Perinatal Death: How Fathers Grieve (1998)

ABSTRACT: The purpose of this study was to explore with fathers their perinatal death experiences. Data were collected from 11 fathers who experienced a perinatal death. Fathers who experienced perinatal death in the second trimester or later reported having a more intense and more prolonged grieving experience. Grief intensity diminished over time and remained mild to moderate for as long as 5 years following the death. Fathers felt their experience was misunderstood by family, friends, and co-workers and they were not adequately supported by their family or the community. Perinatal death is one of the most difficult experiences a parent can face. Perinatal death is denned as any death occurring from conception through 28 days following birth. It is estimated that 15 to 20% of all pregnancies end in miscarriage, usually occurring in the first trimester (Hughes & Page-Liebermann, 1989). However, when weeks 4 through 20 are considered, the spontaneous abortion rate is 10% to 17% (Blackburn & Loper, 1992). In addition, if a fetus is born after 20 weeks, it is a stillbirth. Approximately 85% of neonatal deaths are due to prematurity (Merenstein & Gardner, 1989). No matter when the perinatal death occurs, parents lose their dreams and hopes for their child, a part of themselves, a part of each other, and a part of their future (Keller & Lake, 1990; Rando, 1984). Although the degree to which understanding perinatal death and its impact upon parents is improving, a limited amount of research is focused directly upon fathers and their perceptions of perinatal death. Fathers' experiences are generalized from other forms of grief and then projected onto the perinatal experience. However, perinatal death creates a specific and unique grief. This study explored with fathers their perinatal death experiences. LITERATURE REVIEW Much is written about perinatal grief. The majority of this literature is focused on the mother's experience. When the father's grief was discussed, for the most part, it was done generically as parental grief and few studies specifically addressed the father's perception of the perinatal grief experience. However, Peppers and Knapp (1980) developed the concept of incongruent grieving and described differences between mothers' and fathers' grief responses. They reported women have a higher intensity of grief since they bond earlier with the baby during the pregnancy, whereas fathers begin bonding with the first movements of the baby or after viewing a fetal ultrasound (Pepper & Knapp, 1980). Wallerstedt and Higgins (1996) reported mothers and fathers share equally in the perinatal grief process because the child was a common bond between them. With a perinatal death, a distinctive form of grief, called shadow grief, is created. This grief is with the father throughout his life (Pepper & Knapp, 1980). Grief frequently manifests itself with memory cues, especially on the anniversary of the baby's death. This difference hi grieving between parents does not necessarily influence the couple's relationship. However, several researchers reported a perinatal death experience can bring couples closer together (Hughes & Page-Liebermann, 1989; Menke & McClead, 1990). Others suggested couples drift apart, and 70% to 90% of all married bereaved parents divorce or separate during the year after a stillbirth or a neonatal death (Schiff, 1986). According to Smith and Borgers (1988), the parents' grieving period, though not precisely definable, generally lasts from 18 to 24 months. Fathers' grief encompasses the period from the death to a return to pre-death functioning. Society also places expectations upon the length of time parents are supposed to grieve. Generally, this time is just a few months (Menke & McClead, 1990). In contrast, Hughes and Page-Liebermann, (1989) found all the fathers in their study reported that intense grief lasted no more than 2 months. …