Stillbirth and neonatal death

If your baby has been stillborn or has died soon after birth, we are so sorry for your loss. On this page, we’ve aimed to bring together information that will help you navigate this difficult period, including saying goodbye to your baby, administrative requirements (if relevant), your rights to leave and allowances, your own recovery, and where you can seek support in Belgium.

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
- giving birth to your stillborn baby
- saying goodbye
- looking for answers about why your baby died
- administrative aspects: registering your baby – funeral arrangements – maternity/paternity leave, tax etc.
- physical aspects for mum
- where to find support – suggested reading

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 ¹.

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 have a lot of decisions to make.

You will have a multi-disciplinary team (doctors, midwives, nurses, psychologists) caring for you. They will provide support and comprehensive information on the options available to you.

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 artificially, 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.

Saying goodbye

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 Belgian organisation Boven de Wolken (Dutch-language) / Au-dela Des Nuages (French-language) is dedicated to supporting parents whose babies are stillborn by offering free professional photo sessions to allow parents to capture precious moments with their baby:

“Boven De Wolken is a non-profit organization that supports parents when they lose their baby. We do this by giving them tangible memories and assisting them during those first difficult moments. Our professional photographers do this for free, with heart and soul, with love for precious memories and with respect for them and their baby. Our photos are a lasting memory that will never fade. Photos of their baby, of their new family. Photos that help learn to live with the loss of their child. Photos that they can proudly show to everyone, because parents of a stillborn baby are proud parents too.”

Note that Boven de Wolken can support English-language requests.

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.
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.
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 must indicate the first name(s) of the baby, and can decide to give the family name.

If you are not married and your partner had not yet signed a declaration of recognition (‘acte de reconaissance’ / ‘erkenningakte’), they can declare paternity / co-parentality after the stillbirth, with your agreement.

If your baby 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.

Funeral arrangements

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, parents of a baby who died at any point before 180 days of pregnancy can request that he/she be buried or cremated.

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 or 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.

Funeral costs

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/co-parent leave (if the father/co-parent’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.

Here are some IBCLC lactation consultants in Brussels and the surrounding areas who can support you if needed:

Elke Van Den Bergh from Zwanger in Brussels
Jo Everatt from Antenatal and Baby (mainly online consultations)
Joke Muyldermans from InTeam in Hoeilaart
Sophie Goubau in Auderghem
Gon Balis in Duisburg

This article may also be useful: 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 Service 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 joannefraser_home@hotmail.com for further information or to be added to the Facebook group.

For English-language information and support, you may find two UK charities helpful:
- Sands
- Tommy’s