About Loss During Pregnancy and Infancy Loss during pregnancy and infancy encompasses many circumstances: failed infertility treatment, early miscarriage, therapeutic termination, ectopic pregnancy, fetal death, stillbirth, loss after relinquishing a newborn for adoption, neonatal loss, Sudden Infant Death Syndrome (SIDS), birth defects, chronic disease, unintentional injury and homicide. Regardless of cultural background, the death of an infant can create an over- whelming crisis for parents. Grandparents, siblings, other family members and friends may also mourn the loss. Although family members might not remember exactly what providers said at the time of the death, they would certainly recall whether the provider displayed a caring attitude and offered comfort. Care and comfort can be shown by taking the time to sit with the family, expressing condolences, explaining what is known about the cause of death, and responding to parental needs associated with the death. Parents will take solace in this kindness and remember that support for a lifetime.
KEY FACTORS AFFECTING GRIEF RESPONSE
Age
Family customs and traditions Gender Faith foundation Geographical region Education Economic status
Prior experiences with death and loss
Historical background of the cultural group
While the expression of grief will vary among cultures, the deep sense of loss and sor- row is almost universal. Moreover, the perception of loss may not depend on the length of the pregnancy or the age of the infant. The couple who miscarries or has an ectopic pregnancy might be just as devastated as parents whose older infant died of SIDS.
Some initial grief reactions can include shock, disbelief, guilt, blame, anger and hostil- ity, tears, and somatic complaints. Some parents report hearing the baby cry or seeing the baby. After stillbirth delivery, mothers may describe feeling fetal movement. The provider can reinforce that such experiences are common among many grieving parents. Other parents report that they feel they are “‘going crazy”‘. Providers can again reassure the bereaved that other parents spoke and felt the same way. Parent to parent peer sup- port can be very helpful. Many families benefit from culturally relevant infant loss lit- erature in the appropriate language. Providers should also know about and be prepared to link parents to culturally appropriate pastoral care or offer other information, such as available funeral and burial options, as appropriate.
Key factors can influence the grief response. These factors provide a context to consider the family’s grief response. Providers are encouraged to think about these factors when working with a bereaved family.
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VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT
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