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FREE TO GRIEVE: PARENTS BEAR THE ANGUISH OF ABSTRACT LOSS WHEN `HELLO' MEANS SAYING `GOODBYE'

He weighed less than a pound and was about as long as a pencil when he died. In hospital lingo, at about 20 weeks gestation, that would make him a "product of conception" or maybe a "fetal demise."

The doctor put him on a blue paper towel."Don't put my baby on that," Chris Whipple wanted to say. "It's too cold."

"Could you wrap him in this?" Bryan Whipple asked the doctor, handing him the receiving blanket his sister-in-law had given them.

So the doctor tenderly wrapped Patrick Whipple in the blanket, and later nurses took pictures of the Whipples holding their baby and made a set of heartbreakingly tiny footprints. Later still, the Whipples asked to see their baby one last time.

"He's already been put in a bottle of ether," a nurse explained.The Whipples' experience last June at a Salt Lake-area hospital demonstrates that - although they may still make mistakes - the medical community is trying hard to be sensitive to families who lose a baby through miscarriage, stillbirth or newborn death.

Spurred on by a local support group, SHARE Parents of Utah, local hospitals have undergone "a major turnaround" in the way they treat families who experience a pregnancy loss, says SHARE member Christine Balderas.

"It's rare that we hear a horror story now."

Balderas' own horror story happened 19 years ago, at a time when doctors and nurses still sedated a mother or covered her eyes with a washcloth if her baby was born dead. And while hospitals were trying to shield parents from the trauma, well-meaning friends were offering advice like "Cheer up. You can always try again."

Over the past decade, groups like SHARE have worked hard to teach hospitals and the general public that what parents need is not to pretend that a miscarriage or stillbirth didn't really happen, but to acknowledge it - and remember it.

Hospitals now routinely encourage (but don't insist) that parents hold their stillborn baby and have pictures taken together. They record footprints and save a lock of hair.

Most hospitals now give parents a special receiving blanket to take home. Some, like LDS Hospital, give parents a tiny baby ring as a memento. Others, like Alta View, give baby bonnets, booties and shawls crocheted by volunteers.

SHARE, working with its Hospital Support Council, also encourages medical personnel to explain to parents that they have burial options. Rather than simply incinerate a miscarried baby, hospitals are encouraged to help parents contact afuneral home if they wish.

Having a burial plot to put flowers on provides an "emotional referral point," says parent Karen Osborn, who lost a baby five years ago. And, she adds, if the baby is treated "with dignity and respect," parents tend not to be "tripped up in their grieving" later.

"The problem with baby grief is it's so abstract," Balderas explains. "So it's better if parents can focus in and make it a tangible loss. The more tangible a thing that parents can grasp onto, the better they can get on with their grieving."

Society allows for a certain amount of grieving, she adds, but the amount is often measured against the perceived loss. "If it's a full-term loss, people will give you six weeks, maybe. If it's a miscarriage, it's considered nothing." The assumption, she says, is that if parents never got to know the baby, they won't miss it.

"Sometimes the biggest part of the hurt happens six months later, when everyone else has forgotten," notes Deb Whipple, a newborn intensive care nurse. That's when Whipple sent her sister-in-law and brother, Chris and Bryan Whipple, a Christmas ornament in honor of little Patrick.

The ornament, plus the ring and blanket Deb gave them, and the footprints and photos the hospital provided, and the tree the family planted next to their front porch, all help her hold onto the memory of her baby, says Chris Whipple, especially when other people dismiss it as a "miscarriage."Deb Whipple is one of several dozen local nurses, social workers and clergy who have completed a pregnancy loss counselor certification course taught by Resolve Through Sharing, a national group. LDS Hospital recently sponsored a Resolve Through Sharing certification course in Salt Lake City.

The course instructors urged the Utah nurses to watch for parents who sometimes slip through the cracks, especially those whose miscarriage occurs in the emergency room or in short-stay surgery.

They also encouraged nurses to make follow-up phone calls to parents several weeks, or even months, after leaving the hospital. The nurse, they pointed out, may be one of the few people who actually saw the couple's baby - who knows that the baby did in fact exist.

Don't worry about reminding parents about their loss, the instructors said. "The feelings are either there or not there. The phone call can only help" - a bit of advice that Karen Osborn would echo.

Weeks and even months after Osborn gave birth to a stillborn baby girl, her sister would call to chat.

"I was thinking of that soft little cheek today," her sister would say.

"And I would think," says Osborn, " `Oh, thank you! Somebody in this world still remembers.' "