Stillbirth Grief, Disenfranchised Loss, and What Bereaved Families Actually Need

Stillbirth is among the most under-acknowledged forms of loss in both clinical and cultural contexts. Despite affecting approximately 1 in 160 pregnancies in the United States, stillbirth grief remains poorly understood, inadequately supported, and frequently minimized — even by the professionals and systems that bereaved families encounter in the immediate aftermath of their loss.

For helping professionals, this gap is significant. Families navigating stillbirth and infant loss are not a rare population. They appear in therapy offices, school counseling caseloads, pediatric and obstetric practices, and community organizations. What they need from the professionals they encounter is not a roadmap to recovery — it is informed, accurate, and sustained recognition that what they experienced was a real death that warrants real grief.

This post draws on a conversation with Vallen Webb, a stillbirth loss parent and advocate, featured on the GRIEF Ladies Podcast. Vallen's experience following the stillbirth of her daughter Evelyn in 2019 — and the years of navigation that followed — offers both personal insight and practical guidance for professionals working with this population.

Understanding Stillbirth as a Distinct Grief Experience

Stillbirth grief does not fit neatly into the frameworks most professionals use to understand bereavement. The loss occurs at the intersection of birth and death — two of the most significant human experiences — often without warning and without the social rituals that typically support grieving. There is no funeral tradition that most families have rehearsed. There is frequently no community that knew the baby as a person. And there is often an implicit cultural message that the loss, while sad, is somehow lesser than the death of someone who lived outside the womb.

This minimization is not benign. When a death is not fully acknowledged by the community around the bereaved person, the grief becomes disenfranchised — a term developed by grief scholar Kenneth Doka to describe grief that is not openly acknowledged, publicly mourned, or socially supported. Disenfranchised grief does not resolve more quickly because it is unacknowledged. It typically intensifies, becomes more complicated, and drives the bereaved person toward isolation.

Stillbirth grief is disenfranchised grief by default in most cultural contexts. Professionals who understand this dynamic are better positioned to provide the kind of explicit acknowledgment that can begin to counteract it.

The Secondary Losses That Follow Stillbirth

One of the most important clinical concepts for understanding stillbirth grief — and perinatal loss more broadly — is the reality of secondary losses. The death of the baby is the primary loss, but it initiates a cascade of additional losses that may take years to fully surface.

Vallen's experience illustrates this clearly. Following Evelyn's stillbirth, she navigated postpartum depression in the absence of a living baby — a disorienting experience that many providers are not prepared to recognize or treat. Her husband was deployed overseas and never had the opportunity to hold his daughter, which created a grief experience for each of them that was both shared and profoundly separate. The couple faced the loss of the future they had anticipated, the identity of parenthood they had been moving toward, and the social experience of bringing a baby home that their community had been expecting.

Secondary losses in stillbirth grief may include the loss of parental identity, anticipated milestones, the relationship dynamic that existed during pregnancy, social belonging within parenting communities, trust in the body, and in some cases, the loss of subsequent pregnancies through miscarriage or fertility challenges. Professionals who assess only the primary loss are likely to miss a significant portion of what their client is carrying.

Disenfranchised Grief: Clinical and Systemic Implications

The concept of disenfranchised grief has direct implications for how professionals structure support and how institutions respond to bereaved families. When grief is disenfranchised at a systemic level — meaning the institutions around the bereaved person do not acknowledge or accommodate the loss — the individual's experience of isolation is compounded.

Consider the institutional contexts a stillbirth loss parent might navigate: a hospital discharge without a living baby, a workplace that offers bereavement leave policies that may not cover stillbirth or that offer only a few days, a community that stops checking in after a short period, and a healthcare system that transitions quickly from obstetric to postpartum care without adequate mental health screening or referral.

Each of these institutional responses sends the same implicit message: this loss is not quite real enough to warrant extended support. Professionals working within these systems — or working with clients who have moved through them — need to understand that the absence of institutional acknowledgment is itself a wound that requires attention.

Grief-informed care in this context means actively naming the disenfranchisement, validating the full scope of the loss, and helping clients understand that their grief response is proportionate to what they actually experienced — regardless of whether the world around them has reflected that back.

Rebuilding After Stillbirth: Routine as a Regulatory Tool

Vallen's experience points to something clinically important about the early and middle phases of bereavement following catastrophic loss: structure and routine are not trivial. When the nervous system is dysregulated by grief — and stillbirth grief can produce a level of acute distress that resembles traumatic response — predictable daily structure provides a scaffolding that allows basic functioning to continue.

This is not about keeping busy or avoiding grief. It is about giving the nervous system enough stability to tolerate the grief that needs to be processed. Vallen describes routine as her survival tool when everything else felt out of control — a framing that maps directly onto what we understand about the role of regulation in grief processing.

She also offers four concrete self-care anchors that she returned to consistently: sun exposure, physical movement, water, and sleep. These are not incidental. Each has a documented relationship with mood regulation, stress response, and physiological recovery. For professionals supporting clients in acute grief, these anchors are a practical and accessible starting point — particularly for clients who are too depleted to engage with more complex coping strategies.

This aligns directly with the rebuilding dimension of grief support: helping clients reestablish the basic daily structure and physical self-care that loss often dismantles. Rebuilding does not begin with identity reconstruction or meaning-making. It begins with the body.

Continuing Bonds and Ongoing Memorialization

Seven years after Evelyn's stillbirth, Vallen continues to honor her daughter actively. This is consistent with what contemporary grief research supports: that maintaining a continuing bond with the person who died is not a sign of unresolved grief — it is a healthy and adaptive response to loss.

For professionals, this has practical implications. Clients who are still actively honoring a baby who died years ago are not stuck. They are doing something important. Professionals who pathologize ongoing memorialization, or who communicate — even subtly — that it is time to move on, are working against the grief process rather than with it.

Supporting continuing bonds in stillbirth grief might look like helping clients develop meaningful rituals around anniversaries, supporting legacy projects that honor the baby's brief existence, or simply creating consistent space in session for the client to speak the baby's name and share memories.

Practical Applications for Helping Professionals

Acknowledge the death explicitly and specifically. Use the baby's name if the family has shared it. Refer to the loss as a death. Avoid softened language that minimizes what occurred. Explicit acknowledgment from a professional carries significant weight for bereaved parents who have experienced repeated minimization.

Assess for the full scope of secondary losses. Beyond the primary loss, explore what else the client has lost — parental identity, anticipated milestones, relational dynamics, trust in the body, community belonging. Secondary losses often drive the complexity of the grief response.

Screen for postpartum depression in the absence of a living baby. This is an underrecognized clinical presentation. Bereaved parents, including fathers and non-birthing partners, may experience significant postpartum psychological distress that does not fit standard postpartum screening frameworks.

Normalize disenfranchised grief. Help clients name and understand why their grief may feel invisible to the people around them. Psychoeducation about disenfranchised grief can reduce self-pathologizing and increase the client's ability to seek and accept support.

Support basic regulatory functioning first. Before moving toward meaning-making or identity work, help clients stabilize sleep, movement, nourishment, and daily structure. These are not peripheral concerns — they are the foundation of grief processing.

Do not pathologize ongoing memorialization. Continuing to honor a baby who died years ago is adaptive. Create consistent space for clients to speak about their child, share memories, and describe how they continue to maintain that connection.

About Vallen Webb

Vallen Webb is a stillbirth loss parent and advocate whose daughter Evelyn was stillborn in 2019. Her experience navigating the gaps in support for bereaved families — including postpartum depression without a living baby, a deployed spouse who never held his daughter, and years of secondary losses — has shaped her commitment to increasing awareness and improving support for families affected by stillbirth and infant loss.

Connect with Vallen: Instagram | Facebook

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Perinatal loss, disenfranchised grief, and the clinical complexities of bereavement support are areas addressed in the professional development offerings at the Center for Informed Grief. If you are a clinician, school professional, or organizational leader looking to strengthen your grief-informed practice, explore our trainings and resources at [centerforinformedgrief.com].