A mother and father’s grief

Resources for practical and psychological support after a miscarriage, stillbirth or sudden infant death – especially for English-speakers – are growing.

By ABIGAIL KLEIN LEICHMAN
Reva Judas (photo credit: Courtesy)
Reva Judas
(photo credit: Courtesy)
Rivka and Ari Singer don’t know where their stillborn daughter is buried. Red-headed like her mother, she was born in a Jerusalem hospital in 2009. Their rabbi assured them the hospital would handle the arrangements through a hevra kadisha, a religious burial society.
“That means they wait for other dead babies and put them [in a grave] together,” Rivka Singer says. “They don’t want the parents to know where it is because they want them to move on. It’s very complicated to call the hevra kadisha afterward to ask where the grave is. So you just have to pretend you know she’s in a nice place.”
Now the parents of a healthy baby boy, the Singers only later learned they could have had greater say in the matter. In the absence of any religious or emotional guidance from the hospital social worker, Rivka Singer found an online forum for bereaved mothers, and a free support group at Hadassah University Medical Center in Jerusalem’s Ein Kerem.
Resources for practical and psychological support after a miscarriage, stillbirth or sudden infant death – especially for English-speakers – are growing in Israel. There is increased recognition that in addition to dealing with their grief, Jewish parents also need guidance through unfamiliar areas of religious law and custom.
Yet few hospitals provide a list of relevant contacts, and many couples are simply encouraged to put the loss behind them quickly. “You’ll be back here in 10 months with another baby,” a discharge nurse told Singer. In fact, the Ofra resident had already suffered one miscarriage and would have another within 12 months.
“There’s a lot of pressure on women, especially in the religious community, to accept a miscarriage as Hashem’s [God’s] will and move on,” says Beryl Tritel, a social worker practicing in Ramat Beit Shemesh, Yad Binyamin and Jerusalem. “There are a lot of women suffering. I had a couple of late miscarriages and nobody in the hospital came to talk to me or see how I was doing. My husband asked the nurse for someone to talk to me, so a social worker came but she clearly didn’t know what to say.”
However, there are signs of positive change.
“When a woman loses a baby after 24 weeks [gestation], I speak with her about her emotional feelings,” says Sagit Zeevi, a social worker at Rambam Medical Center in Haifa. During one recent week, she counseled three such mothers.
“We talk about saying goodbye to the baby and whether to see or not to see the baby. We talk about all the things she will deal with after leaving the hospital – the physical symptoms. Her relationship with her husband and with her other children if she has them. What are normal feelings and what are not? How people around her will react. I try to prepare her for everything, and give her a brochure with all the information to take home.”
Translators can convey the information in English, Russian, Arabic or Amharic. Zeevi speaks with the fathers as well, and gives out her personal phone number for future questions. “I also have support groups to help women work through their ordeal and acquire tools for coping with grief and loss so as to enable them to carry on,” says Zeevi.
WESTERN GALILEE Hospital in Nahariya recently hosted Reva Judas, a New Jersey hospital chaplain and founder of Nechamah (www.nechamah.org), a counseling and support group for Jewish parents and grandparents who have suffered pregnancy and infant loss. Her trip was sponsored by the UJA Federation of Northern New Jersey, Nahariya’s Partnership 2000 sister region.
“Western Galilee is opening an infertility clinic and they want to work with me to develop a support group at the hospital for parents who experience pregnancy loss,” says Judas.
She says she hopes to connect it with her Nechamah group at Holy Name Medical Center in Teaneck, NJ.
“One of my dreams is to have a buddy system of people who’ve been through the same situation, but who they won’t run into at the local supermarket,” says Judas.
“The people I met in Nahariya all know very good English, so I think the language barrier won’t be a problem.
Grief is a universal thing.”
Of the 25 Partnership 2000 volunteers in Nahariya with whom Judas met, about half had experienced pregnancy loss, illustrating how common this is.
“Everybody I spoke to about it felt this is needed – even the mayor,” she says. “We talked about the added guilt component in Israel: Parents who’ve lost a baby feel they have no right to ‘complain’ about it when their neighbor’s child may have been killed in a war or a terror attack.”
From July 2 to 8, Judas will lead Nechamah’s first “Health & Healing in Israel” mission. English-speaking Israeli residents may sign up by the end of March for any part of the retreat (nechamacomfort@gmail.com). The itinerary includes self-pampering at a spa hotel, a memorial tree-planting ceremony, a visit to Rachel’s Tomb, art therapy, hikes and daily counseling. Participants can be from any stream of Jewish observance.
“They’re all angry at God no matter how religious they are, so they all share the same feelings,” says Judas, an Orthodox preschool teacher whose own firstborn died soon after birth.
Confronting a uniquely Jewish concern, Judas is working with New Jersey rabbis to give couples control over the burial process. In Jerusalem, A TIME volunteer Chanie Wachsman addresses this issue by making parents aware of their options before it is too late. A TIME-Israel, a branch of a New York-based Jewish-infertility support organization, offers English-speakers medical referrals, workshops, information packets and online or telephone emotional support – not just for infertility, but also for pregnancy and infant loss. (www.Israel@atime.org, 052-377-0444.) “I feel that knowledge of the procedures and options, support in their own language and the ability to make informed choices are highly valuable assets to couples dealing with cultural and religious issues during their time of crisis,” says Wachsman.
She explains to newly bereaved parents that they may choose a hevra kadisha and express their preferences for burial customs. Couples may opt for a Sephardi burial society or an Ashkenazi one outside Jerusalem, as these are more likely to let parents know the location of their baby’s grave and even attend the burial. After reviewing their options, one couple she recently counseled decided on an Ashkenazi burial society in Jerusalem, despite the strictures.
“When the hevra kadisha arrived – the most religious and Yerushalmi one – they had a positive experience relating to them as they knew beforehand what they couldn’t have and what they could,” says Wachsman. “They made peace with the unknown burial site more easily than couples who were shocked by it at the time and felt out of control.”
A TIME is now training labor coaches to prepare and guide couples through stillbirth. “We just trained our first batch of labor coaches in Jerusalem,” Wachsman says. “If someone calls us and says they are about to deliver a stillbirth – in the midst of the birth, too – we can refer them to one of these coaches.”
Recently, the aunt of an expectant mother called A TIME seeking guidance as a labor coach when it became clear that her niece’s fetus was not alive. “I sat on the phone with her in the middle of the night,” says Wachsman.
Also in Jerusalem, doula and hospice volunteer Miriam Maslin (www.miriammaslin.com) trains childbirth professionals to help clients through a stillbirth.
“The doula has to make sure not to project her own feelings, and just be there and honor the client where she is. We can minimize trauma by supporting her in a loving, respectful way and empowering her,” says Maslin.
“Very often they’re fascinated that a woman has the ability – even though knows she’s delivering a stillborn infant – to be a birthing mother in all her glory and power.”
Maslin stresses that the woman’s husband must be included in this process.
“They’re going through it as a couple, and sometimes that is a complicated dynamic,” she says. “It is important to know afterward that often men and women grieve differently, and each needs to be given the support and space they need for that loss in their lives.”
Because miscarriages are often part of a longer struggle with infertility, A TIME and other organizations, such as the Puah Institute for Medicine and Fertility in Accordance with Halacha (www.puahonline.org) offer not only emotional counseling but referrals for genetic testing and highrisk pregnancy specialists for couples ready to try again.
JUDAS SAID that even long after healthy children are eventually born, emotional scars from pregnancy loss can remain.
In January, she spoke at parlor meetings in English-speaking neighborhoods in Efrat and Ra’anana about the importance of community support for parents coming home from the maternity ward empty-handed.
“It’s as simple as offering meals, help with the other kids, or just picking up a phone and saying ‘How are you?’ – especially for fathers, because men hide their grief. I also talk about what not to say; how to just listen and acknowledge. I suggested posting information in the local mikve.”
She stressed that “it’s never too late to do something to commemorate a lost baby. It’s so important to talk about it, even years later.”
Beth Saar, who hosted Judas’s talk on a rainy Saturday afternoon in Ra’anana, miscarried twins 16 years ago in London.
“There was no support afterward,” she recalls. “Life went on. But I think there is a need. There are a lot of groups in Israel for people who’ve lost loved ones to terror, cancer and other kinds of tragedies. But you cannot put us in the same room with them. Our grief is not the same.”
Leigh Maller understands this. A newcomer to Jerusalem from New Jersey, she is the mother of six, and a certified doula and midwife. She also suffered six miscarriages. Through the Jerusalem-based Shalev Center, she’s starting a five-week pregnancy-loss support group (www.shalevcenter.
org/ai1ec–event/lossgroup, 052-541-9115) at her home.
Maller is also gathering contributions for what she hopes will be a live e-book titled Permission. “Women from all over are sharing their stories of loss, and we have a few articles on how to integrate loss from a Jewish perspective,” she says.
This project and her support group are outgrowths of informal counseling she has given couples and siblings over the years.
“I realized that it would be nice if they could hear each other’s stories and how they processed their loss, and use each other as resources,” says Maller. “There’s a lot of silent grief because people don’t realize they can get help.”
In an ideal world, says Rivka Singer, a specially trained social worker would meet with couples in the hospital and send them home with a list of online or in-person support groups. This did not happen at any of the three hospitals where she experienced her stillbirth, a miscarriage in early pregnancy and another at five months’ gestation.
“In the maternity wards, there should be a separate place where a woman can give birth when she knows she’s having a dead baby – although I know that’s not practical,” Singer continues.
“The hardest thing was that we had to be in a delivery room with all the other women going out happily with a baby, knowing for us there would be no baby.”
She also believes that “nurses and doctors should go through a course to learn how to say the right things and not the wrong things.”
One of the “wrong” things is the common platitude that a future baby will somehow nullify the loss. Singer looks lovingly at her cooing son, named Naveh (Oasis) to evoke the idea of a nourishing place reached after a difficult journey.
“He does not take the place of the other babies,” she says. “He came for who he is.”