Tracie Copeland sat in a hospital delivery room.
At 40, getting pregnant hadn’t been as hard as she’d expected. And carrying the boy she and her fiance would name Penn went pretty much as planned. Until eight months in, when she woke at home knowing something was wrong. Until the technician with the ultrasound bowed his head and said he couldn’t find a heartbeat. Until the doctor told Tracie that Penn had inexplicably died.
And now she had to deliver him into the world all the same.
“Everything was just in slow motion. I could not wrap my head around it,” Copeland recalled, now two years down the road. “This was not the worst case scenario. A preemie in the NICU, that was the worst case scenario.”
This wasn’t a possibility. Stillbirth rarely is, at least in the minds of expectant mothers.
Statistically about one in 160 pregnancies in the U.S., or about 1 percent a year, ends in a stillbirth – a woe distinguished from miscarriage, most health experts agree, when the mom carries through 20 weeks.
It’s a death about 10 times more common than Sudden Infant Death Syndrome, yet equally mysterious. Scientists can list a number of factors that can increase the risk of a stillbirth. The mother’s race, age, weight, health and habits can stack the possibilities of misfortune higher. But that doesn’t always yield a ‘why’.
Copeland didn’t get a why.
But she did get the salve of compassion from the hospital staff, who at the time were partners with an organization out of Atlanta called Rachel’s Gift.
The charity provides a box full of ways to tether the memory of a stillborn child’s existence to the grieving parents. In the box sits a crocheted blanket, keepsake-styled cards on which to ink a footprint, a kit to make a hand imprint. There’s also information on getting a special photo portrait of the child. The box also contains contacts for support in grief.
The boxes are free to the hospital to give to parents with only one hook: the hospital’s nursing staff must get four hours of training on how to help parents through likely the toughest hours of their lives.
After incredible lows, Copeland’s life began to soar again. She married fiance Tom and has opened her own real estate brokerage. But the ordeal she had to push through isn’t far from her heart.
She credits Rachel’s Gift for giving her purpose in a world without Penn. She volunteers for the organization now and has hopes to start her own support group for mothers like her.
But in October of 2014, her hell seemed unique.
“We’d just done our tour of this hospital, this room. We met this nurse,” Copeland said. But now the nurse had words never uttered on the expectant-mom tour she’d taken earlier in her pregnancy: “Just stick together. This is the hardest thing you’ve ever done. “
Instead of calling friends and family to her room at Wellington Regional, the Copelands called a pastor. As Tracie prepped to bring Penn into the world, she was peppered with seemingly endless questions about how he should leave: Do you want him cremated? Do you want to wash him? Do you want to hold him?
The epidural. “It was still excruciating.” The delivery. “Quiet.”
“They washed him up and brought him to me. It’s so surreal. He was completely healthy and beautiful. You know he’s not alive, but you don’t want to let him go,” Copeland said. But of course, she had to.
She’d never been so empty handed.
“You feel like it didn’t happen. You want it acknowledged. He was born. He died. It happened,” Copeland said.
Nursing school doesn’t cover how to engage with a mom who delivers a stillborn child, said Lori Beth Blaney, who founded Rachel’s Gift after her daughter, Rachel, was stillborn. At the threshold to become a mom, Lori, who lives just south of Atlanta, was in a car crash and her baby didn’t survive.
“They get kind of bereavement 101. You know, the stages of grief. It’s not very involved. And especially in women’s issues it’s a little different. You have moms with live healthy births, moms with sick babies who go to the NICU and moms whose babies die. They get a lot of training on the first two,” Blaney said.
She describes her experience as a mixed bag.
“The one part they did do beautifully, I had a male nurse who was very gentle and respectful to her and bathed her. But what they didn’t do was talk to me about what I could’ve had – a picture, a keepsake… They didn’t talk to me pretty much at all at the hospital.”
For Toni Ahern, now director of women’s services at Palms West Hospital in Loxahatchee, that moment is crystallized in a 25-year-old memory.
“The baby was 10 pounds, and I remember I didn’t know what to say to her (the mother). It was the first time I was speechless. The baby was absolutely beautiful. I remember laying the baby in her arms and backing up… I should’ve just held her hand. That’s what I should’ve done.”
Just this spring, Palms West became part of the Rachel’s Gift hospital network – one of only a handful in Florida and 21 in the country. The hospital had an informal plan for bereaved moms, but wanted to do more to avoid missteps.
And the list of missteps can be long, Blaney said.
“We hear many bad stories. A lot of them come from lack of knowledge. A lot come from their uncomfortableness,” Blaney said.
Nurses may ask the mom in the throes of delivery whether she still wants to hold the child.
“That’s a horrible time to ask. A lot of moms will change their mind. If a mom says, ‘No’ …there’s no way back,” Blaney said.
Some hospitals move the mother out of the maternity ward to a regular floor, when she might prefer to stay.
Others fail to gather the few keepsakes the parents will ever have that their baby was here.
“We teach the nurses how to have those conversations gently, not so clinically. Not addressing everything at once but over the course of a day or two while mom is there. Try to start collecting mementos,” Blaney said. “When someone older dies, you have physical items to help you grieve. It’s such a small window. A lot of it goes toward validation. There was a life here and they mattered.”
Ahern said the training helped.
“It made us take a step back. We feel better prepared and we feel better that they’re leaving the hospital and someone is following them,” Ahern said. Rachel’s Gift keeps in contacts with its moms over the following year.
The gut punches don’t stop after you leave the hospital, Copeland learned.
Though some moms appreciate staying on the maternity ward, Tracie and Tom couldn’t bear to hear the infant cries amid a steady stream of congratulating friends and family that echoed through the halls. They left after only a day, in a car once fitted with a car seat, to their Lake Worth home with a freshly painted nursery, crib and changing table.
Copeland was still lactating.
“It was such a beautiful day coming home from the hospital. It was sunny. I remember seeing people. For me, my life stopped. It came to a screeching halt, but everybody keeps going,” she said.
And when she couldn’t sleep, she’d find Tom, her rock, alone “just sitting there crying,” she said.
“You’re grieving the future you’ve been planning for him for eight months. In one hour he’s gone.“
They had a vigil. They released balloons.
She went to a mom’s grief group, but the only other mom there had not been through stillbirth. A best friend who had endured a miscarriage was some help – someone who got Copeland out of her pajamas and out of the house.
Still she felt alone. “Nobody can relate to this. I wanted to talk to another mom who went through this.”
Her faith was shaky, and then her pastor said something that clicked: “You went through this experience for a reason. You need to give back and share it.”
Purpose was born.
Copeland called Rachel’s Gift and seven or eight months after Penn died, she was back at the hospital keeping inventory of their boxes and replenishing them when needed – which was more often than she had imagined.
Eventually, the hospital staff changed, says Blaney, and Wellington Regional has not renewed its affiliation with the charity. But that didn’t stop Copeland’s work. She and her husband are now planning a wedding dress donation guide that will fill more of Rachel’s boxes. A binder with plans for a support group is filling as well.
And also in time, Copeland found another mom who could relate. Her doctor connected the two.
Tracie and Tom married four months after Penn’s death, a pin with his initials adorned her dress. “The divorce rate after this is really high,” she said. “The blame game starts. But it pulled us together in a way we didn’t expect.”
A former real estate agent, she got her broker’s license and opened her own business, Copeland & Co. Real Estate. She’s a boss with five agents in her employ.
“Motherhood was my plan. I waited so long for it. I was going to be a stay home mom. And then it was gone. You have a pity party moment. This moment is defining everything. And then you look at yourself in the mirror and think ‘What am I made of right now?’ ” she said.
Now, the couple has their sights on trying for a baby again or maybe adopting or fostering one.
“I had to reinvent myself,” she said.
*A stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.
*Better prenatal care and advances in medical technology over the last 30 years have dramatically reduced the number of stillbirths happening after 28 weeks. But the rate of stillbirth in earlier pregnancies from 20 to 27 weeks has remained steady.
*In the U.S., stillbirth happens in about 1 in 160 pregnancies or about 24,000 a year. Most often the death happens before a woman goes into labor, but some happen during labor and birth.
Source: The U.S. Center for Disease Control and Prevention
The cause of many stillbirths are unknown. The known causes fall into three broad categories:
*Problems with the baby (birth defects or genetic problems)
*Problems with the placenta or umbilical cord (where mother and baby exchange oxygen and nutrients)
*Certain conditions in the mother (for example, uncontrolled diabetes, high blood pressure, or obesity)
Source: The U.S. Center for Disease Control and Prevention