In Today’s Issue:

🔗 The best resources I found this week
📖 Deep dive: What’s Actually Normal After a Baby Dies? A Deep Dive into Cacciatore & Thieleman’s MCN Study

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🔗 The Best Resources I Found This Week

❤️ Normal Complications and Abnormal Assumptions After Perinatal Death – The Cacciatore & Thieleman paper we’re unpacking today. A must‑read if you’ve ever wondered, “Is this level of grief still normal?”​

📋 Bereavement Care Guidelines Used in Health Care Facilities – A 2024 scoping review that quietly challenges a lot of “we’ve always done it this way” thinking. Helpful if you’re trying to align your unit’s practices with current evidence.​

🧭 Support for Mothers, Fathers and Families After Perinatal Death (Cochrane Review) – Looks at what actually helps (and what doesn’t) after perinatal death, including the limits of purely psychological “interventions.” Great for seeing where grief support gets over‑medicalized.​

📖 Deep Dive

What’s Actually Normal After a Baby Dies? A Deep Dive into Cacciatore & Thieleman’s MCN Study

Normal Complications and Abnormal Assumptions After Perinatal Death” by Dr. Joanne Cacciatore and Kara Thieleman, published in MCN: The American Journal of Maternal/Child Nursing.

You can read the paper here

Dr. Cacciatore has spent decades studying bereavement after miscarriage, stillbirth, and infant death. Many of you may recognize her name because she joined us as a guest speaker during a previous Forget Me Not training event. Forget Me Not Event Recap with Dr. Joanne Cacciatore

She also founded Selah Carefarm, a retreat for grieving families where her research continues to shape trauma-informed grief care.

What makes this paper particularly valuable for nurses is the shift it asks us to make in how we interpret grief.

Historically, healthcare has often approached grief as something to resolve or shorten.

Cacciatore and Thieleman challenge that assumption directly, writing that intense grief responses after the death of a baby are “a normal response to an abnormal event.”

That distinction changes how we interpret what we see at the bedside.

Why Grief After the Death of a Baby Is Often Misunderstood

The paper starts with a simple but uncomfortable reality:

“Embodied” is doing a lot of work there.

Parents’ bodies have been pregnant, birthed, lactating, flooded with oxytocin and prolactin, and then are told there is no baby to care for. That’s not just sad—that’s a biological contradiction.​​

Cacciatore and Thieleman argue that parents are grieving inside a “sometimes oppressive social context” that either sees their grief as a normal response to the death of a child…or as pathology.​

Here’s the part most nurses don’t usually hear:

• When family or staff avoid the baby’s name, rush parents to “move on,” or treat the death as “less” than the death of an older child, parents internalize that as “My grief is too much. I am too much.”​

• They call this social constraint—all the ways the environment shuts down or shames normal grief, which is then more strongly associated with worse mental health outcomes.

So the problem usually isn’t “her grief is abnormal.”

The problem is often: “Her grief is normal, and everyone around her is treating it like it’s not.”

In other words, your validation (“Your baby is your child. What you’re feeling makes sense.”) is not fluffy. It is an intervention against an oppressive grief environment.The Myth of a Timeline for Grief

Another assumption the paper challenges is the expectation that grief should move through predictable stages.

In reality, the authors note that grief after the death of a baby often persists in ways that do not follow a clear timeline.

They describe how many bereaved parents continue to maintain a bond with their child through memory-making, rituals, or simply speaking their baby’s name years later.

Older grief models sometimes framed this as an inability to “move on.”

But contemporary grief research recognizes something different.

As the authors explain,

Parents may integrate their child into their lives in ways that evolve over time.

For clinicians, this perspective can be helpful because it reframes behaviors that might otherwise be misunderstood.

A parent speaking about their baby years later is not necessarily experiencing pathological grief.

Often, they are expressing an ongoing relationship with their child.

How Healthcare Providers Shape the Grief Experience

One of my favorite lines from this article (because it’s so honest) is that parents “process their grief experiences within a sometimes oppressive social context.”​

And healthcare is part of that context.

The authors describe two main paths: a humanistic approach and a medicalized approach.​

In the humanistic approach, grief after the death of a baby is treated as a normal, if devastating, response. The focus is presence, connection, ritual, and making meaning.​​

In the medicalized approach, grief is quickly translated into symptoms: sadness becomes “depression,” crying becomes “poor coping,” anger becomes “non‑compliance,” and the solution is diagnosis plus medication.

They’re blunt that language matters. A note that reads “parent tearful, poor coping” sends a very different message than “parent tearful, expressing intense grief after the death of her baby.”

The paper also lines up with what we’ve covered before:

• Parents remember communication at diagnosis in vivid detail for years.​​

• Compassionate, clear, honest communication is associated with better long‑term mental health outcomes.​​

• Rushed discharge, no privacy, limited memory‑making, or staff who avoid the baby’s name all contribute to parents feeling like their child’s death was not worthy of full recognition.​

Put simply: you are not just “there” when the baby dies. You are co‑authoring the story parents will tell themselves about that day for the rest of their lives.

What Is Not Normal: Red Flags to Watch For

The authors distinguish between normal grief and situations where additional intervention may be helpful.

Examples may include persistent inability to function in daily life, suicidal thoughts, substance misuse, or escalating trauma responses over time. In these cases, referral to mental health professionals can be appropriate.

The key point the authors make is that grief itself should not be treated as a disorder.

Final Thought

One of the most meaningful takeaways from this paper is the reminder that grief after the death of a baby does not follow neat clinical rules.

It is complex, deeply personal, and often lifelong.

But what research continues to show is that families remember the people who stood beside them during those moments.

And very often, that person is a nurse.

How did you enjoy today’s deep dive?

(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