Paternal Grief of Stillbirth: A Clarion Call to Action

Living 2,500 miles away at the time, I was not able to offer neither a word of advice nor a shoulder
to cry on for my brother Steven, who went through the silent stillbirth of his second child. The
distance posed only a portion of the obstacle, and my lack of knowledge and understanding
inhibited my ability to offer help and support. Not untilOnly recently did I hold a pointed
conversation with him, discussing his feelings concerning the hardship of his daughters stillbirth.

Comment [SP1]: Hi Matthew! Great job on

your article. Its engaging and I think its
significant that you chose to address this
issue.
Formatted: Left, Space After: 12 pt, Line
spacing: Multiple 1.15 li

I never knew of the depth of sorrow he felt as the unexpected, hopeful pregnancy of his wife
turned to the bitter news of complications that would result in the infants death. Nor was I aware
of the feelings of irritation, annoyance, and anger he felt as he walked down the street, passing
cheerful parents with their giggling childrengrinning as if to spite the smile he would never see
on his own daughters face. Even now, after having talked with my brother, I cannot completely
sympathize with him because . I have never had a similar experience. However, I now possess a
greater understanding of what a grieving father feelsknowledge which, I hope, will help me know
how to strengthen him and others going throughexperiencing similar trials.
Stillbirth: Affecting Mothers and Fathers
Stillbirth is defined as the death of a baby after 20 weeks of pregnancy. It occurs in
approximately 1 in 160 pregnancies (March of Dimes). The perinatal death of a child strongly
affects the parents involved. The word parents is used purposefully, as generally more focus is
placed on the plight of the mother than that of the father. Not only does the mother of the child
experience grief and pain but so does the father. But to what degree? How does paternal grief
relate to that of a mothermaternal grief? How does it differ? In wWhat ways can fathers be helped
through the grieving process?

Comment [SP2]: Changed for parallelism.

OK?

Often, the grieving of a father is overlooked and untreated, left to be resolved at a later timea
time which that may not come. The connection between a father and his unborn child, the grief
accompanied by the childs death, and the role a father plays before and after stillbirth all
contribute to the fathers need of support for fathers. We need to Helping help fathers through the
grieving process in mourning the stillborn child and to finding suitable outlets. This process is just
as important as helping mothers through their grief.
Perinatal Bereavement
The death of a newborn baby is sometimes known and expectedanticipated in advance and,
at other times, or completely unexpected. The death carries with it a load of grief and pain for
parents. Such Pperinatal bereavement (i.e., grief and pain associated with the loss of a child at or
near the time of birth) can be seen at different levels. Factorssuch as gender, personality, number
of living children, a n d environmental or situational eventsand personal responsibilities play a
key role in determining ones a parents bereavement (Fenstermacher and Hupcey 2394).
So many factors make judging a certain couples grief difficult. Additionally, kKnowing exactly how

Comment [SP3]: Changed for concision.

Comment [JS4]: Or usually requires either
(either this or that), but saying the stillborn
death is either known or unknown didnt
really fit. Rephrased to avoide either/or. OK?
Comment [SP5]: Or usually requires either
(either this or that), but saying the stillborn
death is either known or unknown didnt
really fit. Rephrased to avoide either/or. OK?
Comment [SP6]: Changed to bring focus
back to parents. OK?

to sympathize with and support parents is also hard. Promises of a child full of light and life turn to
thoughts and feelings of darkness and death. Grief manifests itself in varying ways for different
parents. Many questions remain unanswered, guilt may accompany the feelings of parents looking
for the cause of their infants death, depression can set in, and anxiety can take over (Cacciatore,.
91).
Maternal Connection and Grief
When all factors that leading to grief are weighed, one of the most prominent and
influential is the mothers connection with the prenatal child. The connection between mother and
child is singular. Because of this connection, Ggenerally, the mother of a stillborn child receives the
majority of the support and sympathy offered to the couple. I do not intend for this statement to
be cynical or sexist in any way. Rather, this statement is to juxtaposes the grief, connection, and role
of both the mother and the father in this particular situation. It is the mother, after all, who
carries the child, develops a bond far deeper and more personal than the father with the baby, feels
its motion, and, eventually, lack of motion (Saflund and Wredling, 1197). Aside from carrying and
experiencing the child internally, the mothers attachment also involves external factors in her
attachment. Planning and preparing the room where the newborn will sleep, deciding on a name to
call him or her, picking out clothes although peripheral or external in naturenot physically attached
to the baby, these factors create a deeper emotional and mental tie between mother and child.
Combining all aspects together, we see a strong bond between a mother-to-be and childa bond
brutally broken when the mother learnsinformed of the childs death.

Comment [SP7]: Changed for formality. OK?

Comment [SP8]: Changed to parallel the

sentence before. OK?
Comment [SP9]: Although you state
mothers have a stronger connection to
children than fathers, it seems to detract from
your argument a little. Consider changing to
develops a deep bond with the baby.
Comment [SP10]: I really like this phrasing.
Comment [SP11]: This is a little redundant
and can be omitted altogether. However, if
you want to keep it I think peripheral in
nature works nicely.

While the connection between mother and child is singular and strong, the perinatal bereavement
of the mother generally lasts longer and is more apparent than the fathers (ONeill, 33). As stillbirth
entails both the birth and death of a child simultaneously, emotions become mixed, having a
profound psychological effect on the mother. As mentioned earlier, various factors (e.g., biological,
environmental, mental, etc.,) combine to form a negative outcome, which often takes the form of
long, drawn-out grief. About 20% of mothers who have a stillbirth will fall into a long episode of
depression, dealing also with possible strains on their relationships with others (especially their
spouse) and feeling out-of-place in social settings (Cacciatore, 91). Amidst mixed emotions and
thoughts, women tend to fare worse psychologically than men (Saflund and Wredling, 1197).
Women take their own time and work by their individual methods of coping, as do men. (See
Figure 1.) The two separate methods of coping, however, are dissimilar and reserve the possibility
of clashing and straining a couples relationship. Thus, in relation to their deeper connection with
the infant, women often need sources of help or comfort personally tailored to their needs,
impertinent to the needs of the father. This contributes to the explanationhelps explain of why
fathers lack a reception of attention.

Comment [SP12]: Im not sure what the

text is trying to say here. Impertinent means
more disrespectful or cheeky. Should we
change it to something similar to separate
from?

Figure 1. This graph shows the grief cycle (generally) typical of individuals affected by change. The amount of time
required to complete the cycle, however, depends on the person and situation (Straker).

Paternal Connection, Grief, and Social Roles

Contrastingly to the connection and grief of the mother, we see the effects of the broken
connection between father and child are less apparentthe not-so-brutally- broken -bond of the father
in this scenario. Because the father is not involved in the actual carrying of the child, the father
lacks the natural bond experienced between mother and child. Instead, what he the father
experiences in this situation is more of a peripheral experience (Stradley). Physically, the father
holds no connection whatsoever with the baby, except that whichwhat he receives through the
mother in a form of vicarious relationship. In explaining the difference in attachment level
between men and women and their child, Brett ONeill (MA, bachelor of applied sciencephysical
therapy) recounts his personal experience in dealing with stillbirth:
A fathers attachment to the unborn child varies. How connected a father is to
that child may affect his reaction to the stillbirth. Perhaps I hid behind the
stronger role as a way of distancing myself from the event and staying in
control. Perhaps I was not as attached as I thought. Either way I was clearly
not as visibly affected as my wife. I was overawed at my wifes sadness. It made
me realize that her love of the child was greater than mine, and her attachment
was also closer. (3334)
Often through no fault of his own, the father is unable to reach the same level of attachment (and
therefore the same level of accompanying grief) as the mother. This lack of connection presents us
with onea reasonable explanation for why men often get overlooked and placed behind the woman
when comforters come to aid the couple in the grieving process.
A fathers expected and assumed social role and the grief he feels accompanying stillbirth are often

Comment [SP13]: How do you feel about

this phrasing? We could cut it completely, but
I think having a topic sentence here helps set
up the section.

Comment [SP14]: I dont think this is

necessary in the text. I think readers can refer
to him in the works cited portion if they want
to know his credentials.

related. Generally, in American patriarchal society, it is the mans responsibility to provide

financially for his family. The logistics of medical care, hospital visits and stays, preparing and
furnishing a new babys room, buying baby clothes, and putting food on the table run through the
fathers mind and dictate how he uses his time. When pPlanning on having a child (a new mouth to
feed, body to cloth, etc.,), it adds an additional pressure to the fathers role as provider. The father
consciously plans for the adjusted budget and works out the logistics previously mentioned.
Physical, fiscal, and even psychological preparations are all made for the birth and future of his new
child. However, when he receives the news of his childs stillbirth, it undermines his preparations
and may psychologically and emotionally affects him.
When informed about the perinatal death of their child, fathers do, in fact, feel shock, anger,
loneliness, emptiness, and helplessness (Badenhorst, Riches, Turton and Hughes, 254). Such an
abrupt, unexpected event requires time to evaluate the shift in projected logistics. However, more
importantly, it requires time to grieve. The father may not have carried the child for twenty or more
weeks, but he remained alongside his wife who did, and it was still his child. He prepared physically,
mentally, financially, emotionally, and often spiritually for the day when he would be able to hold
his newborn infantjust to have such those dreams and hopes haplessly dashed. Fathers along
with mothers need time to grieve, and they require comfort and consolation through the grieving
process.
An additional social role that influences a fathers grief is the relationship he has with his spouse
specifically, his role in emotional support. Consider the more peripheral nature of a fathers
connection and involvement with a stillborn child. Fathers are generally more capable to offer their
spouse needed support and help through the womans grieving process. Consequently, this role
can be both helpful and hurtful to the husband. In assuming the responsibility to provide comfort
and strength, the husband steps up, forgetting his own emotional needs and instead focusing his
efforts on his family the mother (ONeill, 33). This process allows him to avoid, in a way, the
severe pain and grief he may otherwise feel.
As explained in a systematic review of the psychological effects of stillbirth on fathers, the social
role of fathers as an expected support to their partners may be a contributing factor in the
descriptive observation that grief reactions in fathers tend to be less intense than those of
mothers (Badenhorst, Riches, Turton, and Hughes, 254). Although the role of caregiver and
emotional support seemingly diminishes the fathers grief, it truly only delays the inevitable grieving
process he must go through. Brett ONeill says that even with his efforts to console and buoy his
wife, when the funeral was held for their child, I couldnt hold on any longer. It was my time to
grieve (ONeill, 3435). Fathers may assume the role of an anchor in a hard time and put on the
facade of fortitude; however, the grief and pain still remain, requiring an outlet and consequent
shoulder to lean on.
Taking a step back from the immediate issue of stillbirth, we see that external and situational
modifiers can add to the already present grief (Fenstermacher and Hupcey, 2394). In the case of

my brother, many would not know that within the same month his daughter was stillborn he also
underwent the trial of our uncles unexpected death. These two situations worked to augment the
impact of the other, adding to his grief.
External factors such as this experience are not always accounted for when looking at someone
grieving the loss of their infant. One We may not know the financial situation in which someone
lives, the lack or loss of their job, problems in marriage, relationship struggles with family
members, mental state, or other trials they are facing. These external modifierscombined with
the fathers connection, indicators of grief, and social rolesgive a vision of what a father may
experience in the scenario of his childs stillbirth.
Need for Support
With a look at the differences and similarities of a mothers and fathers connection, grief,
and role ensuing the stillbirth of their child, two things become clear: 1) support for both
individuals varies depending on their needs and situations, and 2) support, in whatever form it may
appear, is needed for both individuals. When we think of a situation involving stillbirth, it is easy to
guess the mother will receive the majority of support. There exists in our minds a hierarchy of
grief. Support is offered to the bereaved mother instead of, or in greater abundance compared to,
the father. This support, or lack thereoffore, may come from a nurse, caregiver, friend, family
member, or even the husband.
When the father receives attention, however, he generally does not receive direct inquiries about
his well-being. According to Steven Stradley, it is almost socially acceptable to just push past the
father and talk to the mother. This sentiment may hold true in our society, but it should not be
present. A lack of social support actually correlates with a greater intensity of grief (Badenhorst,
Riches, Turton, and Hughes, 254). Therefore, in order to mitigate the effects stillbirth inflicts on
grieving couples and aid them in coping, support must be offered to both the mother and father to
provide an essential positive element in their lives.

How to Offer Support

How, then, do we offer effective and meaningful support? Even though the grief parents
feel for the loss of their child may never truly end, there are certain things we can do to ease their
pain and help them come toreach acceptance (Conway and Valentina, 55). As Joy Ufema suggests
in an article on gently caring for those affected by neonatal death, a physical object to remember
the baby often helps give comfort to the parents (Ufema, 66). Being open and available to listen,
even without giving specific advice, can also be helpful. We should be perceptive to the feelings of
the couple and willing to let them mourn and take their time. Additionally, we must remember to
ask the father how he is doing and what he needs, rather than simply asking them him how his wife
is faring. This support helps show sympathy and care not only for the couple, but for the oftenneglected father.

Comment [SP15]: Deleting this seems to

add more punch. If you prefer a verb here
though, I think persists works well.

Conclusion
This paper addresses the method of contrasting sentiments and responsibilities between men
and women regarding stillbirth. This method is used not to distance the two, but rather to unite a
husband and a wife. A womans connection with her prenatal child is deeper and stronger than a
fathers. Equally apparent is the fact that men and women vary in the level of grief they feel and the
processes they use in coping with their sorrow. The fact that men and women differ and therefore
behave differently is not new. It spans centuries of couples joining in marriage, complementing each
others strengths, bettering one anothers weaknesses, and working together. In the case with of
stillbirth, the same principle applies. The grieving mother of a stillborn child may always need more
attention and comfort than the father; however, that does not mean that the grieving p r o c e s s needs
to be individually endured.
My brother, although he grieved in his own way and suffered periods of feeling isolated, feels
believes that the relationship he enjoys with his wife has grown since the stillbirth of their daughter.
They learned to grieve together and support one another, bringing not only strength to their marriage
but a l s o healing. Along with the sharing of grief, I suggest that any subsequent comfort, care, and
counsel also be jointly shared. Mothers need love and support from family members and friends
through adverse conditions. Fathers do, as well. I issue a call to anyone who knows someone affected
by the grief of stillbirth; h:. However you choose to lend your support, do not forget to include the
fathers.

Comment [SP16]: Changed to avoid

repetition. OK?

Comment [SP17]: Wonderful, strong

conclusion.

Works Cited
Badenhurst, William, Riches, Samantha, Turton, Penelope , and Hughes, Patricia. The
psychological effects of stillbirth and neonatal death on fathers: Systematic review. Journal of
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2014.
Cacciatore, Joanne. The Silent Birth: A Feminist Perspective. Social Work 54.1 (2009):9195.
Academic Search Premier. Web. 19 March 2014.
Conway, Patricia and Deborah Valentina. Reproductive losses and grieving. Journal of Social Work
and Human Sexuality 6.1 (1987): 4364. Academic Search Premier. Web. 7 April 2014.
Fenstermacher, Kimberly and Judith E. Hupcey. Perinatal bereavement: a principle-based concept
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March 2014.
March of Dimes. Pregnancy Loss. March of Dimes. March of Dimes Foundation, September
2009/February 2010. Web. 19 March 2014.
McColgan, Pamela L. Perinatal loss: Helping families through stillbirth and neonatal death.
Canadas Mental Health 37.1 (1989): 2225. Academic Search Premier. Web. 7 April, 2014.
ONeill, Brett. A Fathers Grief: Dealing With Stillbirth. Nursing Forum 33.4 (1998): 3337.
Academic Search Premier. Web. 19 March 2014.
Saflund, Karen and Wredling, Regina. Differences within couples experience of their hospital care
and well-being three months after experiencing a stillbirth. Acta Obstetricia et Gynecologica
Scandinavica 85.10 (2006): 11931199. Academic Search Premier. Web. 19 March 2014.
Stradley, Steven. Personal Interview. 1 April 2014.
Straker, David. The Kubler-Ross Grief Cycle. Changing Minds. Changing Minds, date unknown.
Web. 7 April 2014.
Ufema, Joy. A need for extra gentleness. Nursing 34.3 (2004):66. Academic Search Premier. Web. 19
March 2014.