This resource includes information about the time after a termination for medical reasons (TFMR). Please use the drop down boxes to find the topic you wish to read. We have presented information in the drop down boxes so that you can take your time and read certain bits of information when the time is right.
There are options to preserve memories and mementoes of your baby after a termination for medical reasons. Some of this will depend on what stage your pregnancy was at when the termination happened. These may include:
Here are some Australian not-for-profit services that specifically help with creating free memories for bereaved parents after baby loss:
Red Nose Treasured Babies program: https://rednosegriefandloss.org.au/support/article/the-treasured-babies-program
Heartfelt Photography: https://heartfelt.org.au/
Possum Portraits: https://www.possumportraits.org/
Other ways of creating memories might happen spontaneously – bereaved parents often describe signs or symbols in nature or everyday life that over time helps them feel a connection with their baby.
Some people want to spend days and nights with their baby, using hospital equipment such as cold cots, bathing and dressing their baby, or watching a midwife do it on their behalf. Some parents worry: How will my baby look? How fragile will they be? How will I cope? If this is the case, please talk to a midwife or social worker about your worries. The majority of bereaved parents cherish memories of time with their babies and research shows this can help with healthy grieving. However, grief is an entirely personal experience and there is no right or wrong way to respond.
You may think about this before the termination and have fixed ideas about time with your baby. But it is OK and natural if you change your mind once you are in the situation.
Autopsy and post mortem are two different names for the same procedure – a careful and detailed medical examination of a body after death.
Autopsies can add to existing medical knowledge regarding fertility and pregnancies, however it is a personal decision for parents to make. It can be a confronting issue to think about. For parents who have been through a termination for medical reasons, an autopsy may provide extra information about the impact of genetic or physical problems.
There may be the option to have a full autopsy, limited autopsy, external examination only or examination. An autopsy is optional. You can take time to discuss any questions with your medical team and think about your decision, so that you can choose the option that is right for you and your family.
Parents will usually start to think and talk about a funeral in the days after a termination. Hospital midwives and social workers can provide some information and some funeral homes have particular experience in services for babies. Cultural or religious beliefs might play a role in decisions about cremation or burial.
Some parents decide not to have a service and ask the hospital to take care of their baby after death. You can choose to hold a private service, invite immediate family or invite a wider circle of family and friends. Once again, this is purely individual and there is no “right” choice, only what feels okay for you in that moment. If you decide to hold a service, a funeral director can support you through this process.
If you choose a cremation, there are many urns made especially for babies and you can look at them online. They can be chosen later – the funeral home can look after the ashes and then transfer them to your special urn when you are ready to take them home. There are lots of options for people to keep some ashes in a ring, pendant or other keepsake. Of course, some people decide to scatter ashes at a chosen place.
Choosing words for a headstone or plaque can feel overwhelming, try and speak to other people, do online research, or take your time to come up with your own expressions for your baby.
Another option for bereaved parents is to have a memorial service at a later date, after a private burial or cremation. Sometimes families decide to do this months later, for various reasons.
Births and deaths are generally registered with the state’s Birth, Deaths and Marriages Registry within a specific time frame. After a termination for medical reasons, an important factor is the week of gestation. Rules vary slightly between states in Australia, so please check the info relevant to your state or territory. However, broadly speaking, if the pregnancy was at 20 weeks or more, the birth and death legally have to be registered. If the pregnancy ended before 20 weeks gestation, the birth and death cannot be registered. For further information: www.servicesaustralia.gov.au/register-birth-your-baby?context=60001
If a legal birth certificate is not possible, you may be eligible for an early pregnancy loss certificate, issued by your state/territory department of Births, Deaths & Marriages. You will need to find the information online for your specific state. Here is the Victorian one as an example: https://www.bdm.vic.gov.au/births/stillbirth-and-pregnancy-loss/early-pregnancy-loss-commemorative-certificate
If the termination took place at 20 weeks or later, parents may be entitled to specific social security benefits through Services Australia (formerly Centrelink). For further information: www.servicesaustralia.gov.au/deciding-between-parental-leave-pay-and-stillborn-baby-payment?context=22221#a2
It is likely that yourself and/or a partner will need to contact workplaces to let them know your baby has died. It is up to you whether you explain the specific circumstances. Some people prefer to use the terms “pregnancy loss” or “death in utero” or simply say that the baby died. It is important that you feel some control regarding the story of you and your baby.
You will probably need time off work for physical recovery and space to grieve. This can be tricky to get your head around in the early days and weeks, so ask for flexibility and let your workplace know you will be in touch again soon. If you have a trusted colleague or manager, let them know what they should tell people at work, whether you want people to contact you and whether they can help with practical support, like meals.
Leave entitlements for stillbirth, neonatal death and terminations vary significantly between workplaces. Some people discover that entitlements are different depending on the type of bereavement, which adds further complexity to the experience.
Before you return to work, think about how you will manage difficult comments from colleagues or clients who don’t know about your bereavement. Innocent comments such as “oh you’re back, congratulations!” Or “what did you have?” can be painful, jarring and excruciating to deal with. It can be useful to rehearse a script ready for situations like these.
How much time you take off work is a totally individual decision. Some bereaved parents want to return soon for structure and distraction, while others take much longer. Some people have to decide based on finances. Lots of parents return to work at reduced hours or days at first, to see how they manage.
Colleagues and managers might need to increase their understanding about what you are going through.
Don’t hesitate to email a factsheet to your workplace, or ask a love one to email it, if you think it might help. One example is here:
https://rednosegriefandloss.org.au/support/article/our-employees-child-has-died-how-can-we-help
If you and a partner have been through the termination together, it is possibly one of the hardest things you have ever faced as a couple.
There are a range of ways you may relate to each other over the coming days, weeks and months. These might swing from: “you are the only person who has any idea what I’m going through, I feel so close to you” to: “how could you deal with things SO differently to me” and anywhere in between.
Don’t be surprised if the relationship goes through lots of fluctuation. Sometimes there are moments when you turn towards each other and rely on each other for support and understanding. However, differences are normal. You might notice them in the way you experience and express grief, how each of you wants to remember your baby, how you use distractions, or how you each reach out to others. Try not to judge each others’ differences. Focus on the moments you share, encourage your partner to talk when they need to, ask about their experience and try to let them know what you are thinking or feeling, and what you need. If you can practise some kindness and compassion towards yourself, you are also more able to offer it to a partner.
One way that grief sometimes shows up in a couple, is increased irritability or a shorter temper than usual. If you notice this is happening, try and acknowledge it and make time to talk about it when you are both less annoyed. Sometimes one parent carries more guilt and sometimes one parent feels blamed for the decision.
It is common that when a partner returns to work, the person who remains at home longer feels an increased sense of loneliness or isolation. This might last a short time or it can linger. Let them know how you are feeling.
Read about couples’ experiences after termination for medical reasons, listen to podcasts, watch videos of other parents talking. If recurrent arguments or sources of conflict start to emerge, professional grief counselling can provide a contained place to talk openly.
If you have a toddler or older child who knew you were pregnant, you may be worried about what to tell them before and after a termination for medical reasons. The general rule is that children will be aware something is happening even if you don’t tell them. They may sense their parents are sadder, distracted or more distressed than usual. If they don’t receive any information, they might worry about what is wrong. The best way to reassure children is to explain that something is happening and to give them honest, concrete, age-appropriate information.
This may sound something like, “the baby wasn’t growing properly and they died” or “the baby’s heart stopped working and they died”. If possible, avoid euphemisms with young children, such as “They have gone to the sky”, “they passed away” or “they are with the angels”. These can be confusing for young children, whose brains understand things literally and aren’t capable of abstract thinking until they are older. You may want to include religious or spiritual beliefs, however try and separate these from the physical reality of what happened to the body. This can sound something like: “their body stopped working and they died but their soul/love/spirit continues in our hearts/in heaven”.
Please be aware these are just examples and they are guided by research on working with young children and grief. It is still a personal choice for you and might be guided strongly by cultural or religious beliefs.
It is also OK to let other children in the family see you being sad and crying, as it helps them to build a healthy understanding of how people grieve after death. If you add an explanation like: “I am crying because I am sad about [….]. It is normal to feel sad when this happens and it is not anything you have done to make me sad” then they will be reassured and less likely to be worried about your show of emotions.
You may fear that exposing your child to grief and death so early will damage them in some way. This is an understandable fear in a modern society that is not grief literate and provides the message that we should “get on with things”. However, research shows the opposite is probably true for most children – if their parents demonstrate healthy models of grieving, talking about loved ones who have died and showing natural sadness, then they will be less scared of people dying and will be able to talk more openly about their own experiences later on.
If possible, try to allow space for a bereaved sibling throughout their childhood to talk and ask questions about the baby who died. Their understanding will grow and change as they move through developmental stages and they may ask for more or different information. They might also want to lead the way with a ritual to remember their sibling, for instance lighting a candle, doing a drawing or having cake. Young kids learn from making some decisions (age-appropriately) so it is OK to ask them what they would like to do.
It can be hard for bereaved parents after a termination for medical reasons to have questions and unfiltered thoughts sprung on them by a young person in the house. There may be times where you don’t feel up to talking about it and this is OK. You can signal this to your child with: “I really want to hear your questions and answer them but my brain just can’t fit that in right now. Let’s make time to talk about it later when I feel up to it.”
Here is a series of books produced especially for siblings and their families after termination for medical reasons:
https://pregnancyafterlosssupport.org/childrens-book-series-termination-for-medical-reasons-review/
It is entirely up to you whether you tell people you have been through a termination for medical reasons, or tell them more simply that your baby died during pregnancy. Yours and your baby’s story belongs to you (and your partner if you have one) and it is important that you get to decide what you share, when and who with.
Some people say that speaking openly about a termination reduces secrecy, stigma, shame and self-blame. However, it is also wise to decide based on how you feel in the moment – who is asking, where you are at the time, how vulnerable you are feeling.
Most people will try to support you or say something comforting. However, you are likely to encounter some people who say the wrong thing by mistake, lack sensitivity or ask lots of questions. Know that it is OK to stop a conversation at any time. You can tell people that you do not want to talk about it anymore and know that this is your way of protecting yourself and your memories of your baby.
As you re-enter the wider world in coming weeks and months, you may face questions from strangers or acquaintances such as: “do you have any children?” or “how many do you have?” This can be a hard question. Try to be gentle with yourself. You can give different answers at different times, depending how you are feeling right then.
Parents sometimes feel guilty – that they have betrayed their baby or ignored them – if they don’t include all the details. But this does not make you a “bad” parent or mean that you are lying, it is the reality of having a raw and painful moment sprung on you and coping as best you can.
It is natural if you feel protective of your baby after they die, the same way parents feel protective of living babies. That may include not wanting to tell people the circumstances in case someone says something hurtful or judgemental. If some people are less respectful and sensitive about your baby and your experience, you are less likely to share with them.
Soon after the termination, you may be unsure whether you want to use words such as mum, dad or parent. Sometimes it takes time after the shock of bereavement to figure out your own language. “Who am I now?”. “Who am I without my baby?” Who am I without having a baby to care for at home?”. “What’s the point?”. Some of these questions, among others, might sound familiar to you.
Some people want friends and family to talk about the baby and use their name. You might be longing for people to refer to you as a mum/dad/parent but often find yourself disappointed. If you can, explain to people close to you that it’s helpful when they talk about you and your baby in language you identify with.
Lots of people describe grieving for the person they were. They talk about missing their sense of security in the world and the safety they felt in understanding the natural order of life and death. All of these are common after a termination for medical reasons.
You might also question how you identify with your body – “has my body failed me?”, “my body hasn’t done what it is supposed to”, “my body is no good at carrying healthy babies”. These thoughts may creep in as you try to make sense of it all. Women are heavily conditioned to believe that having children is a pivotal role in life, and for their bodies, so it is understandable that you struggle with this.
It is really common to find particular dates and milestones painful and difficult. Many parents talk about some of the following anniversaries and milestones:
If you find ways over time to include and honour your baby in these moments, this can make the milestones feel meaningful, although it doesn’t take away the pain of their absence.
After a termination for medical reasons, you might struggle with circumstances that have never been a problem before. Other friends’ pregnancies often trigger difficult feelings and this can come as a surprise. It is really common to feel some jealousy or irritation if other people have healthy babies and seem oblivious to your pain and anxiety. Having thoughts and feelings about this doesn’t make you a “bad” person, it is a signal that what you are dealing with right now is incredibly hard, that you are raw from your bereavement and feeling extra vulnerable.
Seek out people to talk to who can understand your experience without dismissing it. People who can listen and let you talk are like gold dust at this point!
There are circumstances that some bereaved parents need to avoid – such as baby announcements, baby showers and visiting newborn babies. This can be hard in itself but, if this is you, know that you are doing your best to manage your heartbreak and it is OK to behave differently than you would have beforehand.
There are grief services in Australia that work specifically with bereaved parents following pregnancy loss, including terminations for medical reasons.
One type of support is professional – this refers to a person who is a qualified, experienced counsellor. The other type of support is peer-based – this refers to a person who has lived experience similar to yours and has brief training in supporting people.
Some people prefer one type of support over others, and some people access both.
If you want to access professional counselling for yourself or as a couple, Red Nose Grief and Loss provides this service for free, Australia-wide (SANDS used to be a separate organisation but has now merged with Red Nose). Both Red Nose/SANDS and The Pink Elephants Support Network have online groups specifically for people after terminations for medical reasons.
Other professional and peer supports can be found via our Mental Health and Wellbeing Support page.
Through the Unexpected sponsored a print run of the peer-developed companion resources, A Little Help from Jack and A Little Help from Remy. These companion guides were created as a one-stop resource for parents experiencing stillbirth or TFMR.
A Little Help from Remy is written for parents experiencing TFMR. If you are going through the unexpected and would like a free copy A Little Help from Remy posted to you (in Australia), please complete this form.
These resources are provided for information purposes only and should be read in accordance with the Resource Library disclaimer.
If you or a loved one need support, speak to your care providers or see our Mental Health and Wellbeing page for contact information for urgent and/or ongoing support.