Prior to the 1970s, there was little research that perinatal loss caused substantial distress. Today, we know better.
“The typical pattern of grieving a perinatal loss has been recognized for over 50 years.After the initial shock and numbness on learning of the death (especially if it was unexpected), a period of intense confusion usually follows with lapses in memory, anxiety, restlessness, irritability, and somatic distress. As the reality of the death is gradually absorbed, the bereaved yearns for the return of the deceased. Inconsolable sadness and preoccupation with memories of the deceased, with intensely painful periods of loneliness, guilt, anger, and hopelessness over ever feeling better periodically wash over the bereaved in waves of emotion. Over the next year or two, the bereaved gradually becomes reconciled to this permanent loss. There is a resumption of everyday activities, a renewed interest in other relationships and the world in general, and a restored capacity to feel pleasure.” (Source: Helping Families Cope with Perinatal Loss, Irving G. Leon, PhD, http://www.glowm.com/section_view/heading/Helping%20Families%20Cope%20with%20Perinatal%20Loss/item/417)
Perinatal loss leaves bereaved parents feeling more helpless and dazed, doubting the reality of what has happened, partly as a result of the often traumatic, sudden nature of the loss, and the belief that children are not supposed to die before their parents. Grieving demands remembering the sights, sounds, smells and touch of the beloved. When an unborn child dies, there are so few of these sensory memories or interactions, and, in times past, not even a body to see. Much of perinatal loss involved grieving the loss of the future. Many researchers and clinicians now recommend strongly that bereaved parents are given many opportunities to see and hold their baby, to create mementos of their baby’s existence, and to make memories to facilitate the grieving process, as does having a funeral. Making the reality of this child, and his or her death, as clear as possible promotes the tasks of grieving.
Complicating the grief process is the feeling that mother’s often have when they have lost a baby that their bodies have failed them. This feeling of diminished self worth can be more of a long-term challenge after pregnancy loss than grieving the loss of the baby.
Additionally, the plans that were being made by the parents for the arrival of their new baby are thwarted, and often the parents feel stuck and off track.
Fathers grieve the loss of their unborn, stillborn and newborn children, but their grief, typically, tends to be less intense, shorter, and not filled with as much guilt as that of the mother. Sometimes they feel threatened by how sad they can feel, fearing losing complete control of their emotions. Men may express their disappointment and frustration as anger. This incongruence in the intensity and presentation of grief between the parents can lead to conflict between the parents. Additionally, father’s may be take on the role of taking care of the other children, dealing with funeral arrangements, and having to return to work quite quickly – all of which may give him little time to grieve the loss. Some fathers may also work overtime as a way to continue to avoid their own sad feelings and to avoid being with their grieving wife. Sometimes they may unconsciously seek to replace their lost baby or repair damaged self worth by work accomplishments.
In spite of all the challenges inherit in the loss of a baby, most parents are able to weather the storm and come through it with a stronger marital bond. When differences between the couple can be acknowledged and respected with some degree of sharing what has been lost, couples usually find their way back to each other.
Perinatal sibling loss has been caleed the invisitble loss because usually siblings do not see the dead baby, and often there is not acknowledgement of the siblings many questions, confusions and feelings about this loss. Today, siblings are increasingly allowed or encouraged to see the baby as they participat in the opportunites for the entire family to grieve. Children are capable of understanding the fundamental facts of death, and by the age of two or three, children can usually beging to grap these essential details of death of provided with concrete but impresonal examples, such as a dead insect or small animal. Attending the funeral usually helps even youg children by making the death concrete and providing social support. Children need to be prepared for what they will see and hear as well as having a trusted adult nearby to answer any questions that arise. See child grief for more information.
Extended family and friends are more able today to extend sympathy to bereaved parents. While many forms of supportive behavior can be provided (such as advice/feedback, practical suggestions, financial help, and opportunities to socialize), the most valued support is emotional understanding in the forms of being physically present, empathizing with grief and offering encouragement. It is still common, nonetheless, to expect that bereaved parents should rapidly return to “normal,” becoming their “old selves” within a few short weeks or months. There continues to be a lack of appreciation of the depth and duration of the grief after this loss, often extending through the first year and sometimes beyond. Emotional social support from one’s extended family and friends is frequently cited as an important factor facilitating a quicker recovery from perinatal loss.
It may be especially difficult for grandparents to tolerate their children’s painful grieving. Frequently, grandparents will not want to talk about the baby so as not to “upset” the bereaved parents. Grandparents may also challenge the usual hospital practice of having contact with the dead baby, having learned the earlier approach of avoiding any reminders about the baby and suppressing grief. This often results in the parents feeling more isolated and misunderstood, and sometimes less able to grieve because of their own parents’ lack of support.