A woman sits in a dark room.

 

Written by Sarah Rickerd

 

Handling deceased babies and children is one of the most challenging situations funeral directors face. While no death is “better” or “worse” than another, there’s something truly unnatural about children dying before their parents. In these situations, it isn’t just the child that dies — the hopes and dreams that the families held for their babies die as well.

 

If you’ve ever felt uncomfortable handling these types of services, don’t worry — you’re not alone. Burying children isn’t easy for anybody involved, but it’s up to you to make the process as manageable and as healing as possible for the families you serve.

 

As part of Pregnancy and Infant Loss Awareness Month, we polled several baby loss mothers to learn more about what they wish their funeral directors would have known when they went through the process themselves. While it’s impossible to lump all bereaved parents together into a singular experience, we hope their insights will shed some light onto the best ways to handle these devastating situations.

 

No loss is more or less significant than another

While it might initially seem odd that a family who’s suffered an early miscarriage would be as distraught as families that have suffered full-term stillbirths or infant losses, what’s important to remember is that every child — no matter how old — represents a lifetime of hope and possibilities. This is no less true at 12 weeks than it is at 40 weeks.

 

Certainly, your staff members have been trained to offer compassionate care in any circumstance, so this distinction shouldn’t affect the way your funeral home does business. However, if you’ve ever heard an employee express confusion over working on an early loss (or had these feelings yourself), recognize that it’s not about the age of the child to the parents — it’s about what the family hoped that child would be.

 

Treat the baby like a baby

This recommendation might seem self-evident, but plenty of stories exist online of funeral directors that have not afforded families this basic courtesy. And although it may be easier to disconnect than to deal with such difficult losses, doing so does a disservice to your customers.

 

One of the best things you can do for the bereaved families you serve is to treat their babies like, well, babies. Address them by their names when speaking with their parents, and treat them with all the physical care you’d give to living children. Saying goodbye forever to a child is a heartbreaking, impossibly difficult process, but knowing that their babies are in good hands can be comforting to bereaved parents.

 

Every memory is powerful

When older adults die, we can comfort ourselves with the lives they lived and the memories we hold of their presence. When pregnancy and infant losses occur, there are very few opportunities to make memories — which means that those few that do exist become even more powerful to the grieving families.

 

If, for example, you receive the body of a baby from a local hospital wrapped in a blanket, ask the family if they’d like to keep the blanket after services have been completed. While it might not seem significant to you, having that memento can be extremely powerful for bereaved parents who won’t have other opportunities to accumulate belongings that they can associate with their deceased children. Be aware of the truly important role your funeral home plays in this limited window for memory-making.

 

You can also assist bereaved families in the memory-making process by giving them time to be with their babies before burial or cremation. Remember, the few days that exist between delivery and final disposition are the only times these parents will have to spend with their children forever. Allowing families whatever time they need to make memories is one of the best things you can do to serve them in these difficult times.

Hospitals vary widely in their ability to support bereaved families

Concerted efforts by pregnancy loss advocates mean that many hospitals today have support programs in place that guide bereaved parents through the delivery and disposition process. In my case, our hospital had a binder full of detailed procedures for dealing with pregnancy loss so that our care was handled in a sensitive, caring manner. We were also given a folder full of helpful information and a memory box packed with items to help us capture as many details as possible.

 

However, not all hospitals are as organized and prepared as ours was. As a result, you’ll likely encounter both families who are well educated about their options and those who have been completely failed by their medical systems. It may be up to you to educate these parents on all the different disposition and service alternatives that are available to them, and to assist them in making these difficult decisions.

 

Bereaved parents have no idea what they’re doing

Nobody goes into pregnancy expecting to lose the baby. And because pregnancy and infant losses often occur quite suddenly, bereaved parents have to make immediate decisions while struggling with the initial grief and shock of the situation.

 

This can feel paralyzing. When my husband and I were in the hospital, we were asked — within an hour of learning about our daughter’s death — whether we wanted an autopsy, if we’d like to hold the baby after delivery and whether we’d like to bury her or consider cremation. We made the best decisions that we could at the time, but to say that we felt overwhelmed would be a huge understatement!

 

Bereaved parents don’t know about all the options that are available to them because they’ve never had a reason to learn. Unless they’ve been through a loss before, they may not know whether or not things like funeral services, open caskets or even visiting their babies at the funeral home are appropriate. And they may not even know to ask about these things unless you initiate the discussion on what options are available.

 

Consider the following comments on the topic from members of the Bereaved Parents of Madison support group.

 

From Emily G.: “For our second loss, our funeral director invited us to come to the funeral home anytime to see our baby girl while she was there for the funeral/burial. I went every day to hold and kiss her. I wish I had known I could do that for my first born little boy too.”

 

From Melissa Terrill, bereaved parent and founder of Mikayla’s Grace (a charity providing NICU care packages and angel memory boxes to hospitals that serve pregnancy loss families): “I agree with Emily. I wish I would have known it was possible to do that. I think the biggest thing to discuss is making sure families know what their options are, not just answering the questions they might ask. Almost all of these parents have never been through a loss like this and have no idea what options they have. I remember wondering if it was “normal” to have an open casket for our family members and it might be nice to discuss these things more openly, just bringing up ideas of what other families have done so that you don’t feel so alone and aren’t always wondering what is ‘normal.’ We will all choose different paths, but the worst is getting to the other side and having regrets about wishing that you would have known something that could have been easily explained to you.”

 

Dawn S., a maternal/child social worker at St. Mary’s Hospital in Madison, WI, shared the following list of top questions that bereaved parents often have in the wake of their losses:

 

  1. What burial/disposition options do I have, and what are the pros and cons of each? What charges will be applied? If your funeral home waives fees or offers a set fee for infants under a certain age, spell out exactly what’s covered under these arrangements and make it clear to bereaved parents what they will be responsible for.
  2. Are there any cemeteries in the area that offer discounted rates for infants? Many facilities have “Babyland” areas that provide free plots and opening/closing services to bereaved parents.
  3. Will Medicaid cover any funeral costs? If so, what can they be applied to and what exact benefit amounts will the parents be eligible for?
  4. What infant-specific caskets, urns or commemorative jewelry are available?
  5. Can families take their babies home? Are they allowed to transport their babies (and will this affect the death certificate documentation process)?
  6. Are traditional funeral services available to bereaved parents? If so (and especially in cases where funeral homes waive or discount their fees for pregnancy/infant loss), how much of the arranging burden will fall to the parents? Funeral homes tend to have vastly different policies on this subject.
  7. Is home burial an option? If so, do you cover the pros and cons of this alternative with families?

One other important consideration Schramm raised was the small amount of cremated remains that infants produce. Many families find the small volume to be startling, so it’s a good idea to prepare parents for what they’ll receive before handing off the cremains. It may also help to place infant cremains into keepsake urns instead of their full-size counterparts so that the disparity isn’t as visually striking.

 

Be proactive about covering the answers to these questions with the bereaved parents you serve — remember, they may not even know to ask them in the first place. By providing as much information as possible upfront, you’ll minimize the very scary risk that grieving families face of making final disposition decisions that they’ll later regret.

 

Do you have any other insights to share based on your experiences serving bereaved parents? Do you have any questions about how to best handle these sensitive services? Leave your thoughts in the comments section below!

 

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