The Forgotten Grief: For Parents

It is an individual decision when to take the nursery downLittle can be done to change grief. It is one of the experiences of life that we have very little control over. When an infant dies, despair can be overwhelming, and parents who try to find help often find a lack of compassion and understanding about the extent of grief following a stillbirth. Over the next few months, we will add to this page, concrete ways that parents can help themselves and others, and understand the difficult grief facing them as they learn they are normal, and that we learn to live with grief, not 'get over it'.

Understanding your Own Grief

There are thousands of clinical accounts on grief and bereavement, describing processes, phases, stages, and characteristics of grief. When the death of a baby occurs, though, clinical descriptions are of little help to you, the parent. They can neither assuage the depth of pain, nor heal the loss: at best, at the very best they can let you know that what you are going through is perfectly normal. Furthermore, the very difficult experience you are going through is not known to everyone, and therefore many people, even caring people can say or do things without thinking that cause you a great deal of pain. This section deals with feelings and experiences you may have, which may be very troubling as you walk through them. Knowing about your grief will not heal the hurt, but it may help you 'gain balance' knowing that your experiences are normal, and there is hope. Grief is such an individual experience that even though we describe here what many report, your own experience will be different in certain aspects. Feel free to contact us with questions. Time can be arranged to talk online if you should feel the need.

When Your Baby Dies: Choices in Pain

You expected, a least most do, to have a normal pregnancy, and upon birth make announcements that there was a new addition to the family. Instead,a nightmare takes hold. Instead of joyful announcements, you are faced with funeral arrangements, and calling family members with very terrible news.The complete wrenching from joy to grief is so overwhelming, that most experience despair, intermittent with waves of shock and numbness. It is far too great a reality and sorrow to take in all at once. The heart and the mind far from agreement with one another, go back and forth, dealing with the great hurt and changes that are brought about.

Reactions of Others

Most of the initial reactions to the death of your child, occur in the hospital. While some are caring and may intervene, many hospital staff do not understand. Many avoid the room of a grieving parent, unsure of their own bearings. They are afraid of their own uneasiness in dealing with uncomfortable information and emotions. The biggest problem you probably will or have already had in the reactions of others are misunderstandings, and clumsy, unfeeling, or even outright hurtful and cruel 'reasonings'. Probably the most common, but also one of the most unfeeling things people say when a baby dies, is "Don't worry, you can have others." Parents do not want 'others' at the time, they want the baby who died. This comment is akin to saying that a child's life does not matter. "Other babies" may be wanted in the future when grief subsides, but at the moment, it is like ascribing non-personhood to the little one who is being mourned. Another very harmful comment is "Well, it's probably for the best: maybe they would have had a defect." This is unfortunately a comment made often by medical personnel in dealing with an infant loss, in an attempt to cognitively dismiss the pain, but grief is not primarily a cognitive event.

Accepting and Believing the Death

Once the announcements of the baby's death have been made the first choice is how and when to call the family. This is particularly disheartening because it is at the time when the expectations were to call announcing the birth. The emotional experience tears parents apart: it is however one of the first cognitive-emotional steps in realizing the death.

The fact of the death alone does not mean a parent feels or realizes its finality. It takes long periods of time to 'feel' the death as real. Accepting the death as final may come on a mental, or cognitive level, (even this may ebb and flow) but allowing the heart to settle in is quite another matter. The first event that brings home the reality is of course the death itself, the second is the announcement of the death, coupled with decisions about how to handle the death. The third, is of course a difficult one of whether to see the baby. For the next several years, there will be other choices will work toward the integration of the small death into a parent's/family's life. Many parents report experiences in which they still feel fetal movement or hear the baby cry in the weeks after a loss. These incidents need not be alarming in early grief: they are the way the soul begins to come to term with the 'fact' of the loss. For weeks or even months, the heart attempts to 'find' the 'lost' baby somewhere: while most parents know in their heads the death is real and final, it is the heart acceptance that has to be reached before healing can take hold. More will be discussed in this vein as we continue.

CHOICES

Seeing and Holding the Baby

This use to be a controversial decision, but now most hospitals in the western hemisphere allow parents to decide for themselves whether to see and/or hold the infant who has died. The desire to see and hold the infant should never be seen as abnormal. Instead, the choice to say a final goodbye and 'realize' the death by holding the infant who has just died, is often the only thing that can be done to assure healthy grieving. Parents who have decided not to see the baby, have problems later that range from believing the baby is still alive somewhere (that the hospital made a mistake) to 'phantom crying' (hearing a literal cry),or still feeling the baby move. Holding and seeing the baby gives a reality to the death and provides the beginning of closure as a parent is allowed to say his or her goodbyes. With death so anathema in this country still after so much education, it may still seem offensive to some to hold or see an infant who has just died. Most have a wrongful notion that the child is deformed, or quite offensive to look at. The truth is, most infants who have just died look just like other infants---they are of course still, and this is disturbing, but mothers and fathers need a chance to say goodbye. My experience with parents was that the first reaction was tears, and then a very somber counting of toes and fingers, and discussions of who the child looked like in the family. This necessary goodbye needs some preparation, but it is not the 'holding of a deceased infant' but instead a last farewell to a child who will forever remain in memory a part of the family. When queried about their decision to see or hold their infants almost no parents were ever dissatisfied with the choice (Kirkley-Best, 1981) but many who chose not to were very distressed. It does remain an individual decision though, and once pros and cons are weighed, it should be left to parents. The benefits are immediate: there is a sorrowful closure on the 'fact' of the death: it allays concerns about babies being 'switched' in the hospital, or not really dying, or having some horrible defect. There are no cures for grief here, only necessary goodbyes. It must be done tenderly with wisdom: as part of an in-hospital team, we always spoke to parents beforehand in preparation, and then wrapped the baby at least in a receiving blanket, to present to parents. Parents were informed as to slight discolorations of skin, or coolness of touch by a physician or pathologist, and we stayed with parents a few minutes and then allowed time alone. Grief and weeping at the loss of an infant in the hospital is not pathological: it would be pathological not to. If it is uncomfortable for the staff, then they need to deal with their feelings, not try to prevent or inhibit the healthy expression of grief. As a parent, you have a right to grieve. You have a right to see and say goodbye to your child. And you have a right having done that to mourn fully as any would do in the same circumstances. You also have a full right to individual choices: hardly any decision is right for absolutely everyone: seeing or holding your child who has died is a choice and not a 'treatment'. Parents alone must decide with information.

Funeral and Memorial Service Choices

Within hours or a day or two of the death, decisions must be made how to handle the death of a loved child. Because most of these deaths occur in the hospital and are deeply painful, many parents choose in-hospital cremation when that offer is made available. In one study, close to 2/3 of parents chose this option. (Kirkley-Best, 1981b). The reasons though are not often based upon religious beliefs or tradition but upon denial and escape: parents in this degree of pain only want the ordeal to end. They want to go home and cry. Most want to be out of the public eye as they deal with the tragedy. The statistics on cremation of stillbirths vs older persons deaths are almost reversed: burial is chosen more often then. Some faith backgrounds do not condone cremation, and this becomes troublesome for parents. While this is a very individual and personal choice, and should not be pressured, as a parent you have a right to information: while cremation of stillborn babies in many places is more common (this has changed somewhat), there are more regrets with the decision. Some parents feel even years later that they wish they had buried their child instead: it is very difficult to predict how one will feel in the future. One advantage of burial is it gives a 'memorial place' for parents to visit while working through the difficult part of grieving of 'letting go' or surrender and relinquishment of the child to God. Other factors include cost and stability: I remember one mother and father who would normally have chosen burial, but chose cremation instead because they knew they were moving and they did not want their child buried in a place they could not tend or visit. Your personal situation will affect your decisions, but you should have an informed choice. Though the intensity of early grief is overwhelming, it is helpful to try and consider the consequences of the choice down the line. This has to be a deliberate decision though, as grief has a way of giving way to despair, which often crowds out thoughts for the future.

Whatever the mode of interment, you should definitely consider a memorial service for even the smallest of infants. A memorial service can be done independently of a funeral home. A local church or synagogue will often graciously help: some parent help organizations such as SHARE or HAND (See Links) can help with ideas for the service or making arrangements. A Memorial service aids in establishing memories, and gives some form and shape to an ill-defined grief. The chaos in life at the time of a stillbirth requires anchors: a memorial service can be one such anchor: it provides closure on the immediate period of the death. It is after the service that the difficult tasks of grief can then be confronted.

The Funeral Home

No one in life prepares you for a visit to a funeral home when your child dies. Funeral homes, while striving to be sensitive, are businesses and deal with thousands of deaths: it is not new to them. A business-like attitude may seem hurtful to a parent. Also, infant deaths are often handled differently than other types of deaths. One mother I remember was deeply distressed at the graveside to find that the 'less-expensive' coffin for her child was a form of styrofoam: while they did not wish to spend great amounts of money they did not have for the burial, they also of course did not wish the death of their child diminished. Choices at the funeral home are very difficult and painful.

A child who dies in infancy also has to be dressed for burial, and again these are among the most difficult tasks of being human. In older days, the clothing for burial would be made by afamily member, but today, because a funeral home may not even carry such small clothing, newly bereaved parents are faced with the tragic event of shopping for baby clothes or using those already given not for a new baby brought home, but for burial. While there are now choices, many years ago one parent of a very little preemie who passed away, was forced to purchase doll clothing. Thankfully now there are specially designed outfits, and again parent help groups can guide parents where to find appropriate choices. Because hearts and minds are not often in agreement in early bereavement, many funeral directors suggest burying an infant in a blanket: the thought of this tender act in death is often comforting later to parents who have very fews ways to say goodbye and express their love for a briefly known child.

Whether to have a large outdoor service, or a small at home remembrance is entirely an individual decision: people are different and have differing needs in grief. In the years that I dealt with bereaved parents and others I learned that it is not so much what is said or not said, but the liberty that is given others to sorrow freely. There are no quick-fixes to bereavement. A placebo will not "make it go away". When we talk of helpful things like having a memorial service, funeral, or seeing and saying goodbye to the infant, we are only talking about creating anchors and memories which allow grief to continue in a way which will heal: the idea that if we do or say certain things the pain will 'go away' is erroneous. Loving support and liberty are the keys, not prescriptions for yielding a 'cure'.

What to have as part of a memorial service is again, an individual choice, but most parents chose songs that they either wrote or are meaningful to them, readings from scripture, letters or poems to the infant, and short readings or eulogies from family and friends and/or a sermon by a pastor. A baby's funeral is an acknowledgement of their worth in life: they existed, they had a purpose and a part of the family. They will not be forgotten.

Choices in Early Grief

Both in and out of the hospital, parents are very individual: what is harmful for one parent can even be helpful to another. Everyone in grief wants quick answers and easy solutions for how to help in grief, and the truth is, the insight to that helpfulness is on a person by person basis. An example of this came in the witness of a young mother I knew many years ago, whose child had died shortly after birth. After her child died and arrangements were made, she went into the NICU and noted the incubator-bassinet had been remade, and the baby had been dressed for burial. She was incensed, feeling this was her choice, her child, and feelings of bitterness ensued. In her own insight some time later, she said she realized that she might have been equally angry if it had not been done: in other words, grief in its intensity does not always cater to logical or orderly feelings. While giving parents choices is a first priority in the care given in early grief, there are some circumstances where one more choice may be too overwhelming for parents having to make too many painful unwanted choices. A sensitivity to where a parent is, is more important than the same thing done everytime. As a parent, you should realize that whatever choices made at the time, cannot now be changed, but the feelings about those events can be healed. Knowing that confusion and complexity exist in early grief in raw pain sometimes can at least create for you a sense of peace in knowing that your feelings, and experiences are normal, shared by many, and that even those which are more disturbing to you, are not to be unexpected.

At Home: Permission to Grieve

Arriving at home without the long expected infant is only one more of the 'knives' of grief that confront the bereaved parent. For most, the nursery is still up or in development, clothing and blankets were purchased, and shower gifts were given. For most it means the beginning of an unexpected life without the baby so wished for. Coming home from the hospital has some good and bad points: on the one hand, the full lonliness of grief hits a parent in the face without the support the hospital affords; on the other hand the parent alone or with spouse now has a chance to fully grieve and cry without concern for what others think. Grief needs restraints removed and crying even a great deal is a catharsis. Many of the behaviors of early grief are not things alot of persons in the general public would understand: coming home affords privacy and allows an openness for the expression of mourning. In any event issues of marital stress and mourning, sociability, processes of grief and the 'putting away' of nursuries and memorabilia confront the parent who has lost an infant coming home from the hospital. Each of these will be considered.

Being Alone vs Being with Others

One issue for parents and thier friends and families which parents alone must choose, is the degree of social contact in early grief. We have already noted that grief is a very individual experience: no two people mourn in the same way. What we also know is that the sensitive support of another person may be a great comfort and part of the healing process, but only in season. Because Perinatal bereavement is so little understood, some social contact may actually afford not only little comfort but outright cruelty at a time of great pain. It is not helpful to say "try not to think about it too much". or "don't worry, you can have others". A baby is not a commodity which one can replace, he or she is a unique individual and already loved by the parent. Further, adages like "time cures all" and "this too will pass" do not comfort but only explain how little the speaker understands of the intensity of early mourning. Of the hundreds of parents I have talked to who have experienced a loss, most who report a healing person in the process of mourning have pointed to a person who allowed them to grieve in their own way, who patiently listened without judgment and who rather than saying "just the right thing" often said nothing at all: they were simply there, and often helped with the mundane tasks that a parent did not feel up to---even that though is a choice. One of the most hurtful things a person can do to a young mother or father in mourning is to either patronize or control the situation. Relatives that the mourner is not comfortable with during normal lifetime routines and holidays, are not the primary persons to stay with a mourning mother. When a baby is stillborn, they are born and die into an already existing situation: there may already be a strain on the marriage, or in-law problems, or financial problems or in reconstituted familes, and ex-wife and children. Parents have the absolute right to CHOOSE who they want present and they also have the right and often need to choose to be alone. Further, what constitutes comfort is a unique thing also: some need to talk: most need to "tell the story" over and over. This is not abnormal or pathological: it is a healing process which 1) allows a mom to order the events and give clarity to her thinking about the loss and 2) is one of the few things other than crying to reason and feel through the pain. That clarity and order of thinking may aid in the healing process by preventing chaotic and abnormal thoughts which lead later to maladaptive patterns or even delusions. It also is an occasion for the helping person the parent has chosen to reaffirm normal feelings, reactions and beliefs about the death, and to affirm the parent's right to even difficult experiences.

Common Experiences After a Baby Dies

What are some experiences in early grief? Many parents feel very reluctant to talk about things they experience, in the form of thoughts, feelings and even dreams and delusions/hallucinations. In early grief, the whole range of human experience while not appearing 'appropriate' still can be seen as normal or expected. Some experiences and a parent's willingness to talk about them may be cultural: some cultures in the Orient for example, have no difficulty talking about "seeing" or 'experiencing" the presence of a loved one who has died.(Yamamoto et al) Some of the things that are perfectly normal though perhaps not "socially acceptable" in early grief include:

  • Phantom movement-still sensing or feeling the baby move: this may be 'sensed' via real physical sensations as the body returns to normal post-partum, or it may be more of a 'dissociative' reaction, as persons experience in a phantom limb. In early grief, it is not a troublesome experience, it is part of the mourner's attempt to 'find' the lost person or fill a void. It only becomes abnormal if it persists.

  • "Hearing" the baby cry, or having momentary sensations the baby is alive. This also is not abnormal, although pronounced experiences are more likely to follow a parent not having seen or held the infant in the hospital prior to burial or cremation.

  • Dreaming the Baby is alive- so many parents report this, especially mothers, that I think it is more unusual not to. One such dream reported was a mother dreaming she heard her child cry, and going to pick her up and being elated to find the child was alive, but feeling like something was wrong. Upon waking, the rush of bereavement comes back fourfold, and it is often like the loss just occurred all over again. Dreams are not abnormal, no matter how unusual: it is an attempt of each soul to work out emotions and beliefs about what happened: it is a way of coming to terms with the loss. These early dreams are often intense, unusual, and emotional. They like phantom experiences are not unusual unless they last a very long time, and are continuous.

  • Weariness, tightness in the throat, troubled breathing and shortness of breath, lack of appetite, and other somatic symptoms are perfectly normal in all forms of grief including this one. Problems sleeping: either oversleeping or an inability to sleep (insomnia) are also reported often. Parkes and colleagues have noted for years in study after study an increase in doctor visits and physical illnesses, especially 'stress' related illnesses such as ulcerative colitis, asthma, heart and respiratory problems and so on. Many of these symptoms are part of patterns of what is called 'clinical depression' which is also often a response to loss.

  • Agitation, Anxiety and Repetitive behavior.- In early grief, when little can be 'done' many mourning parents turn to repetitive actions to alleviate the anxiety, restlessness and feelings of agitation. This is common to other griefs as well. I once had a student whose parents both died in a murder: for six weeks he washed and waxed his car repetitively. A mother once reported sewing and doing needlework projects all her waking hours: today some will play video games, or solitare or endeavors which require some but not extreme concentration and rote decision-making. This should abate over time, but is a way to keep pain at arms length until the mourner can deal with it. It only becomes abnormal when it is used as an unending escape.
  • Preoccupation with 'images' of the infant, or thoughts or memories. There is nothing wrong with this in the beginning, it will abate over the first couple of years after the loss. In any tragic event, we are necesarily preoccupied with the events of loss: we have to consider, order, arrange, assimilate, accomodate and give meaning to the death. In other words, we have to settle it in our hearts. Feeling an emptiness or void, even a physical one is very normal in grief although it would not be in other life circumstances.

  • Numbness and Shock followed by waves of grief: In an effort to protect the person and body, in early grief or intense tragedies, our bodies and minds 'anesthetize' themselves and we may experience feelings of unreality and what psychologists call 'depersonalization' phenomena, or feeling numb, like we are standing off and watching events from a distance. As the days wear on waves of grief often threaten to overwhelm the mourner; then often the 'numbness' comes back in islands of respite. These are not stages, just a pattern often experienced by those dealing with loss. It is not the same as denial, because the reality of the death is most often acknowledged, [denial would more often take a form of believing or feeling the baby is still alive, which can also be normal in the beginning] but more an ebb and tide of grief. Over months the periods of peace become longer and the grief less overwhelming. It is not abnormal though even years later to experience an overwhelming related to memories or 'anniversaries' associated with the death.
  • Marker Points-Later in grief these are called "anniversary reactions" and are events associated with the death of the infant which bring back memories and mourning anew. what would have been the child's first birthday, the date of the death, the day which would have been a first day of school, Christmas, Thanksgiving, Easter, and so forth: others will be more indiviually defined. Even after some healing has occurred, these 'marker' points can bring grief back: a visit to the gravesite would be an example. While these are very painful, they are still important as one 'integrates' the loss into a life: after time the child while always a part of the family, becomes more surrendered to God, and more at home in the heart.
  • Searching and 'Finding' Many mourners including those who lose infants report a process which is not identifiable to them at first which takes the form of a "searching" and "finding" the lost child. For the bereaved parent, there are certain stimuli that elicit this: seeing a stroller or carriage, a commercial for diapers, a baby's cry in church or synagogue, all these become heightened experiences. The 'finding' is of course unfulfilled, which again brings on bouts of pain and grief. Still it is a normal way the mind has of coming to terms with the 'fact' of the loss. It is not abnormal.
  • Raging and God and faith- While this is covered elsewhered it is briefly noted here as troubling, but normal. When all we believe and expect is turned upside down and we are 'out of control', God is the most convenient one to blame, followed by a spouse or doctor. We cannot control grief or death, we are left helpless in their face, and our 'system' and world view come apart in the midst of a breaking heart. Still, it is essential not to turn away from faith in hurt, but to bring the feelings and thoughts before God in faith. This is the point of healing, not a turning away. (See God and the Death of a Baby)

    these are some of the main patterns of grief, which should not be alarming to experience.

    "Putting Love Away": Taking down the Nursery

    Over time, the physical memories of the baby's death must be put away. Some keep the nursery or other items up till the next child, but it is probably better to experience the 'closure' of coming to terms with the death. Still, for some, it is necessary before or as soon as they come home, for others it takes a year or more. Both are fine: it depends on the meaning associated with act. Some do not want the reminder, others feel it ingracious and unloving to take down the place the baby would have had: each parent must be given utter liberty to make choices. If the nursery stays up years at a time, then yes, it becomes a complication and point of concern. It shows there has been little healing---it does not however grant an invitation to judge or use diagnosis as a whipping post. A parent must integrate and establish the loved child in their heart, surrendered to God, and begin to rebuild.

    Anchoring Grief: Keeping Memorabilia

    All parents NEED to keep some memorabilia. Grief is resolved in part by memory. That is why we 'order' the events of the loss: ask parents to tell the story of the loss. In Stillbirth and neonatal death, we do not have a lifetime of memories; we have only a few trinkets: an ultrasound photograph, the birth and death certificate and footprints, an item of clothing, or a receiving blanket. A few have a photograph or a small memory book for the baby. The most troubling part of keeping memorabilia is the reactions of other people: some think this is a horrid thing---they are insensitive or ignorant and can cause pain for the parents. ALL parents keep some memorabilia, perhaps a small hospital bracelet, just as we do of any child who died. These are the anchors that help memory, order and love grow into a new place. It is not abnormal. .

    Back to Home

    Contact Us


    The Forgotten Grief is a Publication & curriculum Resource authored by Elizabeth K.Best Ph.D. The name is based on her Dissertation in 1981, and the literature Review: The Forgotten Grief published in 1982 in the American Journal of Orthopsychiatry