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Chapter 11

PSY 802 Chapter Notes - Chapter 11: Stillbirth, Medical Necessity, Fetus


Department
Psychology
Course Code
PSY 802
Professor
Thomas Hart
Chapter
11

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Chapter Eleven: Death in Adults’ Lives
Parental Bereavement
Ultimate deprivation: untimely loss of a potential future
Death of a child is considered the least natural of deaths
Bereaved parents often maintain an inner representation of the dead child; “image” sustained through
memories and spiritual beliefs
A kind of immortality that comes with parenthood is ripped away upon death of a child
Experienced by parents of infants, as well as of grown children
Interdependency of child-parent relationship makes the loss of a child profound
Parenting: protecting and caring for a child until he or she can act independently in the world; thus, the death of a
child represents the ultimate failure in being a “good parent”
Rosenblatt: after a child’s death parents tended to become more protective of their other children;
greater vigilance, more rapid response to signs of trouble, and greater awareness of child
vulnerability
“Ghost-protective” Cree tradition: infants given moccasins with holes in the bottom to protect them from
death; if an ancestor’s spirit beckoned, the infant could refuse, pointing out that his/her moccasins “needed
mending”
Childbearing Losses
Comprehensive view of childbearing loss includes birth of a severely impaired child (e.g. congenital
deformity or mental disability)
Parents grieve loss of the “perfect” or “wished-for” child
Perinatal loss: loss pertaining to periods before, during, or after the time of birth
Miscarriage/spontaneous abortion (before 20 weeks): loss of the products of conception before the fetus is viable
Most due to chromosomal abnormalities in fetus
After 20 weeks, most fetuses are viable (able to survive/live successfully outside of the mother’s body)
Stillbirth/sudden intrauterine death (between 20 weeks and birth): results in delivery of a dead child
Induced/artificial/therapeutic/elective abortion: intentional; aim of ending pregnancy by mechanical means or
drugs
Abortion and intense desire to acknowledge unborn fetus is common in Japan (mizuko/”water children”
statues)
Infant death: death that occurs before a child’s first birthday
Neonatal death: within first 28 days after birth
Postneonatal death: death between 28 days and 11 months old
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Reproductive loss: losses resulting from infertility and sterility (of either the male or female); giving up a child for
adoption
Infertile: diminished or absent capacity to produce offspring
Sterility: complete inability to produce offspring
Miscarriage
Parents may be told that miscarriage is simply “nature’s way” of weeding out genetic anomalies
Parents may have difficulty precisely identifying or making sense of their loss
No remains to be buried
Grief can recur with other significant life events (e.g. birth of a subsequent child)
Reaching age 40 or 65 can reawaken feelings of grief
Induced/Artificial/Therapeutic/Elective Abortion
May be a choice or medical necessity
May experience period of deep sadness that may be characterized by guilt, anger, or regret
If pressured into sexual intercourse or abortion, may feel bitter
Worry about judgment
Repercussions may not be felt until later (e.g. when subsequent pregnancy is seen as retribution for earlier
abortion or is very difficult due to infertility)
Conflicting views regarding abortion complicates the situation for those who have had an abortion:
If act is sanctioned, may not recognize that grief for a perceived loss needs to be
expressed/legitimized
Those who perceive a loss may not sanction the act
Tests for fetal genetic diseases are done both in early and later stages of pregnancy (after mother has
felt fetus moving, thus adding to likelihood that many will not understand the choice to abort)
Parents face loss of a particular baby, plus possibility of a childless future due to biological risk
Stillbirth
Many occur at or near full term to otherwise apparently healthy infants
Poor documentation and underreporting means prevalence rates may be inaccurate
In past, hospitals managed stillbirth and removed dead infant as quickly as possible to
avoid/minimize psychological trauma
Mothers told to forget what happened and have another baby as soon as possible
Mothers given tranquilizers if they got too upset
Today, grief for stillborn infants is respected; parents encouraged to see and hold baby, and
information packets including certificate of stillbirth (that acknowledges birth and death)
given
95% choose to see; 90% choose to hold
90% named stillborn baby to recognize that it was part of the family
Very few expressed regret
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