Saturday, December 7, 2013

Perinatal Loss and Disenfranchised Grief

     While exploring the subject of disenfranchised grief and ambiguous loss I came upon a paper titled, Perinatal Loss and Parental Grief: The Challenge of Ambiguity and Disenfranchised Grief.  This published work outlined a study conducted by Dr. Ariella Lang and assistants. The purpose of this study was to identify sources of ambiguity unique to those experiencing perinatal loss and identify how they may contribute to disenfranchised grief. For those who are not already familiar with the term, perinatal loss is the death of an unborn or newly born baby. For the purpose of the study the authors considered ecotopic pregnancies (pregnancies that take place outside the uterus), miscarriages, stillbirths, and neonatal deaths. Thirteen couples were interviewed at two, six, and thirteen months after the death of their child. The sources of the most ambiguity for these couples were identified as ambiguity a) about the viability of the pregnancy, b) about the physical process of losing the pregnancy, c) arrangements for the remains, and d) sharing the news of the loss. Like any loss the bereaved often ask themselves, "How?" and "Why?", but the how's and why's are different for each particular situation and the loss of a neonate is no exception. The study also concluded that there are three main kinds of disenfranchised grief that the bereaved experience after the death of a baby. These are identified as disenfranchised grief a) within the relationship of the couple, b) when communicating with health professionals, and c) when interacting with extended family and community. The couples in this study found it increasingly difficult to express their grief to health care professionals, family and friends, and even each other. In the discussion the author said this of their study,  "The findings of this study help improve our understanding of how many textures of ambiguity ,ambiguous loss, and disenfranchised grief contribute to bereaved couples' suffering and influence their mourning experience surrounding perinatal death". (Lang et al)

       Studies like this are incredibly important to begin to understand and sympathize with those experiencing an ambiguous loss. Empathy is the first and most crucial step we can take when conducting studies of this nature. But there is also the clinical implications of these studies that are vital to providing care for the bereaved. This study particularly calls for sensitivity from health care providers and more well-developed and enforced protocols following the death of a baby. Also, the information gleaned from these interviews and subsequent analysis of them should allow mental health care providers to choose or create a more adequate therapy for those that seek it.

      Lang, A., Fleiszer, A. R., Duhamel, F., Sword, W., Gilbert, K. R., & Corsini-Munt, S. (2011). Perinatal loss and parental grief: The challenge of ambiguity and disenfranchised grief. Omega: Journal Of Death And Dying63(2), 183-196. doi:10.2190/OM.63.2.e

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