Supporting funerals following miscarriage or stillbirth
The loss of a child, either as the result of a miscarriage, termination of a much-wanted pregnancy for reasons of foetal anomaly, or stillbirth, can be one of the most difficult emotional challenges anyone will ever have to face. It can leave people feeling confused, angry and isolated.
Amid this emotional chaos, it can be difficult for people to make clear and coherent decisions regarding what to do with their child’s remains/body and whether they wish to have formal ceremony, for example, a funeral.
This process can be very stressful and is one parents are unprepared for. Given this, many parents feel they are rushed into making decisions they are not yet ready to make or are unsure about. Questions about coffins, flowers, music or readings can all be overwhelming, especially when they have yet to fully comprehend that their much-wanted pregnancy has ended with an outcome they had not envisioned.
It is vital that people get the best support possible from those who are there to help them; funeral directors and crematoria managers can be among the most important points of contact and can have a huge impact on parental experience of bereavement.
These observations are based on the findings of the ‘Death Before Birth’ research project, which examined the ways in which people deal with pregnancy loss and the consequent decisions they made concerning what happened to their baby after death. 35 people who had experienced pregnancy loss of some form (miscarriage, termination for reasons of foetal anomaly, and stillbirth) were interviewed with the aim of gaining greater insight into the decisions they made and any challenges that they faced.
Whether or not to have a funeral or formal ceremony attached to burial or cremation can be an important part of the bereavement process. However, many of those we spoke to had mixed feelings about the experience. By facilitating active decision-making and keeping parents informed and supported, funeral directors and crematoria managers can ensure a more positive experience that helps create important memories.
What parents need to know
Many of the parents we spoke to told us they knew very little about the rules and procedures involved in burial or cremation of the remains or body of their child. Often, they were not sure whether they had to have a funeral or whether they could bury the remains or body on private property. The legal distinction between miscarriage and stillbirth often led to increased confusion and distress.
Many reported being unsure about the level of agency they had in the process; for some this was as a result of being unaware of what was required and what was optional, for others this was because they were unprepared to be making decisions of this sort at a time when they had expected to be bringing home a live baby.
Big decisions included whether to have a public or private funeral, whether or not to attend themselves, and whether or not to invite family and friends. One particular area of confusion was what was meant when hospitals stated that they could have a ‘shared’ cremation or burial. One parent was opposed to the suggestion because “it just kinda felt like he’d be dumped with a bunch of babies into a hole”. They were not aware that, during these burials, an area of soil is left between each child.
Another parent remembered being particularly confused about who was responsible for the obtaining child’s coffin, telling us: “I thought I had to do that all on my own.”
In cases where parents could not attend hospital-arranged burials or cremations, often they were not sure about any ceremonial aspects, for example what sort of music was played or whether there were any readings: “Apparently they play nursery rhymes … as the music?” These are indicative of the wider issue evidenced: parents are often unaware of the options and support available to them and as such may fail to fully utilise them.
In order to prevent this sort of thing happening, parents need to be kept as informed as much as possible. Following the loss of a child, “your brains aren’t really functioning like they normally do” (as one parent put it) and as a result it may not occur to many parents to ask certain questions about the funeral-planning process.
Those who are there to support parents during this emotionally challenging time can help by keeping them constantly up-to-date and making sure all their queries are answered and, where appropriate, anticipated.
What sorts of ceremonies might people want to have?
For parents who have experienced pregnancy loss, a ceremony – whether formal or informal – can be an important opportunity to create valuable memories. As one parent put it: “Even though he’s gone, you need to be creating those memories that are gonna stick with you forever.”
Those we spoke to went about doing this in a range of different ways: some, for example, chose to read a poem or letter to their child during the ceremony, while others preferred that a particular song be played or insisted on dressing their child before the service.
One parent chose for her child to be buried with a five pence coin and told us “I’ll always have a 5p in my purse” to serve as a permanent memory. Although symbolic, these pieces of personalisation serve as priceless souvenirs.
Many of the parents we spoke to felt that they did not realise the significance of these acts of memorialisation at the time and thus failed to take full advantage of the opportunities available to them. For example, one interviewee said: “I’ll always think of him as my son but I don’t think I was made to appreciate that at the time.”
It may, then, be helpful for funeral directors to take a more active role in helping parents to memorialise their child, offering suggestions as to how they might individualise the ceremony. Whether parents want to carry their child’s coffin or simply read them a story, these moments can act as important emotional souvenirs and funeral directors can play an important role by helping parents to create these memories.
Objects that have been in contact with the baby can be particularly important for parents, as this parent’s testimony shows: “I was just a little bit annoyed with the funeral home. I can’t remember exactly what it was, the babygro we’d left her in we’d asked to be returned, it might’ve been a blanket, but, um anyway, they washed it and that was something that really upset me because the smell, I wanted that undisturbed. So now I don’t have that sort of memento.”
Burial or cremation?
A key decision parents have to make after the loss of their child is whether to have a burial or a cremation. A number of those we spoke to felt that they did not want their baby to be “burned”.
Others chose burial as a grave provides a physical place to visit in remembrance of their child: a place to “sit with him and reflect”, as one parent put it.
However, one woman we interviewed regretted choosing a burial. She told us: “I can’t tell you how awful it feels every winter when he gets covered in leaves and covered in mud.” It seems that, at the time they are forced to make the decision, many parents are unaware of the emotional impact various options can have.
This may be something that funeral directors can help with, by discussing with bereaved parents the consequences, both positive and negative, of both options.
Pregnancy loss is usually an unprepared for and emotionally difficult time for bereaved parents. Funeral directors and crematoria managers have an important role to play in supporting and facilitating parental decision-making about options for ceremonies and funerals.
*The authors would also like to thank Patrick Dandy for his research assistanceTags: academic, aftercare, bereavement, Birmingham University, child loss, Death Before Birth, Jeannette Littlemore, miscarriage, Oscar Littlemore, report, Sheelagh McGuinness, stillbirth, study