Remembering Fathers and Siblings

The needs of fathers and siblings receive less attention than those of mothers. “Many fathers feel that they have to be strong for the family and have no permission to grieve,” Cacciatore observed.

And do not forget siblings, she cautioned. “Frequently, they have accompanied the mother to her appointments, listened to the baby’s heartbeat, participated in naming, and excitedly anticipated a new baby.” When the mother returns from the hospital empty-handed, the loss can be “devastating.” Moreover, “the family system changes dramatically, so the child has lost the parents as they used to be.”

Helpful Interventions

Help parents find psychosocial support. This can take the form of a grief support group, perhaps through the hospital or a mental health center, through a religious or spiritual context, or via social media.7,10  

Provide or refer patients to appropriate therapy. This can include  supportive counseling, understanding, explanation, and the opportunity to express emotions and retell stories.8 Refer children to age-appropriate grief groups.

Engage in open dialogue with the parents regarding rituals such as holding, seeing, taking photographs, and other mementoes of their time with the baby who died if possible.8 At any juncture, parents can create a ritual to honor the baby and facilitate the mourning process.

Physical exercise, mindfulness-based approaches and yoga can be helpful in reducing stress and improving sense of wellbeing.7,11,12

Conclusion

Increased awareness is being brought to stillbirth, Cacciatore noted. Further research and consciousness-raising are critical in continuing to develop and disseminate compassionate interventions for this population.

Batya Swift Yasgur MA, LMSW, is a psychotherapist and freelance writer who lives in Teaneck, N.J. She practices therapy in New York City.

References

  1. World Health Organization. Stillbirths. Available at: http://www.who.int/maternal_child_adolescent/epidemiology/stillbirth/en/. Accessed: March 3, 2016.
  2. Centers for Disease Control and Prevention (CDC). Facts about stillbirth. Available at: http://www.cdc.gov/ncbddd/stillbirth/facts.html. Accessed: February 28, 2016.
  3. The Lancet Ending Preventable Stillbirths Study Group. Ending preventable stillbirths: an executive summary for the Lancet’s series. Available at: http://www.thelancet.com/pb/assets/raw/Lancet/stories/series/stillbirths2016-exec-summ.pdf. Accessed: March 1, 2016.
  4. The Lancet. The Silence Around Stillbirth is Still Unspeakable. Available at: https://thebestscienceforbetterlives.com/stillbirth/?utm_campaign=stillbirth&utm_source=lancet_email&utm_medium=email&utm_term=initial_mail&utm_content=button. Accessed: March 1, 2016.
  5. Frøen JF, Cacciatore J, McClure EM, Kuti O, Jokhio AH, Islam M, Shiffman J; Lancet’s Stillbirths Series steering committee. Stillbirths: why they matter. Lancet. 2011; 377(9774):1353-66.
  6. Milunsky A, Friedman EA, Gluck L Advances in Perinatal Medicine (Volume 3). New York, NY: Plenum Publishing Corporation, 1983.
  7. Burden C, Bradley S, Storey C, et al. From grief, guilt pain and stigma to hope and pride – a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BMC Pregnancy Childbirth. 2016; 16(1):9.
  8. Cacciatore J. Psychological effects of stillbirth. Semin Fetal Neonatal Med. 2013;18(2):76-82.
  9. Lacasse JR, Cacciatore J. Prescribing of psychiatric medication to bereaved parents following perinatal/neonatal death: an observational study. Death Stud. 2014; 38(6-10):589-96.
  10. Weiss , Frischer L, Richman J. Parental adjustment to intrapartum and delivery room loss. The role of a hospital-based support program. Clin Perinatol. 1989; 16(4):1009-19.
  11. Roberts LR, Montgomery SB. Mindfulness-based intervention for perinatal grief after stillbirth in rural India. Issues Ment Health Nurs. 2016; 36(3):222-30.
  12. Huberty J, Leiferman JA, Gold KJ, et al. Physical activity and depressive symptoms after stillbirth: informing future interventions. BMC Pregnancy Childbirth. 2014; 14:391.