SILENT SORROW
New book speaks to feelings of parents who have lost a baby

By Deborah Wormser / Special Contributor to The Dallas Morning News
Published 01-06-2000

Carol Cirulli Lanham lost her first son, Patrick, the day before labor was scheduled to be induced. Throughout her fear-filled second pregnancy, she believed the birth of her new baby, Andrew, would put her anxieties to rest.

While at the hospital after delivery, she dreamed that Andrew had died. Even when she called the nursery and was assured that the baby was fine, she remained anxious.

"In the middle of the night, all alone in my hospital room, I cried like I had never cried before - not even when Patrick had died. Now that I had another baby, I understood exactly what had been taken from me," she writes in her book, Pregnancy After a Loss (Berkley, $14.95).

The Dallas mother of three is determined to talk about a silent sorrow shared by thousands of women: the death of a child before birth or in early infancy. Today, Mrs. Lanham speaks at pregnancy loss support groups across the country and hosts an Internet chat room at 8 p.m. each Tuesday night on the SHARE Pregnancy Loss and Infant Loss Support Web site

Mrs. Lanham describes her book as a "what to expect when you're expecting again after a loss."

"There were only one or two other books on what the next pregnancy is like," says Ginny Robinson, coordinator of a pregnancy loss support group called Healing Matters at Medical Center of Plano. Healing Matters, which just marked its 10th anniversary, recently started a Pregnant Again group, an acknowledgment that couples' concerns in subsequent pregnancies are different from those of couples in pregnancy loss support groups.

"Ten years ago, there were not many support groups out there," Ms. Robinson says. "It just wasn't socially recognized that this was a loss, and many felt that couples should not grieve over this. Even now, many people think that if the couple didn't hold the baby, they didn't really know the baby." But many couples bond with the baby as soon as they are pregnant.

Up to one in four pregnancies ends in loss, Mrs. Lanham says, adding that there are no official statistics on early loss. Estimates are that one of every 100 pregnancies that pass 20 weeks' gestation - the halfway point - will fail.

Rising mortality rates

The incidence of pregnancy loss has risen as women increasingly delay childbearing until later in life and reproductive technology has made it possible for otherwise infertile women to become pregnant but more likely to miscarry, Mrs. Lanham says. Another reason the numbers are so high is because tests can confirm a pregnancy at earlier stages. Some women who experience miscarriage would never have realized they were pregnant in the past.

"I was 40 weeks along. Full term," says Mrs. Lanham, who wrote for Vatican radio in Rome and married her husband in a ceremony at the pope's summer residence before the couple moved to Fort Worth. "It was Friday, the 13th of May 1994. I went for a checkup and everything was fine. The doctor was going to induce on Monday. On that Saturday, I didn't feel the baby move. At first, I wasn't worried. Friends had said when you're this close to delivery the baby can slow down."

After several hours passed without movement, the Lanhams became scared and went to the hospital, where they were told that the baby had died. On Sunday, as the doctor was explaining that the standard procedure was to go home and wait for labor to start naturally, Mrs. Lanham began to hemorrhage and was rushed to the operating room for an emergency Caesarean section that saved her life.

Their son had died when his umbilical cord prematurely separated from the placenta, which provides nourishment. After the C-section, Mrs. Lanham and her husband were taken back to the maternity floor at All Saints Hospital in Fort Worth to adjust to their loss amid the sounds of joyful new parents celebrating nearby. Later, a doctor came by to suggest that the Lanhams might need marital counseling to deal with their loss.

"If you talk to any woman who has been through this, my experiences were not unique," she says. "They all have similar experiences to report. Everything about it is horrible."

Like many first-time parents, the Lanhams thought they were "home free" after her pregnancy passed 32 weeks - the point at which premature infants are likely to survive. "None of us ever dream that anything like this could happen," she recalls. She began to realize that one reason no one ever dreams of it is that no one ever talks about it.

"Pregnancy loss is not recognized for the sorrow that it is," she says.

The failure of pregnancy after 20 weeks is considered stillbirth. "I hate that term," Mrs. Lanham says. "It doesn't get across the idea that these are babies, many times healthy babies."

When she became pregnant again only four months later, she realized the vast silence extended to a lack of books to guide women through an experience she describes as starkly different from the hopeful anticipation of her first pregnancy. "One woman described it as "If you've been struck by lightning, you're going to be nervous when you go out in a thunderstorm.' I was very nervous," she says.

During the next five years, the former reporter for the Associated Press and Newsweek magazine wrote Pregnancy After a Loss and added two sons - Andrew, 4, and Michael, 2 - to the family. Mrs. Lanham' s desire to do something to mark Patrick's life led her to interview dozens of women - such as Gail Fasolo - who had become pregnant again after a loss through miscarriage, stillbirth or infant death. "Meeting these women gave me hope," Mrs. Lanham says.

Mrs. Fasolo, who lives in Maryland Heights, Ohio, lost her daughter at 39 weeks' gestation and now has a 6-year-old son, Mario. She began to write as therapy, and Pregnancy After a Loss contains the following quote: "I believe a mother cannot truly appreciate holding a baby in her arms, unless she has once left the hospital with empty arms. She cannot appreciate a baby's cry unless her house has been silent. She cannot appreciate hearing mommy for the millionth time in one day, unless she once thought she would never hear that word. She cannot truly appreciate a baby unless she has known what it was like to have lost one."

Spreading hope

One day, still in despair over her loss, Mrs. Fasolo was shopping at a department store when she noticed a Christmas ornament that said "Hope." She took the ornament home and hung it in her den, keeping it up long after Christmas. When she became pregnant again, she decided to make handmade hope hearts for six other women she knew who were trying to conceive after a loss.

"It was like therapy during my pregnancy," she says. Within two years all six women had babies. She continued to send hope hearts, and women from as far away as Japan began sending her pictures of their new babies. At first, she put the pictures on her mirror, then on a small heart-shaped poster. Now, the pictures cover her closet door.

"You shed tears putting these up because you know what they went through to get to this point," she says.

Mrs. Lanham, who had moved to Dallas early in her second pregnancy, first attended a Pregnant Again group "as a researcher more than as a grieving parent." Through that group she discovered Healing Matters and its annual candlelight ceremony - this year's was on Dec. 6 - for those who have suffered pregnancy or infant loss.

Mrs. Lanham says the ceremony is the one time each year when Patrick' s name is spoken in public. The event includes a keepsake tree with porcelain ornaments bearing each child's name.

It's important to mark the lost child's existence throughout the year, she says. Her family celebrates Patrick's birthday by releasing balloons from his grave each May.

Ms. Robinson praises the thoroughness of Mrs. Lanham's book, which covers everything from choosing a doctor for the subsequent pregnancy to decisions regarding selective reduction of multiple fetuses that result from high-tech treatments for infertility. There is also a chapter on fathers' reactions to pregnancy loss and listings of support groups across the country.

The book, Ms. Robinson says, captures the range of emotions she sees in her work, emotions that would be unnatural in a first-time pregnancy but are commonplace in those that follow a loss.

"Pregnancy is supposed to be the happiest time in your life, yet the couples I see are just scared to death," Ms. Robinson says. "Even after the baby is born, it's a different experience. With a succeeding child, the parents may be overprotective. Some have trouble bonding with the baby because they are afraid something may happen," she says.

Emotional surprises were common for Mrs. Lanham, who discovered that pregnancy loss support groups can scare women who are pregnant again because they will hear about so many things that could go wrong in a pregnancy.

In her talks to support groups, Mrs. Lanham encourages women to participate actively in their medical care. "Ask questions, demand extra visits if necessary. If you feel like you want to go in just to hear the baby's heartbeat, go," she says. Although it is sometimes impossible to know what went wrong, it is important to try to find out - both for grief recovery and to avoid problems in subsequent pregnancies.

Her second obstetrician, Dr. Uel D. Crosby at the University of Texas Southwestern Medical School, labeled her subsequent pregnancy "high concern," which allowed her to get the extra attention given to high-risk pregnancies.

Never the same

Her experience also has changed her "as a woman and as a parent." She realizes that life is fragile and has no guarantees; that her family will always feel incomplete to her. She knows that every day she will think of Patrick and what might have been. And that she will live the rest of her life differently.

"The greatest tribute you can pay to your baby," Mrs. Lanham writes in her book, "is to live a life that is even more meaningful than it otherwise would have been."

Deborah Wormser is a Dallas free-lance writer.

© 2000 The Dallas Morning News All Rights Reserved
Deborah Wormser / Special Contributor to The Dallas Morning News,
SILENT SORROW
New book speaks to feelings of parents who have lost a baby.,
01-06-2000, pp 1C.

©1999 The Dallas Morning News