Saturday, November 28, 2015

Supporting a Grieving Parent

"How can I support my friend? She was pregnant, but the baby died before it was born. What can I do for her?" This is a question I was first asked several years ago, by a co-worker whose close friend had lost a baby late in pregnancy. My friend was not geographically close to the grieving mother, and she felt at a loss to respond to and aid her friend, especially given the fact that she couldn’t see her in person to offer physical help.

I scrambled a bit, at the time, to come up with some good resources for my co-worker and her friend, but since I’ve now had more training in responses to perinatal grief and loss -- as part of my postpartum doula and childbirth education training -- and since I've been asked this question a few more times since my co-worker came to me, I'd like to share some of what I've learned. The thoughts and suggestions in this post are specifically tailored toward friends and family members who are wishing to support grieving loved ones, and they can be applied not just to late-pregnancy loss and stillbirth, but to miscarriage, selective reduction, and crisis pregnancies or life-limiting diagnoses that end in perinatal death.

Supporting a Grieving Parent or Parents:
  • Remember that as with birth and parenting styles, all parents will grieve in their own way. This may be very different from the way that you expect, so remain nonjudgmental.
  • You will not be able to fix the situation and you might not know the "right" thing to say. Be open and honest. You can tell the parents that you wish you had the right words, but you just don’t know what to say.
  • Tell them that you are there for them. Ask a grieving parent, "Do you want to talk?" or "Is there anything you need?" Even if they reply in the negative, you've expressed your desire to be a support. If they're open to help, ask them for specific tasks they may need done, or if they have any ideas for how you can best support them. Give them ideas, if they seem reluctant to suggest anything specific. You might even help them brainstorm (and write down) a list to share with other people who say, "Let me know if you need anything," as many people do in a time of loss. You can also encourage the family (or friends of the family) to hire a postpartum, loss, or bereavement doula to help out at home.
  • Parents will remember the words they hear during their grief…The well-intended comment that “It was meant to be,” or “You can have another,” can have a devastating and long-lasting impact on the fragile emotions of grieving parents. So can religiously oriented statements made by people who do not have an intimate knowledge of the family’s spirituality. Let the parents lead any conversation of their spiritual understanding of loss.
  • Don’t be afraid to sit in silence. Your presence and a gentle touch can have more meaning than a stream of words issued because you feel awkward and that you must say something. One mother said that, in the hospital, sympathetic nurses who simply held her hand made a big difference.
  • If you are comfortable doing so, invite your grieving loved ones to call you whenever they want someone to talk to. You may feel this is implied by the nature of your relationship, but even if you "normally" talk or text every day, your friend may need to hear you say the words directly. It can be healing for a parent to hear that others are open to hearing about the baby who was lost. Some parents want to talk about the loss or their child. Or they may at some point in the future.
  • Understand that grieving parents are sometimes very comforted by holding their babies, by having photos taken of them, or by keeping mementos. Depending on the age of the child who died, some hospitals will arrange for parents to bathe their babies after birth, to dress them, or to take home photos, locks of hair, footprints, plaster casts of hands, blankets, hospital ID bracelets, or special certificates. Some families will plan burials, scatter or keep ashes, have "naming" or memorial ceremonies (even long after the loss). If you are able to honor these choices, regardless of what you might choose in a similar situation, that can also be a way to support parents in their grief. Your friends may even want or need help finding a photographer (A good place to start is Now I Lay Me Down to Sleep) or planning a special memorial service. If this is something you feel comfortable assisting with or attending, let them know. If the loss did not occur in a hospital, or if the hospital did not support the family in their grief, you might suggest the ideas above, or otherwise help the family create ritual and remembrance.
  • You might also offer to help with notifying other family/friends/coworkers/neighborhood merchants of the loss. Sometimes, if there are two parents in the family, and one is a gestational parent, this job falls to the partner/father/husband/wife, but it's important to remember that a partner parent is also grieving. Parents of any gender returning to work might appreciate someone letting their coworkers know about the loss, as well as whether or not they are comfortable being asked about it. Some parents have expressed disappointment when friends and coworkers treat them with silence, as if "ignoring" the loss would hurt less than acknowledging it. Follow their lead on whether they'd like some help paving the way for these interactions.
  • Along those same lines, remember the partner (if applicable). I've heard of partners who are only asked "How's your wife doing?" by well-meaning friends and coworkers. In two-parent families, both parents experience loss (as do grandparents, siblings, and other close family members). There may be differences between the ways people are taught/"allowed" to grieve, sometimes along gender lines and sometimes not, and each parent may have had a different relationship with the baby, but everyone deserves to be acknowledged in bereavement.
  • Did the parent(s) name the baby? If so, use the name in conversation. Make a note of the anniversary of the baby's birth date, death date, or "due date," and reach out on that day to let your friend know you're remembering the child. Remember them on Mothers/Fathers Day, too, if those days are meaningful to the parents. It's not just living with a baby that makes us parents. It's the love we have. For this reason, even parents who have no living children are just that -- parents.
  • Share a book or resource that might help them process the loss (some ideas are below).  You can say, "I know you may not be able to look at this now. Hang on to it. It may help you later." Again, avoid overtly spiritual/religious resources unless you are intimately aware of the family's spiritual beliefs.
  • Find out about area support groups and counselors/therapists who specialize in perinatal loss. Give this information to the grieving parents.
  • Don't stop calling/emailing/making contact. Grief doesn't often dissipate in a quick and linear fashion. It spirals gently upward from the depths of initial shock and acute grief, sometimes wandering sideways and sometimes dipping lower again. Even if your friend(s) ask for time alone, you can check back in -- in a few days, a few weeks, several months or a year down the road.

(these suggestions were adapted from: Nurturing the Family: The Guide for Postpartum Doulas, by Jacqueline Kelleher; and A Silent Sorrow - Pregnancy Loss, Guidance and Support for You and Your Family, by Ingrid Kohn, MSW, Perry-Lynn Moffit, and Isabelle A. Wilkins, MD.)

Of course, every grieving parent is different. Some are good at identifying what they want and need as support, and some are not. Most will fall somewhere in the middle -- and what they want and need may very well change. You cannot know what will feel most or least supportive to your loved one in need. If your help is rebuffed, don't take it personally. And don't be afraid to reach out again after some time has passed, to try again.

Please feel free to comment and share your experiences with support after loss. Did someone help you in a meaningful way while you were grieving? How did you respond to a friend’s grief?

Loss altar created at community event, to honor loved ones.

Selected Resources For Further Reading

A Silent Sorrow - Pregnancy Loss; Guidance and Support for You and Your Family, by Ingrid Kohn, MSW, Perry-Lynn Moffit, and Isabelle A. Wilkins, MD
This book would be an excellent resource for any grieving parent, but it also has many suggestions for siblings, extended family, and friends. I'd recommend the book to anyone who has gone through loss, has received a life-limiting diagnosis for a baby in utero, or who wishes to understand and support the phases of grief that may occur after a baby dies.

For Family, Friends, and Allies - How to help family and friends who are grieving (Stillbirthday)

Perinatal Hospice Resources for Parents "Resources for continuing your pregnancy
with a life-limiting prenatal diagnosis." Also on this site: perinatal hospice programs, listed by state.

Resources on Loss and Grief - From

Now I Lay Me Down to Sleep - NILMDTS trains, educates, and mobilizes professional quality photographers to provide (free) beautiful heirloom portraits to families facing the untimely death of an infant.  We believe these images serve as an important step in the family’s healing process by honoring the child’s legacy."

Share Pregnancy and Infant Loss Support, Inc. - Providing "support toward positive resolution of grief experienced at the time of, or following the death of a baby. This support encompasses emotional, physical, spiritual, and social healing, as well as sustaining the family unit."