregivers, of course, right?

Wendy Rickerd: Right. It's so important that they become self-aware of their own attitudes and beliefs surrounding death, because that can certainly affect care that's provided. And we want that to be a positive experience in light of the situation. And so, you know, we always say, in order to care for someone else, you have to really take good care of yourself, too.

Host: Definitely. That was a theme that sort of came up a lot during COVID when we would do these podcasts, was just trying to remember the healthcare heroes out there on the frontlines and making sure that we were doing everything possible to help them take care of themselves so they could take care of others.

We're discussing the macro a little bit, but a little micro, and let's zero in through the lens of Summa. And what are some of the things specifically at Summa that you guys do to help patients?

Wendy Rickerd: We really want to make the experience as best as possible given the situation wasn't anything anyone had hoped for. And we try to make the patient and family as comfortable as possible by including them in the decisions surrounding their loss, such as holding their baby, touching their baby, counting fingers and toes, taking pictures. These are all ways that we make memories and help acknowledge that this loss is real.

Shannon Blower: Yeah. I got to say the loss of a child, an infant, pregnancy at Summa, it has both an acute and chronic length. There's a linear component to it. And every time in that pastoral care, I'm called to the bedside during a loss of pregnancy. I've seen the nursing staff, they have all of the accoutrements that try to honor the individual beliefs of the families and whatnot. Often, I'd come to provide some sense of spiritual honoring or honoring a sense of whatever rights or things that the parents feel like would honor the gift of that baby's life to them.

And so, there's that acute part that we do there and there's a sort of trauma bonding that occurs there and that can go one of two ways. When someone experiences that level of suffering and loss, they can practice a kind of avoidance of the place and people where it happened. And so, we are intentional about honoring them in real time, trying to make it something that is sacred. And then, from there, to follow up with any sorts of grief counseling or grief recovery to just let them know in real time and then following that this is not something that just goes away. And so, we offered grief counseling where I've met with young fathers who grieve differently. I've met with single moms who say, "This baby was a shame," it was a shame to her. Like, there's just so many things that are uncovered after the hospital stay that if we can honor, we're building a more healing relationship ongoing rather than a trauma-based one where avoidance is practiced.

Host: Yeah. And I'm sure, Shannon, when we think about the healing, you're trying to be inclusive and trying to heal the whole family, right? I'm wondering, you know, the loss of a child, whether it's in pregnancy or after they're born, it impacts the family greatly. And how do you do that? How do you help the whole family when possible?

Shannon Blower: So, a significant part of this is listening deeply, asking the questions that just simply draw out. But we have events right around the Global Wave of Light, we'll talk about in a little bit, where family members can talk. So when we do that, we have grandparents share; we have children siblings share; aunts and uncles share, as well as the primary mother or father. And each of them have a different way of interacting. It changes the family dynamics for sure. The energy has changed. One young man in his 20s said that his older brother had died. And for years, he knew something was up around a certain time. It wasn't talked about much. And when it was, he just felt it was a ghost that was always there and wasn't allowed to address it. When he revisited that with his mother and father present, they were able to join in, even 10, 15 years later, they were able to join in and have a shared narrative around the event, rather than a siloed one. So, there is no question that each family presents a little differently. But more often than not, they grieve siloed, they grieve by themselves, and that's a difficult experience for them. And it begins to impact the way they see the world themselves and life in general.

Host: Yeah, I'm sure. So Wendy, let's talk about some of the resources that are available for people as they're trying to cope or process what's happened. Maybe you can share some of the options that are available.

Wendy Rickerd: There are many options out there. We have, in our immediate surrounding areas, a great resource nearby. Akron Children's has a lot of support groups and services. Many are offered regionally too. So if patients are out far away or in a distant community, there probably is a support group there as well.

 There's resources at Summa as well. And anyone experiencing a pregnancy or infant loss, if they are finding it difficult to access or even locate a support group, we encourage them to call our unit or call Summa's general line and we can point them in the right direction.

Shannon Blower: Yeah, that's correct. From the pastoral care standpoint, we run grief recovery groups as needed. We do one-on-one grief recovery groups and grief counseling. More often than not, it has to do with a safe place for the griever to share their story in ways that they have been shut off culturally. We have an event here once a year. And it is loosely affiliated with Wave of Light. We don't always do it on the same date because the whole month is actually infant loss and pregnancy loss month. But in the event, we provide opportunities for our staff and others to write their baby's name on the card and have their name read at the ceremony. And we make this available through our system. And I was just so taken. One of our nurses came and said, "May I please fill out one of those cards?" I said, "Yes, of course." She filled it out. She placed her baby's name on it. And the birth date or death date was 1979. And I thought to myself, oh my goodness, the sacredness of that mother's longing still all these years wanting it to be honored. And to imagine that this just goes away is a misshaping of what it means to be human. We can do different things with it, but it's always with us.

Host: Absolutely. I think I have a strong sense of this, Wendy, but maybe you could just take up, address this, why is it so important that we talk about this, right? We're talking about it today, of course. But why is it so important for folks to talk about pregnancy and infant loss?

Wendy Rickerd: Well, you're exactly right. That's why this opportunity to speak today is so important. You know, there's a stigma related to pregnancy loss and it makes it taboo to talk about. And this really creates a barrier for people to seek help or getting the care that they need. And oftentimes there's no explanation for the reason that the pregnancy was lost, and there's nothing a person did or did not do that caused it. And so, it's really important to talk about and bring more awareness to, because the more we can have honest discussions like we are today, it just opens doors for people to get help when needed. And, you know, it is okay to grieve.

Shannon Blower: Wendy, I agree a hundred percent. And there's this phenomenon of what it means to be human. And it is that we experience events, even in a group, but somehow we internalize meaning around the event uniquely and differently. And so, sometimes or maybe even often, it is the event that is traumatizing, but it is the inner narrative that we tell ourselves about the event that sometimes makes it even worse. And so in conversation, it allows for my inner narrative, which could be accusing or guilty or shaming. It allows it for it to come out and be seen in the open with another person who loves and cares, right? And so, there is a healing even of the inner narrative that's so important around having conversations. It makes explicit what is implicit.

And then in addition, there's just this loveliness that says, "I want to talk about my baby the same way you want to talk about your Uncle George. This baby impacted me and it may have been short lived and abbreviated, but it impacted me. And it was a redirection of our family and it needs to be honored." And that is, I think, one of the beautiful things that can be provided by communication, open lines, just normalizing, of course, you miss your baby.

Host: Of course. Shannon, you mentioned The Wave of Light, the Global Wave of Light earlier. I want to have you tell us a little bit more about that.

Shannon Blower: Certainly. So, this is an event. It's really phenomenal. Somewhere back in history, you know, the 1980s or something, Congress dedicated that the month of October would honor the infant loss, pregnancy loss. And then, on October 15th, worldwide, it became the day on which, worldwide, at 7:00, those who have experienced loss, or those who want to honor the loss of a loved one, light a candle at 7:00 p.m. as a tribute and testimony that that baby's gone but not forgotten. And so, it is just a lovely way to honor it. But then in association with that, all around the world, there are these virtual events you can participate in, there are community events, there are ways that you can honor this throughout the month by wearing pink and blue. And sometimes even folks who say, "Well, you know, I've not lost a child" will attend and participate in an event as solidarity, as saying, "I stand with you. I see you. I honor this loss too."

And so, it is a phenomenal way of healing. I encourage anyone, if you simply Google Global Way of Light, you will get so much data and information. And it would just be a wonderful help for awareness and an opportunity to connect more meaningfully with the folks you care about.

Wendy Rickerd: Can we just pause for a moment and allow our listeners to envision this wave of light encircling the earth? It's just a beautiful symbolic way to honor those lives, you know, we lost too soon.

Shannon Blower: Agreed, Wendy. Sometimes there's not a candle handy, but to just pause and do it, that's beautiful.

Host: Yeah, it really is. And wondering, Wendy, do you have any advice for people who are listening and maybe haven't personally experienced a loss, but they want to learn more how they can support someone they love or, just get involved, you know, if they feel inclined?

Wendy Rickerd: Right. I think reaching out to those people who are experiencing a loss is so important. Death and dying are uncomfortable subjects for many people. And so, they tend to shy away from those people who practice avoidance. And this is the last thing really those people experiencing a loss need.

And also acknowledging that the loss is real. For many, they have hopes and dreams for this pregnancy. And now, those are gone, and that's very real. And just acknowledging that is very helpful for people.

Shannon Blower: Yeah, Wendy, I couldn't agree more. Sometimes whenever we're saying, "How should I help or what should I do," is just to simply remember that, of course, we're not the experts because we're not the one experiencing it. But if we can have loving curiosity and just, you know, "Hey, remember this is the day" and send them a card or, you know, anniversaries or Christmas, Easter, these sorts of things where there was a notable absence from that family to be able to honor that, to pay attention to good questions or platitudes that sometimes don't hit the mark, but actually what you're trying to do is just provide invitation for someone to share about their baby.

 The most important thing, of course, is I would say to not try and redirect or to not try and cram them back into a culturally appropriate way of grieving. Because if you think about the way our system operates, typically if someone dies in your world, you get three days off and then you're going back to work. And so, that is a trauma that is twofold then. So, even in the workplace, it's not like, "Hey, man. Show up and just get your job done." It is folks coming alongside and saying, "Hey, let me carry that for you," "Hey, let me help you out this way" or whatever. Honoring the person's wishes, of course, but making yourself available, like Wendy was saying, I think is an important thing.

And the other thing too is, it also provides, if they are willing to talk and share, and it feels like a conversation, the more they talk about it, because they have changed through the years, the more they're able to create new meaning around it. And that's really the human existence, the potential, the purpose is we are meaning-making machines. So when something interrupts our predictable trajectory, our natural move is to say, "What does this mean?" And meaning is arrived at in community. So, it just goes on and on, the benefit. of intimate communications around all things lovely.

Host: Thank you for that, Shan. I want to finish up today, and it's a difficult topic, but a heartwarming conversation, and to know there's reasons to be optimistic, that it's okay to talk about this stuff, to grieve, to experience loss, to discuss it with family members and friends and professionals and so forth. Just wondering, Wendy, are there opportunities for someone in the Akron community if they want to support, if they want to help, if they want to get involved?

Wendy Rickerd: Yes. General volunteering is a great way to help. And donations are helpful in purchasing patient support materials, items for comfort care baskets that we use when patients are experiencing a loss on the unit, and for items for memory-making just to help with those little details that often mean so much.

Shannon Blower: Yeah, that's great, Wendy. Sometimes there's the immersive experience that we value and we want that to happen. And sometimes people just feel like, I don't know if I can do that right yet," and they would want to donate. I know that, you know, maternity and Wendy's department has availability for to donate through the foundation through maternity, and then also through pastoral care as well. We have an event once a year where we honor infant pregnancy loss. Sometimes it's on the day of October 15th. Sometimes like last year, it was not, it was a couple of days before. And they could participate in that event. They could donate towards that event. And throughout that week, we pass around candles, the LED candles, and some literature. And they could participate by passing that around throughout the hospital system. So, there's some very specific ways that somebody who wanted to get involved at Summa Health System that they would be able to do it. And we welcome them, because their heart's in the right spot, man. We want to be a friend to them as they're a friend to us.

Host: Yeah, that's well said. That's a perfect way to end. It's nice to meet you both and you both stay well.

Wendy Rickerd: Thank you.

Shannon Blower: Back at you. Appreciate you, man.

Host: And for more information, go to summahealth.org. And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for listening, and we'll talk again next time.