In Today’s Issue:

🔗 The best resources I found this week
📖 Deep dive: Beyond the Birth Mother: How Entire Families Grieve Perinatal Loss - Part 1 of 3: Fathers

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🔗 The Best Resources I Found This Week

• 📋 What good bereavement guidelines actually include
  This 2024 scoping review breaks down key elements in perinatal bereavement care guidelines—like memory-making, communication, shared decision-making, and organizational support—and is a great citation if you’re pushing your unit to update policies.​
  Read on PMC

• 🧠 The ATTEND model paper behind our training
  If you’ve heard us talk about attunement and mindfulness-based bereavement care, this is the original ATTEND model article you can hand to your educator or manager when you want buy-in for protected time or debriefs.​
  Read on MISS Foundation

📖 Deep Dive

Beyond the Birth Mother: How Entire Families Grieve Perinatal Loss
Part 1 of 3: Fathers

This is Part 1 of 3 in our comprehensive series examining how stillbirth, miscarriage, and neonatal death ripple through families. While maternal grief has long dominated the conversation around perinatal loss, groundbreaking research reveals that fathers, siblings, teenagers, and grandparents experience profound and distinct forms of bereavement — yet remain largely unsupported by healthcare systems and society.

This three-part series examines each griever separately:

• Part 1: Fathers — The Invisible Mourners

• Part 2: Children and Teens — When Siblings Grieve

• Part 3: Grandparents — The Double Loss

Part 1: When Fathers Grieve

The Statistics Nobody Talks About

When a pregnancy ends in stillbirth or miscarriage, the focus of medical care, emotional support, and societal attention turns almost exclusively to the mother. Yet among U.S. hospitals, a critical gap persists: fewer than 55% of hospitals address the impact of perinatal loss on fathers or partners in their bereavement protocols. This statistic comes directly from the ATTEND Model research presented at major bereavement training events for labor and delivery nurses—a foundational gap in care that leaves fathers grieving in isolation.10-Practical-Applications-of-the-ATTEND-Model-for-L-D-Nurses.pdf​

The source: The statistic appears in the "10 Practical Applications of the ATTEND Model for LD Nurses" document, which references hospital perinatal bereavement care data. This comprehensive research on hospital practices shows that while maternal grief receives attention in most hospital protocols, paternal grief is addressed in fewer than 55% of facilities across the United States.10-Practical-Applications-of-the-ATTEND-Model-for-L-D-Nurses.pdf​

The Grief Nobody Expects Fathers to Feel

Dom, a young father who experienced multiple miscarriages with his fiancée Ellé, describes the moment everything changed:

Dom's experience captures something critical: fathers experience perinatal grief with the same intensity as mothers, yet navigate it in profound isolation. Research examining fathers' experiences of stillbirth, miscarriage, and neonatal death reveals five dominant themes in how fathers describe their loss: ​

1. The pain with loss: Fathers report multifaceted grief characterized by intense emotional suffering, with pain often spiking at the moment of birth—when they expected joy.

2. State of shock: Like mothers, fathers experience disbelief and difficulty accepting the sudden reality of their baby's death.

3. Suffering in silence: This is the most distinguishing feature of paternal grief. Fathers are significantly more likely than mothers to withdraw, isolate, and keep their pain internalized. (Science Direct)​​

4. Disconnection from self and others: The lack of social and medical support for fathers leads to feelings of alienation from partners, family, and their own identity as fathers.

5. Coping through avoidance: Research shows fathers are more likely than mothers to turn to unhealthy coping mechanisms including avoidance, blame, substance use, and increased alcohol consumption.

Read more here: Fathers’ experiences of perinatal death following miscarriage, stillbirth, and neonatal death: A meta-ethnography (tandfonline)

Why Fathers Grieve Invisibly

Unlike mothers, who experience visible physical changes—hormonal shifts, breast milk production, postpartum recovery—fathers' grief exists in the background. This biological distance is frequently misinterpreted as indicating lesser grief. In fact, the opposite is often true. (Hand Support)​

Additionally, societal gender norms deeply influence how fathers express and manage loss. Many fathers navigate bereavement through what researchers call "stoicism, self-isolation, and hard work"—coping mechanisms that may feel necessary but are ultimately inadequate for processing profound grief. (American Academy of Pediatrics) ​

Research consistently shows that many fathers unconsciously adopt the role of "supportive partner" rather than recognizing themselves as co-grievers. One father expressed it this way: (Science Direct)​

This pattern reflects what researchers call the "mother-mediated dynamic"—where fathers' primary identity becomes their partner's supporter, effectively denying their own legitimate grief and their role as a grieving father.pmc.ncbi.nlm.nih​

The Mental Health Crisis Fathers Face Alone

While some research suggests fathers report less intense grief than mothers on standard grief measures, this apparent difference is deeply misleading. In reality, fathers are significantly more likely to engage in maladaptive coping strategies that compound their suffering:

• Avoidance and emotional suppression: Pushing feelings down rather than processing them

• Increased alcohol and substance use: Using substances to numb pain rather than addressing it

• Withdrawal from family and support systems: Isolating at the moment they need connection most

• Delayed help-seeking: Even when experiencing serious mental health concerns, fathers often don't reach out for professional support

The stoicism that men are culturally conditioned to demonstrate can be particularly consequential, with research highlighting that stoicism ideology may lead to delayed help-seeking, increased caregiver strain, and even suicide risk. (tandfonline​)

Without adequate support or permission to express grief, fathers may experience prolonged mental health challenges that are never identified or treated.

What Real Support for Grieving Fathers Looks Like

Research shows that fathers who communicate openly about their loss and actively engage in grief work show more positive long-term outcomes. Several evidence-based support strategies benefit bereaved fathers:​

Explicit Validation: Healthcare providers must actively validate fathers' grief as legitimate and equally important as mothers' grief. This simple act can be transformative.

Peer Support Groups Specifically for Fathers: Organizations like Sad Dads Club and father-focused bereavement groups provide spaces where fathers can discuss their experiences with others who truly understand. These spaces remove the shame and isolation that many fathers carry.

Involvement in Memory-Making: Encouraging fathers to participate in creating and keeping mementos—photographs, handprints, keepsakes—helps them honor their baby and their role as father. Dom and his fiancée found deep meaning in this:

Couples Support: Addressing the potential for mismatched grief responses between partners, recognizing that fathers and mothers may grieve differently, and helping couples understand and support each other's unique processes.

Mental Health Screening: Proactively screening fathers for depression, anxiety, trauma responses, and substance use—recognizing their increased risk for avoidance-based coping and substance use.

The Support Fathers Need (But Rarely Receive)

When Dom's mother shared her own miscarriage story with him, it helped him feel less alone. He describes what truly made a difference:

Yet this kind of support—family understanding, friends who validate paternal grief, healthcare providers who recognize fathers as grievers—remains inconsistent across hospitals and communities.

One mother who lost a baby shared how she wished healthcare providers had recognized her partner's grief:

This simple instruction acknowledges a critical truth: when a baby dies, both parents grieve. Healthcare providers who recognize this simple fact, and who extend bereavement support to fathers with the same intentionality they extend to mothers, create pathways for healing that current practices often miss.

The Path Forward

The evidence is clear: fathers experience profound, complex grief following perinatal death. Their grief is not a secondary emotion—it is primary, legitimate, and deeply significant. Yet fewer than 55% of hospitals have bereavement protocols that specifically address fathers' needs.

Changing this requires:

1. Hospital bereavement protocols that explicitly include fathers alongside mothers

2. Staff training that recognizes paternal grief and validates it actively

3. Memory-making opportunities that invite and welcome fathers' participation

4. Peer support groups specifically designed for bereaved fathers

5. Mental health screening that recognizes fathers' heightened risk for avoidance and substance use

6. Follow-up care that continues for fathers, not just mothers, in the months after loss

When healthcare providers, families, and communities recognize and support fathers' grief, they open pathways for healing that transform the perinatal loss experience from isolation to connection, from silence to voice, from invisible grief to honored loss.​

Series Navigation

Part 1 of 3: When Fathers Grieve ← You are here
Part 2 of 3: When Siblings Grieve (Coming Next)
Part 3 of 3: When Grandparents Grieve

How did today’s deep dive land for you?

(Select one)

⭐️ It was extremely helpful and gave me new insight

👍 Helpful, mostly a good refresher

✅ I didn’t learn anything new, but it validated what I already do

😕 It missed the mark or I have feedback

👋 That’s a Wrap!

Before you go: Here are ways we can help your hospital

Education: Please share our newsletter with your co-workers. Our priority is empowering nurses with the tools to support patients with modern, evidence-based bereavement education.

Bereavement boxes: Our bereavement boxes were designed out of a need for a modern high quality solution for families suffering from miscarriage, stillborn, or infant death.

Reply to this email “Sample” to get a free sample sent to your hospital.

What we prioritize:

1. Tools for hospitals to create a bereavement experience for families to begin their grief journey

2. Educating nurses with modern bereavement standards and continuing education.

3. Helping hospitals build a foundation of trust and support, so bereaved families feel seen and cared for—now and in the years to come.

These boxes were born out of our own personal losses, including Jay’s (CEO) 15 years of experience working in labor and delivery as a CRNA and witnessing time and again how the hospital experience can profoundly shape a family’s grief journey, for better or for worse.

Until next week,

Trina and Jay
Co-founders of Forget Me Not