When my son was stillborn at 36 weeks, I was angry. Now I'm dedicated to helping reduce stillbirths.

• Marny Smith's son, Heath, was stillborn on September 21, 2019.
• Marny has since learned that many stillbirths are preventable.

Editor's note: This essay contains images of a stillborn baby.

This as-told-to essay is based on a conversation with Marny Smith. It has been edited for length and clarity.

When I think about my son Heath, who was stillborn, I am of course very sad. But I'm also very, very angry.

When I was pregnant with him, I didn't have a baby shower until eight months. That's when I finally felt like this was actually happening. But just a few weeks later, instead of delivering my baby, a doctor was delivering the worst news of my life: "There is no heartbeat."

I couldn't even process what was happening. I had planned to have an elective C-section because I was terrified of labor. But after my baby died, my doctor recommended against it. She said that I would be in so much physical pain from the surgery that it would compound the emotional pain of not having a living child.

So instead, I was induced. I had an epidural and Pitocin. I vomited and pushed. Nurses whisked away my dead baby so I wouldn't have to see him. Afterward, I bled and lactated and fought mastitis. It was a typical postpartum experience, except that I was one of the 24,000 American mothers who gives birth to a dead child each year.

I returned to the hospital to hold my son

After I left the hospital without my baby, I started researching. I learned that mothers that don't see their child often regret it. So a few days after Heath was born, I traveled to the bowels of the hospital with my husband and my mother. A social worker handed me Heath's perfectly formed little body.

He looked asleep, but when I held him, it didn't feel right. His body was entirely limp, and his arms splayed apart in a way that broke my heart yet again. We spent an hour with Heath, holding him and taking pictures. It was surreal and nightmarish, but I knew these were the only memories I would have with my son.

As I learned about preventable stillbirth, I got angry

After a loss, everyone expects you to be sad and grieving. But I was angry. Three days before we found out Heath died, we had a biophysical profile or BPP which is a test that combines a nonstress test with an ultrasound to check the health of the baby. My husband and I both noticed he was moving less, but the doctor assured us he was fine. The day before he died, I noticed he didn't kick me around dinnertime like he always did. My husband asked if I wanted to go to the hospital, but I gave him the honest answer: I was very pregnant and very tired. I just wanted to go to bed.

After Heath died, I realized these were missed opportunities. My doctors had never talked to me about the importance of fetal movement. I know now that decreased movement is often the first sign that an infant is in distress. It's a point of intervention that is too often overlooked.

There are other steps that can save lives, too, like monitoring fetal growth more closely during the third trimester. We never learned exactly why Heath died, but he measured in just the fourth percentile for weight. If we realized this before he died, we may have been able to save him.

Research suggests that up to one in four stillbirths may be preventable, and I'm advocating for reducing stillbirths in America by 20% by 2030. Providers don't talk to patients about stillbirths because they don't want to scare them, but that's infantilizing and disempowering. The Centers for Disease Control and Prevention estimates that babies are ten times more likely to be stillborn than die from sudden infant death syndrome. We need to empower pregnant people by being honest about the risks of stillbirth and how to spot the warning signs.

Now, I'm raising my daughter and remembering Heath

When I was in labor with Heath, I told my husband that I didn't think I could go through pregnancy again. He said he would never ask me to. We explored adoption but ultimately decided that getting pregnant again was right for us. Two years after Heath my daughter, Zosia Heath, was born.

I brought a framed photo of Heath to the hospital. If this baby lived, I wanted her to be greeted by the big brother she would never meet. Heath will always be an important part of our family.

People think that once you have a living child, your heartbreak is over. But no child can ever replace another. The firsts I experienced with Zosia — changing her diaper and buckling her into her tiny car seat — were things that I should have experienced for the first time with Heath. I find joy in my daughter, but there will always be a Heath-shaped hole in my heart.

Marny Smith is a founding member of Push for Empowered Pregnancy.