Some questions of identity: late miscarriage, stillbirth and perinatal loss.

This paper examines some of the attitudes and procedures which de-construct the identities of a mother and baby when loss occurs through late miscarriage, stillbirth and perinatal loss. Various factors which play a part in a woman's acceptance of her loss are explored, such as contact with the dead baby, formal and 'informal' ritual and early hospital discharge. Ways in which hospitals deal with and define these losses are looked at. It is suggested that all-too-often there seems to be no physical or psychological space for a maternity case without a baby. Is she a mother or is she a patient? The findings suggest that both roles may be lost simultaneously. The dead baby is usually whisked away and the bereaved woman sent back to the community with what feels like indecent haste. Birth and death seem to cancel out. Definitional ambiguities and anomalies about the status of the baby are examined and common sense views about 'hierarchies of sadness' are discussed. This study challenges existing assumptions about the way in which some babies are seen by the professionals as 'lesser' losses, and looks at the implications of these perceptions. The findings are based upon interviews with health professionals in four London hospitals; and a series of in-depth interviews with bereaved parents.