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families believe in spiritual and psychological continuity between the living and the dead. As a part of that spirituality, the family continues a relationship with the deceased after death through prayer and visits to the gravesite.


Some grieving Hispanic parents complain that health practitioners, by discounting the importance of spirituality and cultural beliefs, offer a fragmentary approach to care after the loss of a pregnancy or infant death.


Maria’s baby died due to multiple congenital anomalies. At 20 weeks gestation, she was aware of her baby’s condition. Medical staff did not understand her religious beliefs and choice to not terminate the pregnancy. Staff support was limited to weekdays, not weekends or holidays. After delivery, Maria needed a caring, knowledgeable person to help her hold and spend time with her baby.


In many Latino cultures, the entire family—not an individual or even a child’s parents— makes important decisions about life, including medical care. A mother must have time to talk with her husband and extended family before decisions about medical care for herself or her child can be made. Likewise, the major support for the bereaved parents comes from both the nuclear and extended family. Extended family members (cousins, aunts, uncles, grandparents, and godparents) may travel great distances to be with a terminally ill infant and to comfort the bereaved family. Therefore, health professionals should com- municate with the whole family to help them advise and support the parents. However, families new to this country may not have such support. They will need help in locating pastoral care and funeral/burial information.


The family care is a source of emotional and physical support. Since family ties are so strong, a fetal/infant death affects not only the primary family of parents and siblings but extended family as well. The whole family is expected to participate in all decisions making after the death of a baby.


Louisa’s baby had trisomy 18. The baby died shortly after birth. Louisa was an assertive Latina, fluent in English. She was able to make special arrangements for the care of her baby after birth, including having their pastor bless the baby. Her family was with her and they held the baby as much as possible. She knew that she had to advocate for herself because hospital staff were not knowledgeable of the needs of Latino parents.


When an infant dies, some family members may face not only sorrow, but also anger and confusion evoked by conflicts between their traditional values and beliefs and the healthcare system. For example, when an ultrasound scan or other prenatal test detects severe congenital problems, a provider may suggest to the family that the pregnancy be terminated. Latino parents with strong cultural values and beliefs about the sanctity of life may not accept abortion as an option. When a fetal death occurs, many providers will recommend waiting several days for spontaneous labor and delivery to ensue, rather than inducing labor. Some Latinos may believe that the mother will develop cancer if she waits. To determine if these beliefs are relevant to a particular Latino family, providers simply need to ask. When providers transfer a seriously ill newborn to a special care unit, parents may not understand what is happening, especially if a language barrier exists. They may feel powerless and ignored. Providers should use trained interpreters to ensure these fami- lies can participate fully in making decisions about the care of their infant.


VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT


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