All manifestations of grief require acknowledgement in cases of fetal death

Both recovery and the processing of loss should be taken into account in grief caused by fetal death. Yet many parents feel that fetal death is downplayed, a recent doctoral dissertation indicates. There is demand for an increased role of the Evangelical-Lutheran Church in the coping process and grief work.

The birth of a child is among the most significant events in the life of any family. Respectively, a pregnancy ending in the death of the baby in the uterus, or during or soon after birth is an event with fundamental personal repercussions. As a rule, grief experienced after intrauterine death is identical to the grief felt after the death of a liveborn infant.

According to Juha Itkonen, a grief researcher and pastor, those close to the grieving individuals often belittle the loss caused by fetal death and encourage them to move on.

“To many, losing a child is too traumatic an experience to process. Reactions are found to be belittling if members of the close circle say something along the lines ‘Keep your chin up’, ‘It’s good that the baby wasn’t born alive only to die afterwards’ or ‘You’re still young’. Complete silence regarding the matter is also a common phenomenon.”

Itkonen says that the death of a child in utero is often considered a less significant loss compared to the death of a child during or soon after birth. It is as if the deceased wasn’t an actual person or a human being, even though the age difference may be measured in minutes.

“In part, this originates in the fact that over centuries and millennia, stillborn children have been seen as ‘freaks’ in many cultures around the world. It has been impossible to establish a link between a stillborn infant and the living through a rite of passage related to birth, such as baptism.”

Space for processing and coping with grief

Through his doctoral dissertation, Itkonen wishes to propagate a more extensive notion of grief, which provides space for both coping with grief and grieving itself. According to Itkonen, many parents feel anger, emptiness and pain caused by grief during the coping process.

“Based on my research data, effective grief support requires intimate and close contact by a person sharing in the grief. Such encounters should also be founded on dialogue-based interaction free of any hierarchies,” stresses Itkonen.

Those who acknowledged the stillborn child as an actual person were seen in a positive light.

Help for mourners and supporters from a four-pronged coping model

In his dissertation, Itkonen developed a practical tool in the form of a four-pronged coping model, through which individuals who come into contact with people experiencing a crisis can quickly determine whether the individual is in need of long-term support.

“The tool comprises four components: the nature of the crisis caused by loss, personal resources, social support and other simultaneous stress factors,” describes Itkonen.

“Even if one of the components is missing, people are usually able to cope relatively well after a crisis. With two components missing, the ability to cope is in great danger of collapsing. The faltering of three components is guaranteed to cause a collapse, and the loss of all four signifies an actual collapse, which means that help is quickly needed.”

The significance of the work carried out by the Evangelical-Lutheran Church of Finland in supporting mourners and providing help through dialogue shines through Itkonen’s dissertation. The church could assume an even larger role in comprehensive grief support.

“The church could provide even more space to communal rituals that respect grief in collaboration with other supporting parties. Furthermore, the belief in love that conquers death inherent to the church can create an opening for hope through which even the most difficult cases of death and the deepest grief can be processed,” Itkonen says.

The research material consists of 24 narrative-episodic interviews. The interviewees registered for the study through peer support websites.


Juha Itkonen, ThM will defend the doctoral dissertation entitled "Kun vauvaonni vaihtuu kuoleman suruun - Narratiivinen tutkimus kohtukuolemasta, lapsen kuoleman aiheuttamasta surusta ja selviytymisprosessista sekä kirkon tuesta" (The expected baby was stillborn, but still a baby -- A narrative study of stillbirth, parental grieving and recovery processes thereafter, and the (supportive) role of the church in all this) in the Faculty of Theology, University of Helsinki, on 21 September 2018 at 12:00. The public examination will take place at the following address: Porthania, sali P674, Yliopistonkatu 3.

University lecturer Jari Kylmä, University of Tampere, will serve as the opponent, and Professor Auli Vähäkangas as the custos.

Copies of the dissertation can be purchased from Unigrafia. The dissertation is also available in electronic form through the E-thesis service.

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Juha Itkonen

Väittelijä Juha Itkonen (s. 1971, Helsinki) on toiminut vuodesta 2000 ev.lut. kirkon pappina ensin Mäntässä ja Orivedellä ja tällä hetkellä Ruoveden seurakunnan vt. kirkkoherrana. Surututkijana Itkonen on toiminut vuodesta 2010 tehden väitöskirjaa ja kouluttamalla eri tahoja. Hän on kertonut tutkimuksestaan lukuisissa kansainvälisissä konferensseissa Suomessa, Yhdysvalloissa, Hollannissa, Irlannissa ja Ruotsissa. Itkonen on Käpy - Lapsikuolemaperheet ry:n ex-hallituksen jäsen. Hän on ollut toteuttamassa muutama vuosi sitten kansalaisaloitetta, jolla haettiin muutosta lakiin siten, että kuolleena syntyneet voitaisiin merkitä omalla nimellään vanhempien väestörekisterititetoihin. Tämä olisi merkki siitä, että yhteiskunta hyväksyisi heidät oikeiksi ihmisiksi.