Maternal reactions to involuntary fetal/infant death.

While there is a growing body of literature describing the impact of infant loss on mothers, many effects have yet to be reported and many questions have yet to be asked. Indeed, given the nature and frequency of infant loss and the relatively few research endeavors, maternal grief is an area for pioneering investigations. How does a mother respond to the loss of a neonate, to a stillbirth, or to a miscarriage? Are there similarities as well as differences in mothers' reactions to these various types of loss? What kind of psychological, emotional, and social problems do these mothers face? Few investigators have addressed this topic and its attendant questions.

Doctor-patient relationships in fetal/infant death encounters.

A study of concerns of 100 middle-class mothers and fathers who had lost infants revealed that the death of an infant or fetus (through miscarriage) was viewed as devastating because of inadequate community recognition of the loss. The impact of these deaths and the lack of community support forces the parents to turn to their physicians from whom they attempt to seek counsel and comfort. Many physicians, unfortunately, are unable to meet the parent's needs because they cannot deal with death on the personal level, and/or their training militates against their accepting a shift in responsibility from "healer" to "counselor-consoler." Thus, an impasse often is reached in which the expectations of parents exceed the service that the physician is able or willing to render. This detracts from the physician's ability to fulfill adequately his role of provider of total care.