By Jan McDonnell
The program to support families experiencing perinatal loss at Ascension Saint Agnes Healthcare goes back many decades, and has changed over the years. But after the immediate counseling in the wake of loss, we offer free burial for all babies who expire in the perinatal period.
We provide burial for every loss, from very early miscarriage through full term. An early miscarriage may generate a specimen that is processed through surgical pathology, including material that women bring into our ER from losses experienced at home. We also include surgical specimens from ectopic pregnancies. If a woman with an ectopic pregnancy is admitted, the chaplain will offer support as for any other pregnancy loss.
Babies’ remains are stored in a special location in the hospital morgue. We encourage families who are interested to explore private burial, but very few make private arrangements because of the cost. Surgical specimens are automatically kept and stored.
Our infant burial service is held twice per year. The Daughters of Charity donated a plot they held at a local Catholic cemetery, and arranged for a headstone. Nursing, registration and pathology developed a protocol for arranging for burial permission, with policies and procedures approved by Mission Integration and the board of the hospital. New Cathedral Cemetery provides tents, chairs, site preparation, and help during the service. A local funeral home donates a casket, transport, storage, and help at the service. Mission Integration budgets and arranges for flowers.
Spiritual Care sends invitations to families whose babies will be included in the ceremony. We take care that the interval between the baby’s death and the service is no less than four weeks. The interval lets mothers recover from delivery and gives families time to support each other privately during those first few weeks of intense initial grief.
We also take care to be both reverent and lawful as we prepare to bury the bodies of these precious babies. Registration and Nursing obtain permission to bury from parents, assemble death certificates as appropriate, and collect state forms. Two days before the service, the funeral home brings the casket to the morgue. After a prayer by the chaplain, the babies’ bodies are placed in a single casket (or two, if needed) by the pathologist, as the nurse-manager, chaplain and funeral director make sure the paperwork is in order. The funeral home stores the casket until the service, and brings it to the grave site along with stand, podium, tissues, water, and other supplies.
On the day of the service, we give out flowers, pins and programs at check-in, when we also note each baby’s name. Nurses and others who have been involved in care of mother and baby, Daughters of Charity, and others from Saint Agnes attend and welcome the families.
The programs, in English or Spanish, include prayers that we recite together, including Psalm 23. Portions of the service are conducted in both languages by a chaplain who speaks Spanish.
Our service is brief, only 15 minutes long, and includes reading of all the babies’ names. Babies who have not been given formal names are named aloud as Baby [mother’s last name]. The burial service itself is Christian, and includes a reading from the Gospel. But families of other faiths are invited to conduct their own private prayers and rituals afterward if they wish. The chaplain remains for those prayers as well, as do many of the other families. The universality of the grief at the death of a child is a strong bond among those of every faith.
Between 30 and 75 people attend, depending on the number of babies included. Every time we have a service, we find new toys, stuffed animals, angels, plants, and flowers placed on or near the stone. Trucks, action figures, dolls, teddy bears, balls, rattles, painted rocks, Rosaries — the babies touch many hearts and inspire gestures of love.
Once in a while, a woman who has experienced a loss years earlier calls Spiritual Care to ask about our infant burial program. They are hurting because they do not know what happened to their baby’s body, or because they know that it was treated as medical waste. We send these women an invitation to the next service, and promise to speak the name of their child along with all the other names, if they wish. We make sure they know where the site is, and encourage them to make it their own even if they do not come to a service.
For families to whom the burial matters, it matters very much. When we demonstrate love and reverence for each baby, our grief at the death of each child, and our care and concern for each family member — when we hold a ritual and give them a place that acknowledges their loss —when we affirm God’s love for each child and each one who grieves — then we are providing an opportunity for healing grace that is a gift from God to all, transcending language, culture, race, religion, role, and more.
As the Ascension mission statement says, continuing the loving ministry of Jesus as healer, we commit ourselves to serving all persons, with special attention to those most in need. Amen.
Jan McDonnell, BCC, is a perinatal chaplain at St. Agnes Hospital in Baltimore.
