Tamarin Norwood considers how writing practices might help support parents bereaved at birth. This article is part of the series ‘Contemporary Womxn’s Writing and the Medical Humanities’, guest edited for The Polyphony by Rebecca Rosenberg and Benjamin Dalton.
Perinatal loss, which encapsulates miscarriage, induced abortion, stillbirth and neonatal death, is ‘the only type of loss in Western society for which there are no culturally sanctioned rituals or traditions to help the bereaved say good-bye’ (Markin and Zilcha-Mano 2018, 21). Depending on the weeks of gestation, formal acknowledgements such as death certificate and funeral may or may not be available, and whether or not they are, informal acknowledgements may minimize and invalidate parents’ grief. In the well-meaning reassurances of family, friends and medical professionals, we can discern ‘an active culture of denial and intellectualization that discourages parents from grieving’ as they are reassured that the death was, for instance, for the best, that it happens all the time, that they can always have another baby (21).
Compounding this wider sociocultural disenfranchisement is the fact that the baby was itself unknown to its parents, who will often report psychological confusion within themselves, not knowing ‘who or what they have lost’ (Bleyen 2010, 69), and this contributes still further to an overall ‘sense of unreality’ (Murphy and Cacciatore 2017, 130). […] This absence of ‘cultural scripts’, with families struggling to ‘make meaning from loss’ (132) contributes to the fact that the pattern of neonatal and perinatal grief often fails to show the typical linear decline associated with other types of grief, and is more likely to become pathological over time (Lin and Lasker 1996).
For bereaved parents faced with the unreality and double disenfranchisement of socially unsupported grief for a baby even they did not know, the benefits of story-making are threefold. First, it can create a powerful personal narrative robust enough to hold esoteric and otherwise unsupported thoughts and practices, creating a narrative arc that can attenuate the divergence of pathways between parent and baby, binding them together for longer, and even preparing the landscape so that the pathway of the deceased can continue in step with those left behind, and bonds can continue after loss rather than being relinquished. Second, a greater sense of enfranchisement might be clawed back through this process when, by creating their own story, parents becomes an agent of their own narrative rather than its passive recipients (Guilfoyle 2015). Third, by releasing personal grief practices from feelings of irrationality and shame, these stories are more able to enter the social world, challenging the traditional ‘womb to tomb’ model to admit into the life course the social identities of both the unborn and the deceased, in turn contributing to the wider project of releasing neonatal death from the social taboo that stands to jeopardise the grief narratives of bereaved parents of the future.
With mental health resources as stretched as they are, small and relatively inexpensive interventions might support parents to begin this journey on their own. […] Might a dedicated booklet be made available to write in, perhaps guided by prompts to capture those first fleeting impressions, give them weight and space on the page; writing that might be shared within close relationships and further strengthened in these interactions?
Since the above was published, I have begun to collaborate with a baby loss charity to create and deliver just such writing prompts into the hands of parents bereaved at birth, as well as a baby loss bereavement writing group. It is hoped that these interventions will not only make a meaningful difference to grieving parents, but also shed further light on the nature and function of the stories and metaphors created. To learn more about this collaboration please contact the author.
Dr Tamarin Norwood is a researcher at the University of Oxford Centre for Life Writing where she convenes the Lives in Medicine research network. She is a visiting early career research fellow at the Centre for Death and Society, University of Bath, and a postdoctoral research fellow at the Drawing Research Group, Loughborough University where she is writing a book on drawing, metaphor and the maternal experience of neonatal loss.
This text is an extract from and update upon the article “Metaphor and Neonatal Death: how stories can help when a baby dies at birth”, Life Writing 18:1 (2021). The article in turn develops a paper delivered at the Death and Culture III Conference, York St John University UK on 4 September 2020, and “Something from Nothing? Constructing a narrative when a baby dies at birth,” a paper delivered at the CWWMH seminar series on 20 October 2020.
A passage from the author’s autobiographical writing preparing for the neonatal death of her son was published on thepolyphony.org in October 2020 to mark Baby Loss Awareness Week.
Bleyen, Jan. 2010. “The Materialities of Absence after Stillbirth: Historical Perspectives.” In The Matter of Death: Space, Place and Materiality, edited by Jenny Hockey, Carol Komaromy and Kate Woodthorpe, 69-84. Basingstoke: Palgrave Macmillan.
Guilfoyle, Michael. 2015. “Listening in narrative therapy: double listening and empathetic positioning.” South African Journal of Psychology 45(1): 36-49. doi: 10.1177/0081246314556711 sap.sagepub.com
Lin, S. X., and Lasker, J. N. 1996. “Patterns of grief reaction after pregnancy loss.” American Journal of Orthopsychiatry 66(2): 262–271. doi: http://dx.doi.org/10.1037/h0080177
Markin, Rayna D. and Zilcha-Mano, Sigal. 2018. “Cultural Processes in Psychotherapy for Perinatal Loss: Breaking the Cultural Taboo Against Perinatal Grief.” Psychotherapy 55(1): 20-26. doi: http://dx.doi.org/10.1037/pst0000122
Murphy, Samantha and Cacciatore, Joanne. 2017. “The psychological, social, and economic impact of stillbirth on families. Seminars in Fetal and Neonatal Medicine 22: 129-134. doi: http://dx.doi.org/10.1016/j.siny.2017.02.002