The Role of Compassion in Perinatal Bereavement Care

How practicing compassion benefits parents–and you too!

Posted Jun 30, 2019

The last post explored why practicing accept and connect is so therapeutic for bereaved parents, and offered a number of tips for effective practice.

This post looks at the practice of compassion and how it

  • boosts your ability to accept and connect with parents,
  • wards off burnout, empathy fatigue, and secondary traumatic distress, and 
  • contributes to your professional fulfillment.

What is compassion?

Compassion is a feeling of caring, loving kindness, and connection without becoming enmeshed. It enables you to offer true support to someone who is suffering, while also remembering that you are not the one who is suffering. Because you can see the suffering but are not enmeshed in it, your priority is to seek and achieve long-term solutions, rather than feeling the urgency to implement short term, quick fixes. Compassion is the heart and head working together, enabling you to be heartfelt and insightful as well as courageous and wise.

The practice of compassion means approaching parents with great care, loving kindness, and advocacy. It includes

  • being mindful, attentive, and deliberate;
  • being gentle and calm in the presence of profound suffering;
  • seeing, respecting, and valuing the whole person;
  • building a warm rapport;
  • slowing down, listening, and collaborating;
  • supporting parents in getting and doing what they want.

Practicing compassion is not another task to add, but rather it occurs simultaneously with all your routine caregiving tasks, including perinatal bereavement care. The practice of compassion informs what you do and how you do it, for example,

  • being fully present for ongoing conversations with parents about their baby and their experience and what's important and meaningful to them and what special memories they would like to create,
  • supporting parents in determining for themselves how and when, or whether to spend time with their babies,
  • making photographs of parents with their baby, with permission,
  • helping them gather the keepsakes they value,
  • following their lead, and letting them set the pace.

Because compassionate caregiving is so comforting to parents, your job feels easier and you feel more competent and confident. Being a compassionate caregiver can be central to your identity, boosting your feelings of professional fulfillment and likely achieving your original career goals, vision, and mission.

Isn’t compassion the same as empathy?

Many people use the terms “empathy” and “compassion” interchangeably. And indeed, there is much overlap. Both entail

  • being aware that someone is suffering,
  • viewing the situation from their perspective,
  • understanding their feelings, and
  • caring about their well-being.

But there is a critical difference between compassion and empathy:

  • When you empathize, you can actually feel the despair you witness in parents, and you suffer along with them.
  • When practicing compassion, you are also a witness to parents’ despair, but you don’t feel it yourself, nor do you suffer along with them.

How do we know about this distinction between compassion and empathy?

Brain scanning research shows that these two states are quite different.
Imagine a room with two brain-imaging machines.

A grieving mother is inside one. Inside the other--you, her assigned caregiver. The mother is instructed to talk about her emotional experiences around her baby’s death; you are instructed to listen and empathize.

As the grieving mother talks tearfully about her baby, the emotional pain centers of her brain light up, indicating her suffering.  As you listen with empathy, the emotional pain centers of your brain light up as well, indicating your emotional suffering. In other words, when we emotionally empathize with a suffering person, we suffer as well.

In contrast, what if you were instructed to practice compassion, and did so effectively? (Research has scanned the brains of experienced practitioners of compassion meditation.) As you listen to the grieving mother talk tearfully about her baby, her pain centers light up, but not yours. Instead, in your brain, the prosocial affiliation centers light up, indicating that you care and want to offer support and long term solutions that are truly effective.

What are the implications of this research?

This research highlights the important differences between compassion and empathy, and explains the contrasting results these two states can have on your practice of perinatal bereavement care.

For example, when we feel emotional empathy, we resonate with the suffering we witness. And we are eager to protect and direct parents because we want to alleviate their suffering, as to also alleviate our own.

Unfortunately, our empathic attempts to protect and direct parents can often compound their suffering, as parents are merely doing what you think is right, and at your pace. As parents continue to suffer, so do we in our empathy, putting us at risk for vicarious or secondary traumatic stressempathy fatigue, and burnout.

In contrast, compassion is what enables us to easily and effectively “accept and connect.” This means walking with parents as they lean into their suffering, and it’s our compassionate companionship that parents find truly comforting and therapeutic. Because practicing compassion does not elicit our emotional pain, it reduces our risk of burnout, empathy fatigue, and secondary traumatic stress. And because compassion is good for parents, it’s good for practitioners, inspiring a sense of competence, confidence, and professional fulfillment.

The next post looks more closely at empathy and how it differs from compassion, and what "accept and connect" looks like in practice.

Suggested Resources:

Koloroutis M (ed). Relationship-Based Care: A Model for Transforming Practice. Creative Health Care Management, 2004.

Study Shows Compassion Meditation Changes the Brain, Center for Healthy Minds, University of Wisconsin, Madison, 2008

Sustainable Compassion for Health Professionals, a webinar produced by the Schwartz Center

Sustaining Compassion in Health Care, an article in Greater Good Magazine, 2013.

Youngson R. Time to Care: How to Love Your Patients and Your Job. CreateSpace, 2012.