Ambiguous Loss: Implications for Perinatal and Neonatal Nurses

Death and grieving are regular events in the human lifecycle, and the rituals associated with the loss bring closure to dear ones. Ambiguous loss, a term coined by Pauline Boss, is a state in which there is no actual "death" and, therefore, no "grieving" or closure associated with it. Pregnancy is a happy event most of the time; however, the loss of pregnancy can be distressing to the parents. Additionally, a prenatal diagnosis can be an emotional burden to the family where the fetus is there, but an unknown loss is anticipated. While the birth of a child is expected to be a joyful event, premature birth and subsequent admission to the NICU for prolonged periods with fluctuating conditions force the parent to be in a constant crisis mode where the outcome is unknown. This can mentally, physically, and emotionally drain the parents and may cause depression or other mental health challenges. Perinatal and neonatal nurses are uniquely positioned to recognize the warning signs of emerging grief crises in the parents and support them appropriately. Such support can equip the parents for a healthy transition of care to home and help parents learn to live a healthy life despite the challenges.