Perinatal bereavement: what is motherhood?

Perinatal bereavement: what is motherhood?

Parents faced with the premature death of their child deplore a lack of recognition. It is from this feeling of invisibility that the words “mamange” and “papange” were created. What exactly do they mean? And how can we help bereaved couples? Clinical psychologist Claudia Bettelheim-Pechikoff discusses the specificities of perinatal bereavement and the possibilities for support.

In Europe, nearly 7,000 families are affected each year by the loss of a child during pregnancy or during the first days of life.

Definition: what does the term “mommy” mean?

The term “mamange” is a so-called portmanteau word, resulting from the contraction of two words: mom and angel. It is a word invented by families affected by perinatal bereavement to designate a grieving mother of a child who died before or a few days after birth. “This expression is meaningful to the extent that symbolically it expresses the inseparable bond between a mother and her little angel. It’s a way for these women to be recognized as parents and for what they have experienced.”, explains the clinical psychologist. “They felt their baby move, imagined it and sometimes they carried it in their arms.”, she adds. The term “mommy” is important for these mothers, so that these moments do not fall into oblivion.

What is a “papange”?

The word “papange” designates a man who has suffered the loss of a child, either during his partner’s pregnancy or after the child’s birth. This term was born from the need to also recognize the experiences of fathers going through this terrible loss. We also speak of “parange” to designate the two parents.

“Parange”, a term which, however, is not unanimously accepted

If the creation of these words comes from a need for recognition, some parents, however, do not feel represented by these terms. Testimonies even reveal that they are unbearable because they are so watered down. This is the case of Coralina Den who, touched by the death of her baby, wrote on her Instagram account @air_et_elles: “I am not a mother, just a grieving mother. No one would want to use this term, because it smacks of heaviness, of endless sorrow, of being torn apart. He sounds right, he speaks the truth.”

Many bereaved families see a religious or spiritual connotation in which they do not identify. This is how in 2021, these moms and dads called on the public authorities through a petition, so that a fairer word would be officially dedicated to them.

What is perinatal bereavement?

According to Claudia Bettelheim-Pechikoff, perinatal mourning refers to a reactive psychological process that parents experience following an experience of loss around birth. Several scenarios can enter into this context:

  • The fetal death in the womb (MFIU). It designates the spontaneous death of the fetus before the term of pregnancy, more specifically between the 15th week of amenorrhea and delivery;
  • The death of a child in the first months of life (sudden death infant);
  • The death of a child in neonatology following premature birth and/or medical complications;
  • A medical termination of pregnancy (IMG). It can be carried out by the medical profession if the continuation of the pregnancy endangers the health of the mother and if there is a probability that the fetus is affected by a serious and irreversible pathology;
  • THE miscarriages. They correspond to a spontaneous termination of the pregnancy before the 22nd week of amenorrhea, the date of viability of the fetus;
  • L’Abortion (IVG). “This decision on the part of the pregnant woman can also enter into this context of mourning, although it results from a particular condition.underlines the clinical psychologist.
  • The sterility and its psychological consequences to another extent.

For the psychologist, it is important to emphasize that perinatal mourning of course affects the parents first, but also the rest of the family in the broad sense: siblings, grandparents, etc.

Perinatal mourning remains a taboo subject. For what ?

Death is and remains a taboo subject in our society. Just look at all the questions and debates surrounding euthanasia and this notion of “assisted dying”. Nevertheless, “if death at the end of life can be taken for granted, the confrontation with the death of a baby, regardless of the context, is a paradox”, declares the psychologist. “Giving death when you want to give life is sometimes unthinkable.”, she adds. For the specialist, the taboo results from a desire by society to erase all traces and anxieties that arise when the death of a newborn is mentioned. Without forgetting the injunctions of happiness around pregnancy and motherhood which do not really help to free speech. This moment in the life of a woman and a couple which is necessarily linked to a feeling of fullness, serenity or even fulfillment, leaves little room for drama when it arises.

However, offering support to bereaved parents is fundamental. “For these people, the lack of recognition associated, sometimes, with a lack of explanations regarding the tragedy that occurred, can have significant psychological consequences. note Claudia Bettelheim-Pechikoff.

Perinatal bereavement: where are we from a legal point of view?

Having your stillborn child recognized can be an important step in the grieving process. But what does the law say exactly? The law of January 8, 1993, subsequently amended in 2021 to guarantee parents more rights, stipulates that children born without life from 22 weeks or weighing more than 500 grams must be declared to the civil registry within 3 days. The attribution of a first name is obligatory. Birth and death certificates are also established and reported in the family record book. “This law allows the child to belong to his or her grieving family. This is essential to begin grieving work and not fear forgetting,” emphasizes Claudia Betteilheim-Pechikoff.

Also, once the pregnancy reaches 15 weeks, a medical certificate of delivery can be requested. In this case, assigning a first name is optional. Regardless of the age of the fetus, parents can decide whether or not to organize an individual funeral.

What feelings can the loss of a child awaken in parents going through this ordeal?

The loss of a child can arouse in women a feeling of guilt, shame, and of course, shock when it is announced. Several emotions can intertwine, first a feeling of helplessness, feeling useless, the feeling of emptiness, then sadness, anger, even rage. “Some parents are inconsolable, sink into melancholy and unable to overcome this grief”, explains the psychologist. “We must understand everything that this mourning involves. The mourning of the lost child certainly, but also among certain parents the hope of being able to conceive again”she emphasizes.

Perinatal bereavement: what impact on the couple?

Couples who go through this type of drama are initially in psychological survival. Everyone, with their resources and their personal history, will try to cope with this unbearable event. “It is possible that the two partners move forward according to a different temporality in this work of mourning, which can be a source of conflicts and reproaches., note Claudia Bettelheim-Pechikoff. “We must bear the emptiness, the sorrow of the other, while being present for each other. Which is not obvious”adds the specialist.

Loss of a child: how to get support and find help?

While it is true that a certain coldness has been criticized by the medical profession in the management of perinatal bereavement, it must be emphasized that things are changing. According to the clinical psychologist, teams in maternity wards are increasingly better trained to support these first moments of mourning. On site, psychologists and child psychiatrists can offer listening and support to parents. At the same time, liberal psychologists with experience in perinatal care can also be consulted, not only by parents, but also by brothers and sisters. “These too must be taken into account. They are bearing the brunt of the effects of this event.”souligne Claudia Bettelheim-Pechikoff.

Forums, associations, testimonials for the Mamanges and Papanges

What can also be valuable help is being able to surround yourself, discuss and confide in other people who have experienced a similar tragedy. Associations, such as Agapa and Petite Emilie, provide support to bereaved families, particularly through support groups and discussion forums.

It is also possible to listen to testimonies on this subject, through podcasts (eg: Bliss Stories, Luna Podcast) which talk about maternity and perinatal mourning.

How to support a “mommy” and a “dad” without being clumsy?

Finding the right words, being afraid of being too much or not enough present… How can we support parents who are going through such a terrible ordeal, without sinking into awkwardness? Because yes, certain frequent sentences like ” you are young, you will have others…“, certainly have a good intention, but turn out to be very clumsy, even violent, for bereaved parents. Conversely, opting for silence for fear of rekindling the pain is not a good option either. “The indifference of loved ones can arouse anger and/or incomprehension among parents., specifies the clinical psychologist. “However, the pain of these parents must be welcomed and heard”she adds.

The role of loved ones (and those around them) is to offer a listening ear, a space of support, without forcing confidence or providing advice…