Although still very taboo, stillbirth and neonatal death (defined as the death of a baby within four weeks of birth) are unfortunately more common than most people realise.
According to 2016 statistics, in Belgium, around:
- 1 in 180 babies is stillborn 1
- 1 in 480 babies dies during the neonatal period, i.e. within the first four weeks after birth 2
Parents who lose their baby often feel very isolated, as friends and family may not know how to support them, and they may have trouble finding the information they need, especially if they don’t speak French or Dutch.
- If you know someone who has lost a baby, this document from UK stillbirth charity Sands may help you in supporting the bereaved parents.
- If you have lost your baby, the information below may be useful for you:
Definition of stillbirth in Belgium
Under Belgian legislation, the loss of a baby in utero after 22 weeks gestation (140 days of pregnancy) or with a birth weight of more than 500g is considered a stillbirth 3.
Before 30 March 2019, a stillborn baby could only be officially registered – and therefore officially named with the Belgian authorities – if he/she was born after at least 180 days of pregnancy (i.e. almost 28 weeks gestation).
Since 31 March 2019:
- a baby who is stillborn after 140 days of pregnancy can be officially registered with the Belgian authorities, and therefore officially named. Only a first name can be given to babies stillborn before 180 days.
- a family name, as well as a first name, can be given to a baby who was stillborn after more than 180 days of pregnancy.
There is a one-year transition period during which time parents whose baby was stillborn between 140 and 180 days, and who wish to have their baby registered, to do so.
This request needs to be made before 31 March 2020.
Giving birth to your stillborn baby
Being told that your baby has died in the uterus comes as a huge shock, and you may have trouble believing the news. In the following hours and days you may have a lot of decisions to make. Unless there is a medical urgency, you should have some time to come to terms with the news.
You will have a multi-disciplinary team (doctors, midwives, nurses, psychologists) to support you through this time, and provide comprehensive information on the options available, as well as advice.
Many mums are scared of giving birth to their baby. Unless there is a reason for a caesarean birth, you will most likely give birth naturally. In most cases your labour will have to be started artifically, i.e. induced.
Hospital staff will be particularly sensitive to your needs, e.g. in terms of pain relief and who you want to be present.
If your baby dies during birth
Although a baby can die due to a trauma or event during the birth itself, this is very rare if you are being supported by the appropriate professionals who will be monitoring the condition of both you and your baby during labour.
The decision of whether or not to see, hold, or photograph your baby is a very personal one, and hospital staff should respect your choice. Even if you decide not to, staff may offer to take photos of your baby, which may then be included in your medical file should you wish to look at them in the future. They may also offer to make foot and/or handprints of your baby.
The website of the UK stillbirth and neonatal death charity Sands provides some useful practical information and suggestions about saying goodbye to your baby and ways to remember your baby.
Remember though that this is a UK website, so advice about registration and funeral formalities will not apply in Belgium. See below for further information about procedures and admin in Belgium.
Looking for answers
For some parents whose baby is stillborn, there is a definite cause, while for many others, there are simply no answers – in many stillbirths, the baby appears to be completely healthy. If your doctor is not sure why your baby died, there are various tests that may provide some answers. There is no obligation to agree to any of these tests, but results may help avoid problems in future pregnancies.
In Belgium, thorough testing is offered, and may include:
- analysis of the placenta, membranes and umbilical cord;
- maternal blood tests to check for certain conditions;
- tests for infection.
The website of the UK stillbirth and neonatal death charity Sands includes information on possible causes of stillbirth and neonatal death as well as on ongoing research and efforts to prevent such deaths.
You will also be offered a post mortem examination of your baby, which may be able to provide significant information about why he/she died. A post mortem would only be carried out with your full consent, and after your care provider has explained the kind of tests that you can request to be carried out.
The UK stillbirth charity Sands has compiled a useful document aimed at helping parents make the decision of whether or not to request a post mortem.
Registering the stillbirth / death
The staff looking after you will be able to tell you what you need to do, and in many cases, will offer to liaise with the commune on your behalf.
If your baby:
|was stillborn before 140 days of pregnancy||Your baby's stillbirth cannot be registered.
Some parents ask for a ‘declaration of a late miscarriage’ (‘déclaration de fausse couche tardive’), which is needed if you wish to have a funeral for your baby.
See below for more information on funeral arrangements.
|was stillborn between 140 and 180 days of pregnancy||Your baby's stillbirth can be registered, but this is not mandatory.
Your doctor or midwife completes an official declaration of the stillbirth (‘déclaration d’enfant sans vie’ / ‘akte van een doodgeboren kind’), in which you can indicate the first name(s) of the baby – a family name can unfortunately not be given.
Since a change to legislation on 31 March 2019, the father of a stillborn baby or the co-parent who is not married to the baby’s mother, or who had not yet signed a declaration of recognition ('acte de reconaissance' / 'erkenningakte'), can declare paternity / co-parentality after the stillbirth, with the mother's agreement.
|was stillborn after at least 180 days of pregnancy||Your baby's stillbirth must be registered.
Your doctor or midwife completes an official declaration of the stillbirth (‘déclaration d’enfant sans vie’ / ‘akte van een doodgeboren kind’), in which you can indicate the first name(s) of the baby.
Since a change to legislation on 31 March 2019:
|was born but died shortly after birth (irrespective of how long the pregnancy lasted)||Your baby's birth and death must be registered.
This is also the case if your baby died before the birth could be registered.
The staff looking after you will be able to tell you what you need to do, and may be able to help you start making arrangements, such as contacting a funeral home / undertakers.
If your baby:
|was stillborn before 180 days of pregnancy||In Brussels and Wallonia, if your baby was miscarried or stillborn between 106 and 180 days of pregnancy, you can request that he/she can be either buried in a special section of your commune’s cemetery or be cremated and the ashes scattered in a special section of your commune’s cemetery – all communes should have a small area of their cemetery reserved for the burial of babies who were stillborn before 180 days of pregnancy, and for the scattering of ashes.
In Flanders, the above applies irrespective of when the baby died before 180 days of pregnancy.
Your doctor or midwife can make the request to the commune. To be able to do this, your doctor or midwife needs to complete a ‘declaration of late miscarriage’ (‘déclaration de fausse couche tardive’) - they can the make the request to the commune for the cremation / burial on your behalf. A funeral home will take care of the transport of your baby.
|was stillborn after at least 180 days of pregnancy |
was born but died shortly after birth (irrespective of how long the pregnancy lasted)
|Your baby must be buried or cremated - burial or scattering of your baby's ashes can be in the cemetery of your choice.|
Cremation / burial cannot take place less than 24 hours after the stillbirth / death.
While Belgian mutuelles will contribute to funeral costs for a baby who was born but died shortly after birth, this is not the case for babies who are stillborn – this is because a stillborn baby has never officially been registered as a ‘dependent’ of either parent. This unfortunate loophole means that parents whose baby is stillborn may be faced with fees of around €1000 for even a simple funeral/cremation.
Some employers have been known to contribute to funeral costs. Your HR department will be able to advise you.
Note that the Crematorium de Bruxelles does not charge for cremation of a baby who was miscarried or stillborn between 106 and 180 days of pregnancy.
Admin – worth knowing
If your baby was stillborn after 180 days of pregnancy, or born but died shortly after birth irrespective of how long the pregnancy lasted, and you are part of the Belgian social security system, you are still entitled to:
- paid maternity leave and paternity leave (if the father’s name appears on the declaration of stillbirth/death certificate) – for this, you will still have to liaise with your mutuelle(s), and provide a copy of the declaration of the stillbirth / death certificate.
Note that if you wish to return to work before the end of your maternity leave, you may require a doctor’s certificate.
- the birth allowance (‘prime de naissance’ / ‘kraamgeld’) from the Belgian state – this is typically paid as of the 7th month of pregnancy, but even if you did not claim it at this time, you are still entitled to it provided the pregnancy lasted at least 180 days. You have five years from the date of the stillbirth / birth to claim the birth allowance.
Whether or not you applied for this allowance during the pregnancy, you will still have to provide your family allowance agency with a copy of the declaration of stillbirth / death certificate.
- tax deductions for your baby for the tax year in which he/she was stillborn / died – your baby is still considered as fiscally dependent for that tax year, which will entitle you to some tax deductions.
It is also worth knowing that bills for medical care related to the loss of your baby, e.g. consultations, blood tests and ultrasounds, can continue to come for quite a while after the stillbirth/death, which may feel like insensitive reminders as you are trying to come to terms with your loss.
Physical aspects for mum
|Milk production||If your baby was stillborn in the third trimester or dies soon after birth, your milk may still come in, which may be very emotionally difficult.
Your doctor can prescribe medication to help prevent your milk coming in and/or a lactation consultant can help you manage and decrease milk production.
This article may also be of some use: http://www.glowinthewoods.com/how-to-stop-lactation/
|Physical recovery after the birth||You may still benefit from some postnatal physiotherapy to help re-strengthen your pelvic floor muscles, which would have weakened during pregnancy, and which may have weakened further during a vaginal birth.
In addition to the nine sessions of perinatal physiotherapy you are entitled to per pregnancy, each calendar year you can also have a total of 18 sessions for a specific reason (i.e. two additional prescriptions of nine sessions each) and so, any extra sessions you need can be taken under the umbrella of 'pelvic floor re-education'.
Where to find support
- An independent midwife is a good point of contact for holistic support after losing a baby. This is also covered by the mutuelle.
- Community Help Services offer a helpline (+32 (0)2 648 40 14) as well as English-speaking psychologists, psychotherapists, bereavement counselors.
- The Brussels Childbirth Trust (BCT) has an ‘Experiences Register’ – this allows BCT members to be put in touch with other members who have experienced stillbirth, and who can offer support and advice.
- Waterloo-based mum Joanne Fraser has set up a support group, Pregnancy and Infant Loss Support Belgium, for the loss of a pregnancy, stillbirth, infant death, conceiving or expecting after a loss.
“It is a terrible thing to have to go through the loss of a baby in a foreign country away from family and friends. Even worse is not having anyone to speak to about it.”
Joanne has been involved in grief support for a while now and – having not really found a group here in Belgium – decided to start one. The group currently has a closed Facebook group, which gives an opportunity to meet and support each other.
Email email@example.com for further information or to be added to the Facebook group.
The UK stillbirth and neonatal death charity Sands and baby health charity Tommy’s both offers a wonderful range of materials about bereavement and about topics such as choices you might be offered, remembering your baby, special information for dads, as well as advice for how friends, family and employers can help and support bereaved parents.
You might also like to read personal accounts such as:
- Brussels: Données périnatales en Région bruxelloise – Année 2016; Flanders: Perinatale activiteiten in Vlaanderen 2016; Wallonia: Données périnatales en Wallonie – Année 2016 – in French
- 17 JUIN 1999 – Arrêté royal prescrivant l’établissement d’une statistique annuelle des causes de décès / 17 JUNI 1999 – Koninklijk besluit waarbij het opmaken van een jaarlijkse statistiek van de overlijdensoorzaken wordt voorgeschreven
http://www.ejustice.just.fgov.be/cgi_loi/change_lg.pl?language=fr&la=F&cn=1999061735&table_name=loi (in French)