Parents of stillborns struggle with grief process 

By its very nature — established, consistent, prescribed — a ritual isn't usually considered newsworthy.

But what has made the news lately are the sort of makeshift rituals created in the aftermath of events for which there is no established, consistent or prescribed action.

Republican presidential candidate Rick Santorum, for example, has drawn attention this month for an account of how his family mourned the loss of his and his wife's eighth child at 20 weeks gestation: By bringing the body home for their other children to hold and bid goodbye. And the Duggar family, stars of the TLC program "19 Kids and Counting," stirred up controversy last month by displaying professional photos featuring a hand and the feet of their stillborn 20th child at a memorial service for her.

Although these losses were handled differently, an issue highlighted by both — and by the heated responses they generated — is the lack of a standard for mourning a child who was never alive in the world.

"They never fathom the idea and don't know what to do next," Breanne Bradley, a registered nurse in labor and delivery with St. Luke's Hospital of Kansas City, says of parents facing this kind of loss. She adds, concerning the perception of people who haven't personally experienced this, that "with a baby that's alive longer ... because of the impact the infant has made in someone's life while alive, there seems more reason to mourn. But parents that have lost a baby prior to birth go through the same grieving process anyone would go through."

This can hold true not only in stillbirth situations but also in miscarriages and ectopic pregnancies, adds Ms. Bradley, who also serves as coordinator of St. Luke's infant loss and grief support team. The team provides immediate grieving care to patients as well as follow-up care for those who consent to it, which includes contact at times that might be especially difficult for them: Their due date, Mother's Day, Father's Day, their own birthdays, the holiday season. And every December, St. Luke's hosts a candle lighting service in memory of infants and children who have died, including those who died before birth.

But this kind of recognition is not the norm. What's much more common, especially in cases in which a pregnancy is lost before progressing very far, is a lack of acknowledgement and understanding from people who aren't personally familiar with the experience. Kathy Contreras, the head of Heartland Health's obstetrical bereavement committee, notes that even among other parents who have lost children, those whose children died before birth often feel out of place.

"I've had some people tell me that they have checked out (Heartland's) loss of a child support group but feel left out because they don't have the memories or as much to hold onto 'happy-wise' as people who have had children for a while after birth," she adds. " ... It is different. Extremely."

But the fact that parents who have experienced miscarriages or stillbirths don't have the memories that other parents do doesn't mean they don't want their children remembered, and there are a number of possibilities for doing this. Some suggested by the website www.babyzone.com include holding a candle lighting ceremony; keeping a memory box of items such as a positive pregnancy test and congratulations cards; planting a tree, a flower or even an entire memorial garden; collecting funds for a cause; or creating something else to symbolize the value of the life lost. For those who aren't particularly crafty themselves, there's always the option of buying something, such as a piece of art or jewelry (some designers have lines specifically for honoring children who died before birth).

Whatever avenue parents decide to take, counselors agree that the need to memorialize is normal, even if there isn't a cultural precedent for doing so. And although this lack of a precedent can make it difficult to determine how to make a commemoration, perhaps it also leaves the door open for possibilities better suited for a particular person and situation than any cookie-cutter approach would be.

It also might offer a chance to see a memorializing significance in something other than a headstone. Kathy Powers, pastoral associate at Our Lady of Guadalupe Catholic Church, cites as an example of this possibility a statue of a weeping angel on the church's grounds. The memorial is meant to honor children who died before birth, and although pregnancies ended through abortion are its primary focus, the statue could speak to other situations, as well.

"Every piece of art is in the eye of the beholder," Ms. Powers notes. "If you see the angel weeping, it might help you understand that God grieves with you."

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