The emergence and effect of hospital protocols for perinatal loss in Canada

Authors

  • Deborah Davidson

Keywords:

perinatal loss, bereavement, griefwork, hospital protocols

Abstract

Abstract

The 1980s and 1990s saw the remaking of the meaning of perinatal death in Canadian hospitals from that of the silencing to the recognition and attention to women’s grief (Davidson, 2007). By the mid-twentieth century both birth and death were increasingly removed from the home and placed in healthcare and funeral facilities (Aries, 1981; Walter, 1994). Beginning in the 1950s when hospital birth had become the general social norm, death around the time of birth became a new institutional concern. Using a symbolic interactionist approach, I document how this new standard of care emerged as perinatal bereavement protocols in the Canadian context. Situating the emergence in its historical context, it is examined here through the time-relevant literature – that is, the literature that influenced the changes from the 1960s through the early 2000s. Then, examined through more recent literature, I illustrate how the protocols continue to work for one extended family after their experience of stillbirth in 2012.

References

Ariès, P. (1981). The hour of our death. New York: Knopf.

Armstrong, D. (1987). Silence and truth in death and dying. Social Science of Medicine, 24(8), 651–657. doi: 10.1016/0277-9536(87)90308-X

Auger, J. A. (2000). Social perspectives on death and dying. Halifax, NS: Fernwood.

Basile, M. L., & Thorsteinsson, E. B. (2015). Parents’ evaluation of support in Australian hospitals following stillbirth. PeerJ, 3, e1049. doi: 10.7717/peerj.1049

Bereaved Familiesof Ontario. (2002). How we can help [brochure]. Toronto, ON: Bereaved Families of Ontario.

Blumer, H. (1962). Society as symbolic interaction. In A.Rose (Ed.), Human behavior and social processes. Boston, MA: Houghton Mifflin.

Borg, S., & Lasker, J. (1982). When pregnancy fails: Coping with miscarriage, stillbirth and infant death. London: Routledge & Kegan Paul.

Bowlby, J. (1961). Process of mourning. International Journal of Psychoanalysis, 42, 317–340.

Bowlby, J. (1979). The making and breaking of affectional bonds. London: Tavistock.

Braun, M. J., & Berg, D. H. (1994). Meaning reconstruction in the experience of perinatal bereavement. Death Studies, 18, 105–129. doi: 10.1080/07481189408252647

Cacciatore, J. (2010). The unique experiences of women and their families after the death of a baby. Social Work in Health Care, 49(2), 134–148. doi: 10.1080/00981380903158078

Cacciatore, J. (2012). Stillbirth: Patient-centered psychosocial care. Clinical Obstetrics and Gynecology, 53(3), 691–699. doi: 10.1097/GRF.0b013e3181eba1c6

Cacciatore, J., & Bushfield, S. (2007). Stillbirth: The mother’s experience and implications for improving care. Journal of Social Work in End-of-Life & Palliative Care, 3(3), 59–79. doi: 10.1300/J457v03n03_06

Capitulo, K. L. (2005). Evidence for healing interventions with perinatal bereavement. MCN: American Journal of Maternal Child Nursing, 30(6), 389–396.

Cassidy, P. R. (2018). Care quality following intrauterine death in Spanish hospitals: Results from an online survey. BMC Pregnancy and Childbirth, 18(22).

Cecil, R. (1996a). Introduction: An insignificant event? Literary and anthropological perspectives on pregnancy loss. In R.Cecil (Ed.), The anthropology of pregnancy. Oxford: Berg.

Cecil, R. (1996b). Memories of pregnancy loss: Recollections of elderly women in Northern Ireland. In R.Cecil (Ed.), The anthropology of pregnancy loss. Oxford: Berg.

Clark, D. (1993). Introduction. In D.Clark (Ed.), The sociology of death. Oxford: Blackwell.

Covington, S. S., & Theut, S. K. (1993). Reactions to perinatal loss: A qualitative analysis of the National Maternal and Infant Health Survey. The American Journal of Orthopsychiatry, 63, 215–222. doi: 10.1037/h0079417

Davidson, D. (2007). The emergence of hospital protocols for perinatal bereavement, 1950–2000. Toronto, ON: York University.

Davidson, D. (2008). A technology of care: Caregiver response to perinatal loss. Women’s Studies International Forum, special edition, Women and Technologies of Reproduction, 31(4), 278–284. doi: 10.1016/j.wsif.2008.05.009

Davidson, D. (2011). Reflections on doing research grounded in my experience of perinatal loss: From auto/biography to autoethnography. Sociological Research Online, 16(1), 6. doi: 10.5153/sro.2293

Davidson, D. (2018). The need for bereavement support following perinatal loss. Bereavement Care, 37(1), 31–34. doi: 10.1080/02682621.2018.1444316

Davidson, D., & Letherby, G. (2014). Griefwork online: Perinatal loss, lifecourse disruption and online support. Human Fertility, 3, 214–217. doi: 10.3109/14647273.2014.945498

Erlandsson, K., Warland, J., Cacciatore, J., & Rådestad, I. (2013). Seeing and holding a stillborn baby: Mothers’ feelings in relation to how their babies were presented to them after birth – findings from an online questionnaire. Midwifery, 29(3), 246–250. doi: 10.1016/j.midw.2012.01.007

Fielding, A., Haddow, G., Wilson, S., & Fernandes, C. (2009). Parents’ and families’ experiences of care by health care professionals in the hospital setting following perinatal death: A systematic review. BI library of systematic reviews. JBI Libr Syst Rev, 7(8 Suppl), 1–22.

Gilbert, K. R., & Smart, L. S. (1992). Coping with infant or fetal loss: The couple’s healing process. New York: Brunner/Mazel.

Goldbach, K. R. C., Dunn, D. S., Toedter, L. J., & Lasker, J. N. (1991). The effects of gestational age and gender on grief after pregnancy loss. American Journal of Orthopsychiatry, 61(3), 461–469. doi: 10.1037/h0079261

Gravensteen, I. K., Helgadóttir, L. B., Jacobsen, E., Rådestad, I., Sandset, P. M., & Ekeberg, Ø. (2013). Women’s experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: A retrospective study. BMJ Open, 3, e003323. doi: 10.1136/bmjopen-2013-003323

Harper, M. B., & Wisian, N. B. (1994). Care of bereaved parents: a study of patient satisfaction. Journal of Reproductive Medicine, 39(2), 80–86.

Health Canada. (1968). Recommended standards for maternity and newborn care. Ottawa, ON: Queen’s Printer.

Health Canada. (1975). Recommended standards for maternity and newborn care. Ottawa, ON: Queen’s Printer.

Health Canada. (2000). Family-centred maternity and newborn care: National guidelines. Ottawa, ON: Minister of Public Works and Government Services.

Hebert, M. P. (1998). Perinatal bereavement in its cultural context. Death Studies, 22(1), 61–78. doi: 10.1080/074811898201731

Homans, P. (2000). Introduction. In P.Homans (Ed.), Symbolic loss: The ambiguity of mourning and memory at century’s end. Charlottesville: University of Virginia Press.

Kirkley-Best, E., Kellner, K. R., & Ladue, T. (1985). Attitudes toward stillbirth and death threat level in a sample of obstetricians. Omega, 15(4), 317–327. doi: 10.2190/Y1H6-FL6A-RUUG-R0Q1

Klaus, M. H., & Kennell, J. H. (1976). Maternal-infant bonding: The impact of early separation or loss on family development. Saint Louis: Mosby.

Koopmans, L., Wilson, T., Cacciatore, J., & Flendy, V. (2013). Support for mothers, fathers and families after perinatal death (Review). The Cochrane Library, 6, 1–22.

Layne, L. L. (1990). Motherhood lost: Cultural dimensions of miscarriage and stillbirth in America. Women’s Health, 16(3-4), 69–98. doi: 10.1300/J013v16n03_05

Layne, L. L. (1992). Of fetuses and angels: Fragmentation and integration in narratives of pregnancy loss. Knowledge and Society, 9, 29–58.

Layne, L. L. (1996). Never such innocence again: Irony, nature and technoscience in narratives of pregnancy loss. In R.Cecil (Ed.), Comparative studies in pregnancy loss. Oxford: Berg.

Layne, L. L. (1997). Breaking the silence: An agenda for a feminist discourse on pregnancy loss. Feminist Studies, 23(2), 289–315. doi: 10.2307/3178398

Layne, L. L. (2000). He was a real baby with baby things.’ A material culture analysis of personhood, parenthood and pregnancy loss. Journal of Material Culture, 5, 321–345. doi: 10.1177/135918350000500304

Layne, L. L. (2003). Motherhood lost: A feminist account of pregnancy loss in America. New York: Routledge.

Leon, I. G. (1990). When a baby dies: Psychotherapy for pregnancy and newborn loss. New Haven, CT: Yale University Press.

Leon, I. G. (1992). Perinatal loss: Choreographing grief on the obstetric unit. The American Journal of Orthopsychiatry, 62, 7–8. doi: 10.1037/h0079315

Letherby, G. (1993). The meanings of miscarriage. Women’s Studies International Forum, 16(2), 165–180. doi: 10.1016/0277-5395(93)90006-U

Littlewood, J. (1993). The denial of death and rites of passage in contemporary societies. In D.Clark (Ed.), The sociology of death. Oxford: Blackwell.

Malacrida, C. (1998). Mourning the dreams: How parents make meaning from miscarriage, stillbirth and early infant death. Edmonton, AB: Qualitative Institute.

Malacrida, C. (1999). Complicating mourning: The social economy of perinatal death. Qualitative Health Research, 9(4), 504–519. doi: 10.1177/104973299129122036

Mattley, C. (2002). The temporality of emotion: Constructing past emotions. Symbolic Interaction, 25(3), 363–378. doi: 10.1525/si.2002.25.3.363

Mellor, P. (1993). Death in high modernity. In D.Clark (Ed.), The sociology of death. Oxford: Blackwell.

Mills, C. W. (1959). The sociological imagination. New York: Oxford University Press.

Mitchinson, W. (2002). Giving birth in Canada 1900–1950. Toronto, ON: University of Toronto Press.

Moohan, J., Ashe, R. G., & Cecil, R. (1994). The management of miscarriage: Results from a survey at one hospital. Journal of Reproductive and Infant Psychology, 12, 17–19. doi: 10.1080/02646839408408863

Murphy, S., & Cacciatore, J. (2017). The psychological, social, and economic impact of stillbirth on families. Seminars in Fetal & Neonatal Medicine, 22, 129–134. doi: 10.1016/j.siny.2017.02.002

Peppers, L. G. (1989). Grief and elective abortion: Implications for the counselor. In K.Doka (Ed.), Disenfranchised grief: Recognizing hidden sorrow. Lexington, MA: Lexington.

Peppers, L. G., & Knapp, R. J. (1980a). Maternal reaction to involuntary fetal/infant death. Psychiatry, 43, 155. doi: 10.1080/00332747.1980.11024061

Peppers, L. G., & Knapp, R. J. (1980b). Motherhood and mourning: Perinatal death. New York: Praeger.

Prior, L. (2000). The social distribution of sentiments. In D.Dickenson, M.Johnson, & J. S.Katz (Eds.), Death dying and bereavement. London: Sage.

Pullen, S., Golden, M. A., & Cacciatore, J. (2012). ‘I’ll never forget those cold words as long as I live’: Parent perceptions of death notification for stillbirth. Journal of Social Work in End-of-Life & Palliative Care, 8, 339–355. doi: 10.1080/15524256.2012.732022

Rajan, L., & Oakley, A. (1993). No pills for heartache: The importance of social support for women who suffer pregnancy loss. Journal of Reproductive and Infant Psychology, 11, 75–87. doi: 10.1080/02646839308403198

Raphael-Leff, J. (1991). Psychological processes of childbearing. London: Chapman and Hall.

Rådestad, I., Surkan, J., Steineck, G., Cnattingius, S., Onelov, E., & Dickman, P. W. (2007). Long-term outcomes for mothers who have or have not held their stillborn baby. Midwifery, 1–8.

Reinharz, S. (1987). The social psychology of a miscarriage: An application of symbolic interaction theory and method. In M. J.Deegan & M.Hill (Eds.), Women and symbolic interaction. Boston, MA: Allen and Unwin.

Reinharz, S. (1988). What’s missing in miscarriage? Journal of Community Psychology, 16(1), 84–103. doi: 10.1002/1520-6629(198801)16:1<84::AID-JCOP2290160110>3.0.CO;2-G

Sandstrom, K. L., Martin, D. D., & Fine, G. A. (2003). Symbols, selves, and social reality: A symbolic interactionist approach to social psychology and sociology. Los Angeles, CA: Roxbury.

Savage, J. A. (1989). Mourning unlived lives: A psychological study of childbearing loss. Wilmette, IL: Chiron.

Seale, C. (1998). Constructing death: The sociology of dying and bereavement. Cambridge: Cambridge University Press.

Simonds, W., & Rothman, B. K. (1992). Centuries of solace: Expressions of maternal grief in popular literature. Philadelphia, PA: Temple University Press.

Slade, P. (1994). Predicting the psychological impact of miscarriage. Journal of Reproductive and Infant Psychology, 12, 5–16. doi: 10.1080/02646839408408862

Small, N. (2001). Theories of grief: A critical review. In J. L.Hockey, J.Katz, & N.Small (Eds.), Grief, mourning and death. London: Open University Press.

Small, N., & Hockey, J. (2001). Discourse into practice: The production of bereavement care. In J. L.Hockey, J.Katz, & N.Small (Eds.), Grief, mourning and death. London: Open University Press.

Smith, A. C., & Borgers, S. B. (1988). Parental grief response to perinatal death. Omega, 19(3), 203–214. doi: 10.2190/BV16-G1FD-6CYG-CVXF

Stinson, K. M., Lasker, J. N., Lohmann, J., & Toedter, L. J. (1992). Parents’ grief following pregnancy loss: A comparison of mothers and fathers. Family Relations, 41, 218–223. doi: 10.2307/584836

Stroebe, M., & Shut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–244. doi: 10.1080/074811899201046

Sudnow, D. (1967). Passing on: The social organization of dying. Englewood Cliffs, NJ: Prentice Hall.

Theut, S. K., Zaslow, M. J., Rabinovich, B. A., Bartko, J. J., & Morihisa, J. M. (1990). Resolution of parental bereavement after a perinatal loss. Journal of the American Academy of Child and Adolescent Psychiatry, 29(4), 521–525. doi: 10.1097/00004583-199007000-00003

Toetder, L. J., Lasker, J. N., & Janssen, J. E. M. (2001). International comparison of studies using the Perinatal Grief Scale. Death Studies, 25(3), 205–228. doi: 10.1080/074811801750073251

Turton, P., Evans, C., & Hughes, P. (2009). Long-term psychosocial sequelae of stillbirth: Phase II of a nested case-control cohort study. Archives of Womens’ Mental Health, 12, 35–41. doi: 10.1007/s00737-008-0040-7

Walter, T. (1993). Sociologists never die: British sociology and death. In D.Clark (Ed.), The sociology of death. Oxford: Blackwell.

Walter, T. (1994). The revival of death. London: Routledge.

Walter, T. (2000). Modern death: taboo or not taboo? In D.Dickenson, M.Johnson, & J. S.Katz (Eds.), Death dying and bereavement. London: Sage.

Zeanah, C. (1989). Adaptation following perinatal loss: A critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 28(4), 467–48. doi: 10.1097/00004583-198907000-00001

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2020-01-02

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