I reviewed her chart as she sat in front of me for her new OB appointment. Two of her children had died in a freak accident in the recent years and now she was pregnant again. She told me this was a planned pregnancy. “This must be a complicated happiness,” I said. She nodded in complete agreement. I shared, that I too had lost a child- under very different circumstances- and we had a little side conversation about child loss.
“I had some people tell me ‘I know exactly how you feel because my child died too!’” she said, “But I’m like, ‘no you don’t. Your child died in gang related gun violence. He was doing something he shouldn’t have been doing. My children were innocently sitting at home!’”
It was a powerful statement.
Hierarchy of loss. It is something we discuss a lot in the loss community- loss is loss, we say. Is there a hierarchy? I think yes and no. I think it is a different loss experience having a miscarriage at 5 weeks and one at 12. I think it is different having a stillbirth versus a neonatal loss. I think it is different having a neonatal loss versus child loss. I think it is different having a child die from something preventable versus random. I say I think before each of these statements because I have only experienced one such scenario. I know there are some people out there unfortunate enough to have experienced more than one of these and perhaps these people can speak better of how, if at all, the losses are different.
I often feel almost guilty in the loss world because my baby was born alive- I got to meet her, though briefly. Many of my loss friends never had the privilege of hearing their baby cry- whether it be through miscarriage or stillbirth. Weird, right? To feel some sort of guilt about my baby living? I had to experience other loss, like the loss of a carefree pregnancy and the pain that comes with wondering if my child is suffering. But I also know exactly why my child died, while others won’t ever have that knowledge. I could go back and forth about how my loss was harder in some ways and easier in others- but it isn’t a competition. There are no winners in babyloss. All I really want is the pain related to my loss acknowledged as real and legitimate.
My patient is right in a way- her loss is different because her children were dong nothing wrong. The other woman’s child was engaged in risky behavior. But my patient is misguided in a way too- I’m sure that other woman was not only mourning the death of her child, but also the loss of what he could have been- the child not involved in gangs. She probably had complicated guilt over her child having some responsibility in his own death or maybe feels responsible herself for being unable to keep him out of gang violence.
I think what it comes down to is no one knows exactly how each of us feels, but we are all sad over our losses- the early ones, the expected ones, the preventable ones and the random, unexplainable ones. I know I am constantly seeking the person who knows exactly how I feel, but I think I’d be hard pressed to find another 34 year old midwife who lost her first child to an extremely rare and random combination of birth defects. So for now I take solace in the comforting words of others who share aspects of my loss. Those with infertility know what it’s like to wait almost two years and have no baby to show for it. Those who miscarry know what it’s like to have the dreams of a normal pregnancy ripped away. Those who chose to terminate based on a difficult prenatal diagnosis know what it’s like to make extremely hard decisions for their child. Those who have a stillbirth know what it’s like to birth a baby but leave the hospital with empty arms. Those who have neonatal loss know what it’s like to watch their children die, wondering if they suffer. Those who have child loss, preventable or not, know what it’s like to bury a child.
We are not the same, but we are. We are all sad.
What are your thoughts? Is there a hierarchy of loss?
Credit: Return to Zero https://www.facebook.com/returntozerofilm
Expecting the Unexpected 
Such a good post. There is too often a perceived hierarchy about baby loss. You are so right – it does not matter how our child has been lost. A mother mourns. It is all awful. We are all bereft. We are all sad.
thank you. we all mourn our different losses and we morn in our different ways.
Meghan, Your loss is different from anyone else’s because Mabel was different from anyone else and that is why she is so special. I think we all try to compare loses in order to understand. You have taught me that what we really need to do is acknowledge the presence and loss of Mabel. Like you said there is no winner in the child loss world. We all need to try and see the positives and the fact that Mabel has touched our lives is a positive for me.
Love you
Kathleen
Kathleen Flattery Abrams Designer McKenzie Baker Interiors 910.231.1959 Wilmington, NC
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Yes- she was so very different. I agree- we compare because we want understanding, and validation, to know our loss counts too and our hurt is real. you’re right-acknowledgement is the heart of what we want! thankyou.
Beautifully written and thought out. I think there is a hierarchy of sorts but at the same time that doesn’t minimize an individual’s pain. A mom who suffered a 6 weeks miscarriage is hurting tremendously and her pain deserves to be recognized but it cannot be placed on the same level as someone who suffered a late miscarriage or a stillbirth or a neonatal loss or an infant loss or a child loss. I would never dream of comparing my stillbirth to a mom who lost a child to SIDS for instance. I think what needs to be reinforced is that individuals should stop trying to relate to each other’s losses by comparing their level of pain. They should recognize each other’s losses for what they are, the loss of hopes and dreams, the loss of a child, and bond on that common factor. I hope this makes some sense. And I’m entirely open to listening to anyone dissenting from my opinion.
I think you and I are of the same opinion- our losses are different. but they do have a common denominator- they are all losses. so i think there is a hierarchy is a way, but focusing on the differences dont do anyone any favors. you make sense to me.
Which would be “worse”, SIDS or a stillbirth? I think it could easily be argued either way, both have their “pros” (I held him his whole life v. I got see him look back at me) and “cons” (my family didn’t get to meet her v. the paramedics came into my home) but there is no real answer. I’ve only been through one type of loss but I’ve been to many support groups, and at the end of the day I absolutely don’t believe that either SIDS or stillbirth is more difficult to process, mourn, cope with and survive than the other.
yes! i think both are so sad- its like asking which would i choose? frankly, neither. I find the same pros/cons in the idea of would I have wanted all the info, knowing my baby might die- pros, I could prepare for these few hours and they were as calm as possilble. cons- my pregnancy experience, the joy of it was robbed from me. i feel like these pros/cons apply to comparing all losses. we can argue back and forth- play which is worse, but if feels so close to all the “at least” statements we all hate so much, right? ultimately we all just want recognition that what we have gone through is sad!
Every grief is unique because every person lost is unique. I wish we all would acknowledge the terrible pain experienced by another cannot ever be compared satisfactorily to our own. I only know my pain, and it is awful to me. There is no worse, no better…just different. I understand the need to try to get someone else to understand just how awful it is, because it sometimes it feels to big to carry on my own. However, trying to minimize their loss to prove mine is worse is NOT the way to do it. Nor do I think having people say, “I don’t know how you do it. I would just die” very helpful. I already feel isolated and alone in this pain, this only pushes me further away. I wish we would stop trying to compare and instead offer compassion and love to the grieving.
Oh yes, I find that phrase so very unhelpful too!all it does it make me feel like I”m failing even in grief. I think what they are trying to say is “you deserve a medal just for getting our of bed!” it’s amazing how much power a few words have.
this is very meaningful post. I have experienced this myself and few occasions compared my loss to others. I guess it is mother’s nature to feel that her loss and her child are more important.
I compare myself too. and I think you hit the nail on the head- there is some nature in it, the comparison. We just want to know our losses matter.
I notice you said you feel “almost guilty” about your experience with Mabel. To be honest, for a long time I got very jealous of people whose baby had a peaceful life or who got to spend more meaningful time with their baby than I did. I don’t think that makes my loss “worse”, but it did confront me with a lot of difficult, important issues to work through, especially anger that my experience and my son’s life were far from the best that they could have been. That was a whole separate set of very difficult, ugly, painful stuff to grapple with -an extra, hard thing to grieve. If I hadn’t talked to other loss moms and realized how upset I was about missing out on that precious time, I wouldn’t have recognized that I needed to work through those feelings. But that doesn’t take away from the magnitude of your loss in any way… We’ve all got our work cut out for us, and at least for me, “comparing” has helped me identify what my own work needs to be. If that makes sense 🙂
right- so much work in the grief processing. I think you’re right- the comparing helps us work through our regrets, what we can remember with peace and some how help us relinquish the sense of control we thought we had!
Thank you for writing this. It’s something I often think about. I lost my first pregnancy after we discovered the baby had anencephaly at the 12 week scan. I think because it was so early but also I still feel a lot of guilt about ending the pregnancy even though there was no hope going ahead and all of the experts recommended it, means I don’t feel my grief is as justified as others who have experienced loss. I think bottling up the emotions because I didn’t feel I had a right to grieve certainly stored up a whole heap of trouble (which thankfully counseling eventually helped).
I think getting a fatal prognosis for your baby is never easy- never. I hold no judgement for those who learn of their baby’s condition early enough that termination is an option. I have no idea what I would do if I was told Mabel wouldnt live for certain at 12 weeks (we were told at 27 weeks that her prognosis was very poor, but not for certain fatal). It’s another kind of grieving that comes with a fatal diagnosis- whether it be carrying to term or terminating. I’m sort of part of a community that carried to term- except mine wasnt so much a choice (yes, I chose to carry for Down Syndrome, but that’s not fatal) but I find there is often judgement in that community against those who made the heartbreaking choice not to. I wonder if they would have judged me if I had different circumstances. I feel like my message is the same here- we are all sad, yes our circumstances are different and in some ways there is a hierarchy, but no one should be judged for feeling sad. Everyone’s grief is valid. I’m glad counseling has helped you find that your grief is absolutely justified. I’m so sorry for your loss.
A lady in my online baby-loss group that has had the unfortunate experience of both an early loss and stillbirth put it like this:
I know what you mean. I found one of the hardest emotions at first was the feeling that no one else in the world could understand how much pain I was in. I feel like some people who have been through miscarriages might be even harder to connect with some times. The reason for that is, after my 12 week miscarriage, I thought that that was as sad and desperate as anyone could be. I felt like my pain must be similar to that of anyone losing a baby at any stage. Because it was truly terrible, it really was. It wasn’t until I had a late loss that I understood that the pain of my miscarriage was just a sliver compared to the pain of losing my daughter.
I think she said it so well- we only know as much sadness as we know. It’s kind of like the pain scale we use in medicine- 0-10. I have people come in without a grimace or any guarding and say their pain is a 10 out of 10. I’ve seen pain of 10- it’s usually full blown labor, a kidney stone, a broken bone (or as I tell people “your hand in a blender”). But to them their pain is real- it’s the worst they’ve known, so it’s a 10. if/when they get into labor or have a kidney stone or whatever, they often re-evaluate their pain. I had one lady who happened to be taking some percocets in pregnancy for back pain. After labor she said, “i thought my back pain was really bad, but now I realize it wasnt nearly as bad as I thought it was.” That’s not a totally relatable story- because miscarriage pain is still bad. It’s just about knowing what you know. If I ever miscarry after loss, it will still be so incredibly painful, but I’m unsure it will be at the same level as Mabel’s loss, because now I know that pain. I like how that lady put it- she still recognized her miscarriage as pain, but recognized it was on a different level as her later loss.
What a refreshing, honest and open reflection on loss. Death is too much of a taboo and while I know you will never be grateful in any way shape or form for the loss of Mabel, I hope you can find comfort in the friends you have made through this. Thank you again for sharing x
Thank you- your words are well put- I”ll never be grateful for her loss, but I am grateful for the friends I have made.
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