Tara Shafer

To Begin Again

Talking to Children About Pregnancy & Infant Loss

Acknowledging loss and confusion young children may feel will help them heal.

Posted Sep 12, 2014

In the winter of 2005, my second son was stillborn well into my third trimester. I had, at that time, a living son who was almost three years old. When I recall that winter, I remember that the hardest thing my husband and I did was to explain to our toddler that the baby he had been promised would not be coming to live with us.

We have an understandable impulse to shield children from painful realities.  Infant death is unimaginable, and pregnancy loss can be both abstract and utterly devastating.  Children in a family facing this trauma tend to be quite young, and this may compound the impulse to obscure the loss. However, a lack of constructive dialogue from parent to child may come at a cost, no matter how well intended the silence.  Talking about pregnancy and infant loss remains a social taboo even though 1 in 4 pregnancies end in miscarriage, and an additional 50,000 children are stillborn or die in the first thirty days of life in the United States annually.

The loss of a pregnancy or an infant touches on the concept of ambiguous loss which impacts children as well as adults.  “Ambiguous loss refers to the physical or psychological experiences of families that are not as concrete or identifiable as traditional losses … [these losses may be] considered to be taboo … such as a miscarriage … ‘the relationship is not recognized, the loss is not recognized, or the griever is not perceived as one with permission to grieve’ … [B]ereaved children experiencing ambiguous loss often fit into one of these categories.” (Ambiguous Loss and Its Effects on Children: Implications and Interventions for School Counselors, Guidry, Simpson, Test & Bloomfield).  

Adults do not always recognize ambiguous loss/grief as experienced by children and thus do not affirm or validate the experiences of these children.  Moreover, the children themselves have difficulty in conceptualizing and articulating their loss and may feel alone and confused.  Some may develop cognitive, emotional and behavioral problems as the result of familial stress.

Among the many challenges in discussing pregnancy and infant loss with children is the central fact that there is no one correct way to approach the topic.  Even within one family, different ages and individual personalities may require different approaches.

Writes pediatrician Dr. David Fenner, “No one knows your child better than you do and in many ways, no one knows you better than your child … [W]hile it is natural to try to set your emotions aside and show your children only your brave face, they will sense and share your sadness. Often they will have an insight into your emotions that no one else can sense and on a level no one else can reach. Their opportunity to help you will help in their healing as well. Don’t be afraid to let them in.” file://localhost/(http/::reconceivingloss.com:helping-siblings-through-the-grieving-process-by-dr-david-fenner:).

Note that it is not necessary to provide a great amount of detail. Says Dr. Fenner, “children will often ‘set aside’ bad news on issues they don’t understand only to revisit it again and again to digest in small bites what they don’t understand.” Let them help you pace yourself, and trust that this is a healthy coping mechanism.  

In addition, each party may benefit simply from parent/child connection and presence.  If a parent needs some respite, this is an excellent way to make use of offers of assistance from friends and family eager to help. Finally, children sometimes need reassurance regarding their own health and safety as well as that of their parent(s).  Be careful not to inadvertently distance children during this time and to seek pediatric assistance if a child’s anxiety becomes excessive.

To the extent that you are able, it is helpful to engage your child’s process.  Writes Fenner, “[F]or toddlers and preschoolers, the line between imagination and reality is often blurred. Your child might say at a later time that he misses the baby. In a way, the concept that he had of the baby and the thoughts of what they would do together were to him, real. Support him as he works through his reality.” In this way, parent and child grief around pregnancy and infant loss may not be so very different.

During that terrible and beautiful winter, when I got down on the floor and played with my son, it is true that I have seldom experienced such intimacy.  I still think a lot about that searing winter when the dead and the living were juxtaposed, each clamoring impossibly to be understood.  I think of us playing with unit blocks and Matchbox cars in a winter-light filled room with rainbows glancing off of prisms. I remember the white-hot grief and the blunt-force trauma of my sudden loss, and also the sweet presence of my little boy in the shafts of sunlight.

My husband and I struggled with how to explain stillbirth to a toddler. Much of the advice we received seemed better suited to an older child facing the loss of someone with whom they had a tangible relationship.  In practice, this advice made little sense and we were afraid to do harm inadvertently.  There was good evidence to suggest that play therapy could be helpful but I did not have the skills to employ it.  We were frequently stumped.  I am always conflicted on the question of how much of my children’s experience it is appropriate to reveal here and so I will confess to many mistakes and leave it at that. 

We have, as parents, a powerful impulse to correct things.  When something terrible happens we want to explain it or fix it.  Or, in the absence of explanation, we want to demonstrate our steady presence in the face of it.  After the stillbirth our pediatrician gave us some excellent advice.  To this day it remains the most helpful advice I ever received about parenting after baby loss. He suggested that we decide on two or three things we would not budge on as parents.  Things like bedtime, how much television to watch, or sugar intake. “Then,” he said, “you can be flexible about anything else.”  I see now that he was telling us to be gentle with ourselves. And to do what we could to create a modicum of clarity during that bewildering time.

Making two or three go-to rules about parenting post-loss is a good idea.   The definition of these things – no matter what they are – enables dialogue between partners regarding priorities and boundaries. When daily life is utterly overwhelming, it is comforting to remember the minimalist agreed upon rules.  They are grounding.  

Almost a decade later, the threads of ambiguous loss connect us all.  Each of my children asks about the brother they never knew. They are not scared or sad, necessarily.   They are interested and curious to imagine his life.  We all experience his loss in a different way, but we are all in it together, wondering as a family, and carrying on.  

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