I Lost a Child Too: The Experience of Men After a Child's Stillbirth

Stillbirth is an extremely unsettling experience in which death precedes the beginning of life, what should have been a joyous event becomes tragic, and happiness and reward are replaced by severe loss and pain (Gensch & Midland, 2000;Harrigan, Naber, Jensen, Tse, & Perez, 1993; Knuppel & Drukker, 1986; Lawn et al.,2011). Stillbirth, defined as the birth of a lifeless fetus after the twenty-second week of pregnancy, is depicted in the scientific literature as a taxing emotional experience that evokes in the parent's feelings of grief and reactions consistent with posttraumatic stress (Horesh, Nukrian, & Bialik, 2018). In recent decades, an increasing amount of research has been conducted on the experience of women following stillbirth. By contrast, the experience of men after the birth of their stillborn child has drawn scant research interest, and is all but absent from the social and professional discourse, thus maintaining a disregard for men's experience of loss. The current research aimed to initiate research on this subject, thereby reducing the knowledge gap, and ideally – even if only somewhat – redressing this imbalance.

Earlier studies have treated men who experienced the loss of a stillborn child as part of a couple, or have otherwise compared them to a control group of couples who delivered healthy babies. Hence, these studies did not focus on men's feelings, but rather treated them as part of a unit. During the 1980s, when men's grief was compared to that of their spouses, it was found that the level of grief among the men was lower, but the information about them remained partial and of limited generalizability.

Studies that have focused exclusively on the experiences of men reveal the anguish and formidable emotional grief they feel immediately upon the loss and for many years to follow. Despite these findings, men who have experienced the loss of a stillborn child become, for the most part, “forgotten mourners,” both socially and clinically. Therefore, the present study aimed to continue mapping men's experiences of having a stillborn child and the attitudes of family and society towards their loss and distress in light of what researchers and practitioners refer to as "disenfranchised grief."

The term "disenfranchised grief " is based on the notion that every society has a set of norms for dealing with grief that defines who should mourn and for what, as well as when, how, where, and for how long one should mourn. The term was first coined by Doka (1989; 2002), who listed five cases in which society withholds or minimizes its recognition of a person's loss and expressions of grief: when the relationship between the mourner and the deceased is not publicly known, when the loss itself is not known, when society defines the person as unable to grieve, when the circumstances of death are abnormal, and when the mourner mourns in ways deemed unacceptable by others.

The knowledge accumulated so far suggests different reasons as to why the grief of men who experience the loss of a stillborn child is “disenfranchised." One reason for the grief of men in Israel being largely unacknowledged is that stillbirth is often not considered death in the Jewish tradition, and therefore not in Israel either.

The consequences of a stillbirth's complex status in Judaism are particularly pronounced among men, as their relationship with the child is only recognized after the birth of the child, and because some men's manner and timing of mourning deviate from the accepted norms.

This study, which focused exclusively on men's experience of the loss of a stillborn child from their own perspective, was based on the phenomenological approach. This approach encourages the use of mapping to understand phenomena as perceived and presented by those who experience them. In order to allow as wide and diverse a range of interviewees as possible, the study employed criterion sampling, consisting of only two criteria: Hebrew-speaking men who experienced the loss of a stillborn child.

The 30 interviewees included men from all over the country between the ages of 29 and 55. At the time of the interview, the time elapsed since the loss of the child ranged between three weeks and 22 years. The interviews – lasting between one and three hours – were based on an interview protocol, but also allowed for a freeflowing and in-depth conversation about the experience of loss following the stillbirth of a child, from the interviewee's point of view.

Data analysis was conducted in three main stages. The first stage involved a horizontal analysis of the interviews as a whole, the second included the creation of clusters for broad topics, and the third stage focused on describing the core of the experience, which was organized into different themes. The quality of the research was ensured in several ways: openly and explicitly reporting on all phases of the research (transparency), setting aside prior knowledge and biases of the researcher (bracketing), and continuously referring to the researcher's epistemological position as a woman questioning men about a phenomenon that is still widely regarded as “feminine.” In addition, both the research in general and the analysis of the interviews in particular were accompanied by self-observation that included an examination of the researcher's attitudes and sensibilities, and by ongoing and in-depth professional dialogues with the dissertation advisor.

One of the preliminary observations that emerged, prior even to the analysis of the interviews, was the men's rapid and eager response to the invitation to be interviewed. Within 48 hours of posting the invitation to take part in the study on social media, 30 men had already applied. These reactions, which were surprising and touching, revealed in themselves the sense of loneliness that accompanies the loss experienced by men after a child’s stillbirth. The analysis of the interviews uncovered three explanations for the willingness of these men to participate in the study: their desire to influence our understanding of stillbirth, their desire to support other men who have experienced or will experience a similar loss, and the sense of marginalization that they experienced based on their gender regarding the loss of their child. In most of the interviews (23/30), the men referred to all three factors in explaining their motivation to participate in the study.

During the interviews, the men described their loss as a traumatic experience that shook their world and changed their lives and themselves beyond recognition. Of the many issues that arose in the interviews, three specific themes that frame the experience of loss and came up in all the interviews were examined. 

The first theme exposes the discrepancy between men's experience of pain and loss on the one hand, and the lack of awareness toward them and their emotional vulnerability, on the other. The men encountered this lack of awareness immediately upon arrival at the hospital. Thus, alongside feelings of attachment towards the soon to-be born child, the men also reported being treated in a manner that devalued what they were experiencing, first by the medical personnel and later by family and friends. The death of the child was described by them as the loss of a son or daughter that led some of them to refer to themselves as "bereaved fathers." The use of this emotionally-charged term illustrates their profound sense of loss and underscores the lack of recognition with which their grief was met. In sharp contrast to the recognition, compassion, and support that other bereaved fathers receive, the second theme examined refers to the experience of men after a child’s stillbirth of remaining alone, devoid of practical and/or emotional support. Not only is the attention of others directed almost exclusively towards their partners, but these men are also expected to take on complex and demanding roles related to the loss. These roles include supporting the partner, managing various bureaucratic tasks in the hospital and elsewhere, and informing their social circles about the loss. The lack of recognition, coupled with the need to perform the roles imposed upon them, seem to cause men to suppress their grief. Consequently, some experience it in a much more pronounced manner at a later stage – days, weeks, months, and sometimes even years after the loss occurs.

The third theme that arose in most of the interviews with even greater frequency was the support, or lack thereof, they received from their parents. In many interviews, the bereaved grandparents were cited as a source of particularly acute disappointment. Only in a few cases was their support noted as “accurate,” “appropriate,” and “sensitive.” In others, interviewees described feeling shattered, lonely, and deeply disappointed as a result of the parents' lack of emotional presence, which in some instances led to the men's temporary or even prolonged estrangement from them. The men's focus on their relationships with and expectations of their parents underlines their need for empathy and recognition of their grief during the period immediately after the loss and in subsequent months and years. Thus, parents' support for their grieving sons appears to be of particular importance.

All of the themes that were gleaned from this study contribute to the overarching understanding that men's experience of having a stillborn child consists of deep feelings of loss, pain, and grief. These tend to become amplified in the face of the lack of validation from those around them. In this study, the complex concept of “disenfranchised grief” experienced by men following a child's stillbirth was systematically explored for the first time.

Similar observations were noted almost two decades ago in the context of research on the experience of men after a partner’s abortion. The accumulation of all the elements associated with “disenfranchised grief” add to the complexity of the loss itself, beginning with the lack of acknowledgement of the father-child relationship during pregnancy, and through the lack of acknowledgement of the loss itself. Moreover, men are not acknowledged as objects of the loss as well, and their grief and status as valid mourners remain unrecognized too. The means by which these men may express their grief are denied, and ultimately, so too is the legitimacy to publicly mourn their loss.

This unique interlocking of characteristics associated with unacknowledged grief leaves men isolated in their own pain, without a space in which they can share their experience. This combination of elements further intensifies the experience of loss and has far-reaching implications for the men’s personal, marital, and family lives. When men were asked about their needs following the loss, their responses all focused on the need for an emotional space of their own, in which they could be seen and listened to.

This study, by its very nature, afforded a discursive space for men who experienced the loss of a stillborn child. It may also help raise awareness of the experience’s many facets, and of the way men who have undergone the loss of a child in this way experience their loss. Ideally, the findings of this study will also promote the creation of specially targeted interventions for men who have experienced this particular kind of loss, and for those surrounding them.