The silent sorrow.

• Author: Moffitt, Perry-Lynn
• Position: Life in America - Miscarriages, full-term stillbirths and newborn deaths

MORE THAN 1,000,000 couples in the U.S. alone each year endure the sorrow of a spontaneous pregnancy loss, from first trimester miscarriages to full-term stillbirths and newborn deaths. This represents about 31% of all conceptions and this figure is on the rise, partially because of the trend towards later childbearing. Although pregnancy loss is so prevalent, many parents suffer this particular sorrow in silence.

American society does not deal well with death in general and with pregnancy loss in particular. In spite of all of the modern medical advances, death remains the ultimate mystery, and the death of a baby during pregnancy or shortly after birth is especially troubling. Friends, family, medical professionals, and members of the clergy can be so unsettled by a pregnancy loss that they may fail to offer even the most basic consolation to grieving parents, relying on platitudes instead. Couples who are told that the loss of their baby was "God's will" or that "It happened for the best" often feel they are being denied the fight to grieve. As one father argued, "If things always happened for the best, there would be no pregnancy loss in the world to begin with."

Why has our ability to offer compassion following a pregnancy loss lagged so far behind a clearly growing need to grieve? The Rev. Vienna Cobb Anderson, who for many years served a congregation in Washington, D.C., believes that this gap is related to our newly distant relationship with death and its main expression, grief. She remembers from her own Southern upbringing how important social customs surrounding death used to be. The clothing people wore and the sprig of flowers or the purple wreath on the door enabled everyone in the community "to know that a family was in need and required special attention and care. People knew about the death and cooked meals, or called and just came by."

In ministering to her own parishioners, Anderson has seen how that important sense of community around death has been lost, especially for that of an unborn or newborn child. By relying on the telephone to spread the news of a death, Anderson believes people end up feeling even more removed from the event. "So often I hear members of my congregation say they didn't bother to visit people in mourning because they would probably cry and upset everybody, without realizing that this is exactly what should happen, that people are more upset if they don't see their friends and relatives crying with them."

Part of our inability to deal with the death of babies through pregnancy loss is based in our modern belief that death is something that can be conquered. The development of antibiotics and vaccines in the last century drastically reduced disease, infant mortality, and the death of mothers during childbirth. This led to the notion that death could be vanquished in a petri dish or by a syringe. Even when we acknowledge that death is not something we can overcome indefinitely, we keep it at a distance. Today, more people die away from their homes, sequestered in a sterile hospital setting where strict roles govern the inclusion or exclusion of family and friends.

We also tend to assume that, in the days before the development of medical advances, parents somehow hardened themselves to the pervasive loss of their children during pregnancy and after birth. We have nurtured the notion that the only way mothers and fathers could have coped with such constant sorrow was through what historian Simon Schama calls a "deliberate protective callousness." In An Embarrassment of Riches, Schama points out that, in spite of the frequency of pregnancy losses and infant death, 17th-century Dutch families grieved and mourned quite openly. Family portraits often included the images of deceased children represented as angels floating above the living members of the family, and he cites numerous personal poems and letters of condolence as proof that families expressed their grief and incorporated it into their lives.

Even among our own American pioneer women, pregnancy losses were acknowledged and grieved. Historian Judith Walzer Leavitt notes that, although women were forced by necessity to accept the deaths of their babies, they revealed their true feelings in their diaries. "Statistics do not tell the whole story," Leavitt says. "A woman might lose just one child and carry the grief forever."

On her 20th birthday in 1816, Sarah Preston Everett married the nephew of patriot Nathan Hale and began a lifelong journal. Twenty-five years later, she looked back over her marriage and noted in her diary that she remembered all of her children in great detail, including the ones who died shortly after birth: "I have borne eleven children, and have been permitted to keep until this day seven--One blossom of hope, just dawned upon this world, lived but a brief hour, and was transplanted by the all knowing Creator to his gardens of joy.... Now there are seven here, and four awaiting us on the other side of Jordan."

With the development and popularization of photography during the 19th century, American families adapted the old Dutch custom of painting their lost babies into family portraits by photographing their dead children. Although this practice may seem unsavory to our modern sensibilities, a photographic record enabled families to acknowledge their loss. express their grief, and honor the memories of their offspring.

Today is another matter. "Most of us feel we have to keep life nice," Anderson says of contemporary society. "We are afraid of pain and vulnerability and the tenuousness of life--and nothing...