The movie begins with Maggie and Aaron Royal in the home stretch of their first pregnancy. Then a few weeks before their due date, they find out that their baby boy is stillborn. A stillbirth is a fetal death occurring after 20 weeks of pregnancy. I assume most viewers were like me- crying along with the Royals as they had to make quick decisions about how the baby would be delivered, if they would like to take pictures, and if the baby would be buried or cremated. The movie then follows the Royals in the months that follow as they grieve, try to hold onto their marriage, re-enter the work force, and (unexpectedly) begin a second pregnancy.
While the movie focuses on an individual family (based on the true story lived by the director Sean Hanish), there are many public health implications we should be talking about:
- Public Knowledge and Language: Several times in the film Maggie makes the distinction that a stillbirth is not the same as a miscarriage. Does the public know the difference? From Maggie’s reaction, it is clear that the comparison can be quite offensive to the parents of stillborn children. These deaths happen much later when the babies are often viable. They are (in many cases) full-term. The mothers have felt the babies moving and are visibly “showing” in their pregnancy. They do not have the option of dealing with their loss privately.
- However, I will note that many who have suffered a miscarriage will relate to the emotions that Maggie and Aaron experience. In revealing her own miscarriage Maggie’s mother tells her, “It’s still a loss Maggie. And it still hurts. It’s not just the loss of a baby, it’s the loss of a possibility of what might have been- and that is exactly the same.” Perhaps there is a way for the stillbirth and miscarriage communities to support each other while still making this important distinction in language and definition?
- Stigma: Wow! Did I cringe watching some of Maggie’s friends and family members interact with her after the loss of her baby! Some people just walked away to avoid her, others pushed their religious views on her (“this was God’s will, etc). She made people uncomfortable because they did not know what to say or how to help her. This is fascinating considering the prevalence statistics on stillbirth (various sources showing it occurs between 1 in 160 and 1 in 200 pregnancies)- it is not that uncommon! I think that the movie does a great job of pointing this out. This happens to people. We need to learn how to talk about it and support our friends and family.
- Training for Providers: After learning their son has died, Maggie and Aaron have a conversation with their doctor and a social worker about their plans for their son. They are clearly in shock. As the social worker asks if they have thought about burial or cremation for their son, Aaron asks in frustration and disbelief, “Should we have thought about it?” How do medical, nursing, and social work programs/training prepare providers to have this conversation? Do providers know how to have it in a way that respects the family without further traumatizing them (or the providers themselves)?
- Support for Providers: In probably the most incredible scene of the movie, we see Maggie deliver her stillborn son. And one thing I kept thinking was- what kind of support is in place to help the medical providers in this situation? Maggie and Aaron had a labor and delivery nurse and doctor with them- how much does this weigh on those providers? They deal with not just stillbirth, but other difficult situations (preterm births, maternal complications, etc.)- I hope that they are given coping skills and the option of speaking with a social worker or other support at the hospital if needed. I would imagine that dealing with this type of case would be incredibly mentally and physically taxing for a provider.
While the subject matter is incredibly difficult, the film is exquisite. Minnie Driver is amazing. And although you are grieving with the characters, you also leave hopeful.
What did others think? Leave me a comment- I would love to hear your thoughts!
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