Psychological aspects of perinatal loss.
OBJECTIVE
Parents are attached to their unborn children, and loss around the time of birth is a serious trauma. Parental grief is a normal response, and may last for many months. Clinicians have always sought to implement practices that will help recovery, and for a generation, have advocated that parents have contact with the body of their dead infant, believing that this will facilitate mourning. Review of the literature shows that no previous systematic evidence has ever been offered to support this practice.


RESULTS
Recent research throws doubt on the therapeutic value of the practice of encouraging contact with the dead infant. These findings are outlined and discussed.


CONCLUSIONS
Following an outline of what is already known about the psychological effects of perinatal loss, the paper focuses on the evidence that aspects of psychosocial management are associated with better outcomes. It goes on to describe the cultural context in which psychosocial management changed and parents were first encouraged to see and handle their dead infant, and explores the distinction between the medical and cultural models which may frame this behaviour in very different ways. Finally, it briefly discusses the ethical position of staff who advise parents about their choice to see or not see their infant's body.
Hughes
Patricia
P
Department of Psychiatry, St George's Hospital Medical School, London, UK. p.hughes@sghms.ac.uk
Riches
Samantha
S
D000223:Adaptation, Psychological; D003376:Counseling; D005260:Female; D005313:Fetal Death; D006117:Grief; D006801:Humans; D007231:Infant, Newborn; D010290:Parents / Q000523:psychology*; D011247:Pregnancy