We hope that this pamphlet will provide you with answers to any questions you may have in the time following the birth.

Register the birth

A birth at 22 weeks of pregnancy and later must be registered with the authorities by no later than 14 days after the birth. The registration is electronic and is submitted by the maternity ward. The birth of a living child before the 22nd week of pregnancy also must be registered. You will have to register the death yourself. Everyone, regardless of religious belief, must register the death at their local parish within eight days. You can find the address of your local church office on www.sogn.dk  by typing in the address of the mother or parents. Read more in the pamphlet ”Folder fra Københavns Kirkegårde” (in Danish only).

A stillbirth before gestational age 22+0 does not need to be registered. Legally speaking, this is considered a miscarriage, not a stillbirth.

Funeral

When a child dies or is stillborn from gestational age 22+0 or later, the parents are responsible for ensuring that the death is notified to the relevant authorities (priest/church office). The parents are also responsible for the burial or cremation of the child. The cemetery office can help you with the many practicalities related to a funeral or cremation. The cemetery office assists everyone regardless of religious beliefs. Parents can also contact a funeral undertaker, who will then take care of all the practicalities. Please see the pamphlet ”Folder fra Københavns Kirkegårde” for additional information regarding the funeral of an infant.

Special regulations apply if the child was born before gestational age 22+0 and did not display any signs of life. For additional information, please see the pamphlet ”Folder fra Københavns Kirkegårde”.

Mortuary

The child can remain at the mortuary at Rigshospitalet until the funeral. The mortuary is located on Frederik V’s vej 11. It is possible to view the child in a specially prepared room at the mortuary. Relatives are welcome. Please call the mortuary on tel. +45 35 43 53 03 to arrange an appointment. Opening hours are limited.

Post-mortem examination

A post-mortem examination is performed on some children after birth. Additional information can be found in the pamphlet ”Information til forældre vedrørende obduktion” (in Danish only) provided by the maternity ward, and the book ”Når I har mistet”(in Danish only) by Landsforeningen Spædbarnsdød (Danish association for stillbirth)

Becoming parents and siblings of a deceased child 

It is very common to experience a psychological reaction after losing a child. It is natural to feel enormous grief and sadness. Some feel anger about what has happened. Some feel nothing at all. People react differently to grief. You will probably experience that the grieving process is different for everyone. It is important that you talk together about these difficult emotions, even if you find it difficult to understand each other. Accept each other’s different grieving processes. It is natural for people to react differently. Some people find it helpful to speak with a professional. Others may benefit from speaking to people who have experienced the same loss. How children react and understand grief depends on their age. It is important to involve a child’s extended adult network when a tragic event has occurred. Let family, friends and the child’s teachers/carers know about what has happened. Share and discuss your thoughts with them.

You have been given the book ”Når I har mistet” by Landsforeningen Spædbarnsdød. This book provides information on how to involve siblings, relationships and relatives, as well as practical advice and care.  You can contact Landsforeningen Spædbarnsdød on tel. +45 39 61 24 51 every weekday between 09:00-14:00. The association will contact you themselves if you gave your midwife consent to send a referral to Landsforeningen Spædbarnsdød.

Consultation after birth

After the birth, you will be able to speak with the midwife who was present at the delivery or the midwife who followed you during your pregnancy. The need to speak with the midwife may not arise until long after the birth. You are therefore always welcome to contact us and set up an appointment. Call us on tel. +45 35 45 96 30 and leave a message for the midwife. She will call you back to arrange an appointment.

You can also arrange a consultation with the obstetrician after the birth. If you would like a consultation with the obstetrician, call us on tel. +45 35 45 40 02. If more than two months have passed since the birth, you may need a referral from your general practitioner before the consultation can take place.

Home visit by a health visitor  

The midwife will usually notify your health visitor of the birth and you will be contacted by the health visitor within a few days. The health visitor will always offer to come by and help with e.g. stopping milk production, possible reactions to the birth, sibling needs, any pain you may have, etc.

You can also contact the health visitor via your municipality. A visit by a health visitor is not usually offered in connection with an abortion or a miscarriage.

Psychological assistance

Some find it helpful to speak with a psychologist after losing a child. Your general practitioner can refer you to a psychologist. A referral means that the cost will be subsidised if the psychologist is part of the healthcare system. You can decide which psychologist you wish to use. Visit www. psykologeridanmark.dk(in Danish only) for additional information.
A referral for psychological counselling can be issued up to six months after the birth.

You may be eligible for a subsidy via your private health insurance. Rules for co-payment may vary. You will have to cover the total cost of psychological counselling if you do not have a referral.

Sleep and rest

It can be easy to overlook your own basic needs when you are grieving over the loss of a child.  Everything may seem hopeless and meaningless, and taking care of yourself and each other may be the last thing on your mind. Some people experience that they have difficulty sleeping, while others find it difficult to stay awake. Many experience that everyday tasks such as making dinner feels overwhelming. Although it may seem trite, it is important that you take care of yourself and that you try to continue everyday routines - especially regarding sleeping and eating.

In the event of several days of sleeplessness and an increasing sense of grief, contact Maternity Section 4021 on tel. +45 35 45 40 21 to arrange an appointment and possible hospitalisation for a few days.

Bleeding after birth

After a birth, there will be bleeding that is stronger than normal menstruation. After a few days, the bleeding will turn into a bloody discharge of varying appearance. The discharge will lessen over the next six to eight weeks. There may be small clots of blood in the first few days, this is completely normal.
The bloody discharge stems from the wound in the uterus where the placenta was attached. Due to the risk of infection in the uterus, we advise against using bathtub and swimming in the ocean or in a swimming pool while you are bleeding. For the same reason, avoid using tampons during the first few months after birth. We also recommend using a condom during intercourse for the first eight weeks after birth.

Contact the maternity ward or your own GP if you experience the following: - Abdominal pains

• Foul smelling discharge
• Fever

If you have any questions about vaginal tears, bleeding or similar during the first four weeks after birth, contact the obstetrics emergency department on tel. +45 35 45 96 30. After the first four weeks, contact your own GP or call 1813.

Stopping milk production

Your body will start producing milk after the birth - even if you are not breastfeeding. Milk production stops by itself, but it can also be stopped by medication.
A close-fitting sports bra can help stop milk production. By tying your breasts tightly, the mammary glands will feel less full and production will decrease. A little milk will be produced despite using medication and tying. If your breasts feel tender, some of the milk can be expressed by massage. However, milk production will continue as long as milk is emptied from the breasts. Expressing should only occur if your breasts are very tender and only until the discomfort has ceased.

If your breasts are very tender, we recommend taking a long, hot shower. Use the hot water from the showerhead to massage your breasts and gently glide your fingers towards the nipple. To express the milk, gently squeeze around the nipple. This will help minimise tenderness.

Contact the obstetrics emergency department on tel. +45 35 45 96 30 if you experience pain, fever (over 38.5°C) or red blemishes on your breasts. 

Stitches

Small tears often occur in connection with birth. These tears are stitched using absorbable sutures. The sutures will disappear within two to three weeks - in some cases up to five weeks after birth. During the first few days, the tear might feel painful, sting or itch. Contact the obstetrics emergency department on tel. +45 35 45 96 30 if you are experiencing considerable pain or if the stitches feel uncomfortable a week after birth.

Advice on dealing with soreness after birth:

• Sit on a soft pillow. It is not good to use an inflatable swimming ring because this will push the tissue together and hinder blood flow, thereby impairing wound healing
• Pour water onto a pad, put it in a plastic bag and place it in the freezer. Use the frozen pad on any swelling. Wrap the pad in some cloth and use it for a maximum of 20 minutes.
• Painkillers - see the section ”After-pains” below.

Personal hygiene

Wash after each visit to the toilet in order to prevent inflammation in the uterus and around any stitches you may have. 
You can use a shower head or a jug of lukewarm water. Change pads often during the first few days.

After-pains

After-pains are caused by contractions of your uterus as it returns to its pre pregnancy size.  You may need to take some pain relief during the first few days e.g. Pamol, Pinex or Panodil. Follow the instructions on the package.

Urination

It may be difficult to sense whether you need to urinate for the first 24 hours following birth. You should urinate by no later than four hours after birth. During the first 24 hours, go to the bathroom every four to five hours when you are awake. The uterus will contract easier and the bleeding will lessen when the bladder is empty. Contact the obstetrics emergency department on tel. +45 35 45 96 30 if you cannot urinate or if you feel as if you cannot empty your bladder.

Bowel movements

It is normal to not have any bowel movements in the first few days if you were given an enema in connection with the birth. Over the course of the subsequent days, gastrointestinal and bowel function usually return to normal. Constipation can be prevented by eating whole-wheat bread, raw vegetables, prunes and similar. Remember to drink plenty of liquids. If you are still constipated after four to five days, you can take a mild laxative.  Laxatives should only be taken for a short period of time, otherwise your stomach will become used to having help. Fibre supplements can be used to prevent constipation. 

They can be sprinkled on e.g. yoghurt products. Remember to drink plenty of fluids when taking fibre supplements as they absorb a lot of liquid.

If you have any problems holding your stool a week after birth, you should contact your GP.

Postnatal exercises

To avoid a prolapsed uterus and issues in connection with urination and intercourse, it is important to do pelvic floor exercises several times a day for the rest of your life. In connection with your eight-week postpartum visit to your GP, he/ she will check whether you are using your pelvic muscles correctly during the exercises. Postnatal exercise classes for women who have lost their children are available. They can usually be found at evening schools or similar.

Sex after birth

In the period following birth, you may not have the energy, time or desire for sexual intercourse. This can be a vulnerable time in your relationship. Many women experience decreased sex drive at the beginning. 

However, tolerance, devotion and tenderness are the basis for resuming sexual relations. Start off gently and carefully. There may be some pain in connection with tears, an episiotomy or scars. Your vagina can be a bit tender and dry due to hormonal changes. Water-based lubricants can help with this, while also making the condom more elastic thus reducing the risk of breakage.

We recommend using a condom during the first eight weeks after birth to avoid infection in the uterus.

General practitioners

Eight weeks after the birth, your GP will offer you a follow-up appointment for a gynaecological examination and consultation on contraception.

Access to your medical journal

You can read your medical journal online 14 days after it has been updated. Log in towww.sundhed.dk with your MitID (eID solution). Click on ”Mine sundhedsdata”” in the menu ”Min sundhed.dk” (in Danish only). Select ”Min e-journal”, click on the link ”forløb”.
You can also find your medical journal at www. minsundhedsplatform.dk.

Useful telephone numbers and websites: