By Dr. Ambra Beretta, clinical psychologist, cognitive-behavioral psychotherapist, and representative of the CiaoLapo Association for the Marche region
The experience of fathers coping with perinatal bereavement in our country is still a taboo subject. The underlying assumption is that suffering can, at best, be acknowledged only in the mother, because it is believed that the father—not having felt his child grow or move inside him—establishes a true bond of attachment only after birth. This way of thinking has fueled an old and deeply rooted cultural prejudice that men “suffer less,” that loss is “less severe” for them, and that it is, in any case, easier for them to come to terms with.
Recent studies, however, show that fathers’ attachment to their children begins as early as pregnancy: fathers, in fact, welcome into their minds a child they have never seen—one they do not carry in their womb—and dream about the future and the kind of father they will be.
Attending prenatal appointments, ultrasound scans, and childbirth preparation classes, as well as spending time with the baby (whether born prematurely or at term), promotes and fosters the development of the father-child bond. The loss of a child, regardless of the gestational age at which it occurs, abruptly severs this bond and shatters the dream of a future life together, leading to a profound collapse of expectations, a loss of hope, and the end of the dream of becoming parents.
Emotions Associated with Loss
The fathers who participated in the studies and were given the opportunity to describe their emotions reported feeling “empty,” useless, and unable to control their pain and fear, and said they experienced shock, disbelief, despair, sadness, frustration, and a sense of inadequacy. The fathers’ accounts also frequently reveal a sense of helplessness or inadequacy (especially during labor and delivery), a strong sense of responsibility in having to handle bureaucratic and organizational tasks (such as filling out forms, signing paperwork, making arrangements for the burial or funeral service…) and in having to inform family and friends of the loss. Many of them reported that having to deal with these matters was not easy; at such a stressful time for themselves, they would have simply wanted time to come to terms with what was happening.
It is also important to note that fathers who had experienced losses at early gestational ages did not report experiencing less intense grief than those who had experienced losses at later gestational ages.
The Trap of “Having to Be Strong”
Although experiencing grief and all the emotions described so far following the loss of a child is entirely natural, over the years, cultural expectations that men must be and appear “strong,” without revealing their innermost feelings, have meant that fathers’ suffering has gone unrecognized, relegating them to the role of caregivers for their partners regardless of their own emotional and psychological state.
The literature suggests that fathers experience a constant emotional conflict between supporting their partners and expressing their own suffering—which they feel they have no right to show—and they do everything they can to avoid disappointing social expectations of how a man should behave when faced with traumatic situations such as the loss of a child. They do not openly express their grief so as not to appear vulnerable or out of fear of causing their partners further sadness and pain. It is common for many of the fathers who reach out to CiaoLapo to report that they are concerned about their partners’ mental health; they ask for support and guidance on the “right” way to help them, without making any mention of their own needs or emotional experiences.
“Many fathers facing perinatal bereavement feel as if they are trapped behind a glass wall; they participate in everything that happens, memorize everything that is done and said, witness their partner’s suffering, deliver the bad news to friends and relatives, and take care of their other children—yet they remain detached from their own feelings”(Ravaldi, 2024, Perinatal Bereavement: A Complex and Painful Experience , p. 85).
Unfortunately, this difficulty in tuning in to one’s own emotions is also sustained and reinforced by improper care practices: in many hospitals and community settings, where psychological support is available immediately after the loss, it is often reserved almost exclusively for mothers, leaving fathers completely alone and marginalized as they work through their grief.
Recognizing Oneself as a Father
A central theme that has emerged in recent literature concerns the extreme difficulty men have in recognizing their role as fathers: they know they were fathers up until the moment of the loss, but they are unable to define themselves as such afterward. Even when they have other living children, when asked how many children they have, they struggle to include the children they have lost. Defining themselves as fathers is much more complicated in cases of early loss, mainly due to a failure to acknowledge the traumatic experience and a lack of rituals that can be shared and that make the experience of loss feel “real.” In cases of loss occurring at more advanced gestational ages, collecting mementos such as hand and foot prints, taking photos, being able to bathe their baby, cutting a lock of hair if present, dressing the baby, and holding the baby in their arms are perceived as moments in which fathers were able to experience, even if only briefly, their parenthood—and this has proven to be very valuable in affirming their identity as fathers.
From “doing” to “being”
To cope with the unpleasant emotions associated with grief, studies have found a general tendency among fathers to use strategies such as “distracting” themselves from thoughts of the loss, emotional avoidance, and over-investing in work, hobbies, sports, or household activities in order to keep themselves as busy as possible throughout the day. Some fathers resort to dangerous coping strategies and behaviors such as alcohol abuse, drug abuse, gambling, and excessive and unjustified spending.
Furthermore, fathers are often tempted to try to speed up the grieving process and believe that trying to rationalize the loss may be a helpful way to do so.
Involving fathers and providing them with dedicated spaces where they can express themselves without feeling judged in any way—where their sadness is not trivialized and their pain is acknowledged—should be viewed as an essential part of a comprehensive and shared approach. This enables us to provide fathers with tools that promote the use of healthier, more functional, and more effective coping strategies, as well as the expression of all emotions in an authentic and unfiltered manner.
Those fathers who allow themselves the opportunity to simply be with their emotions—shifting from a mode of “doing” to one of “listening,” “feeling,” and “accepting”—discover that: how it is neither necessary nor helpful to impose time limits on themselves within which they must prove they are feeling better, and that loss should not be “overcome” but rather integrated into their life journey and into their personal, couple, and family histories. (Ravaldi, 2023).
The grief of fathers following a perinatal loss can no longer be ignored
International researchers, trained professionals who work with perinatal bereavement, and organizations that support and accompany parents after a loss are unanimous in suggesting that it is essential to pay special attention to the father, his experiences, and the short-, medium- and long-term consequences of bereavement on his physical, psychological, social, and relational well-being.
Further research is needed because most studies on perinatal bereavement have focused on the maternal experience; for this reason, our understanding of the impact of this loss on fathers remains very limited, and consequently, so do the support options provided by healthcare facilities. Perinatal loss is an emotionally devastating experience that can lead to fathers’ isolation and has implications for intimate relationships and future plans for parenthood; for this reason, support, closeness, and acceptance from loved ones and healthcare professionals are essential.
If grief is ignored or not acknowledged, the grieving process can become stalled, and the likelihood of experiencing complicated grief and long-term psychological consequences—such as depressive disorders, anxiety disorders, and PTSD (post-traumatic stress disorder)—increases.
What helps fathers process their grief properly:
- the presence of trained hospital and community staff who can provide early grief support and who include the father throughout the entire process—from the diagnosis of their child’s death, through their partner’s hospitalization, and after discharge.
- the existence of a stable relationship in which each partner can freely express their needs and feel that these needs are accepted, listened to, not judged, and respected;
- the presence of a family of origin that offers support, affection, and emotional availability, and that does not reinforce gender stereotypes regarding how men should or should not express their emotions and their experiences related to grief;
- acknowledging that you need help and allowing yourself time to take care of yourself in order to integrate the experience of loss into your life and give it your own personal meaning;
- societal recognition of the loss, of that child’s story, and of the role as a father played by all men who have longed for their children but cannot hold them in their arms;
- reducing the stigma surrounding perinatal bereavement, as this makes it easier to talk about perinatal loss with people outside one’s own family.
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