A Review of the Literature on Three Types of Disenfranchised Grief ...

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onding with <strong>the</strong>ir baby; in o<strong>the</strong>r words, <strong>the</strong> importance <strong>of</strong> <strong>the</strong> birthmo<strong>the</strong>r-child relationship is completely discounted. The second type involves situations in which <strong>the</strong> loss is not recognized as being significant. This occurs with birthmo<strong>the</strong>rs because people tend to focus on <strong>the</strong> fact that <strong>the</strong> loss is voluntary and <strong>the</strong> child does not die, but instead begins what is assumed to be a better life. This is illustrated when birthmo<strong>the</strong>rs are encouraged to forget and move on as if <strong>the</strong> pregnancy, birth, and relinquishment never happened. The third type <strong>of</strong> disenfranchised grief involves <strong>the</strong> griever being excluded. Birthmo<strong>the</strong>rs are <strong>of</strong>ten excluded and denied <strong>the</strong> right to grieve because <strong>the</strong>re is a misconception that <strong>the</strong>y are uncaring and glad to be rid <strong>of</strong> <strong>the</strong> relinquished child. The fourth type occurs when <strong>the</strong> circumstances surrounding <strong>the</strong> loss are stigmatized or invoke anxiety and inhibit <strong>the</strong> giving and receiving <strong>of</strong> social support. This is illustrated when social support is withheld from birthmo<strong>the</strong>rs because <strong>of</strong> <strong>the</strong> social stigma attached to unwed and teenage pregnancy. The fifth type <strong>of</strong> disenfranchised grief suggested by Doka occurs when <strong>the</strong> wayan individual grieves conflicts with social expectations for appropriate grief reactions. When birthmo<strong>the</strong>rs grieve in a way that is unexpected or unique, <strong>the</strong>ir experience can be disenfranchised by nurses, doctors, and counselors (Aloi, 2009). Aloi (2009) focused on <strong>the</strong> crucial role <strong>of</strong> nurses in influencing <strong>the</strong> birthmo<strong>the</strong>r's relinquishment experience, ability to grieve, and future emotional adjustment. She asserted that nurses' attitudes, acknowledgment, and intervention in regard to birthmo<strong>the</strong>rs are extremely important for facilitating effective grieving. Unfortunately, "many nurses do not even recognize <strong>the</strong> birthmo<strong>the</strong>r's need to grieve, do not approve <strong>of</strong> <strong>the</strong> birthmo<strong>the</strong>r's decision, or are at a loss <strong>of</strong> what to say, thus contributing to her disenfranchisement" (p. 27). Nurses frequently <strong>of</strong>fer unhelpful advice such as telling <strong>the</strong> birthmo<strong>the</strong>r to forget about <strong>the</strong> relinquishment and move on, which can make grieving much more difficult. 26
To counter <strong>the</strong>se problems Aloi (2009) suggested that nurses be provided with birthmo<strong>the</strong>r grief education and awareness training and be informed when a relinquishing birthmo<strong>the</strong>r is first admitted to <strong>the</strong> hospital. Because birthmo<strong>the</strong>rs may be afraid to bring up <strong>the</strong> relinquishment for fear <strong>of</strong> being judged, <strong>the</strong> nurse should bring up <strong>the</strong> subject in order to foster an open exchange and make <strong>the</strong> woman feel comfortable. The nurse should focus on listening, acknowledging, and validating without <strong>of</strong>fering advice. It would also be beneficial for <strong>the</strong> nurse to <strong>of</strong>fer <strong>the</strong> mo<strong>the</strong>r <strong>the</strong> opportunity to see, hold, and say goodbye to <strong>the</strong> child. All <strong>of</strong> <strong>the</strong>se measures will serve to lessen birthmo<strong>the</strong>r disenfranchisement and allow for effective grieving. Conclusions. Although a fair amount <strong>of</strong> literature on birthmo<strong>the</strong>r grief exists, we are still far from having a full understanding <strong>of</strong> <strong>the</strong> birthmo<strong>the</strong>r grief experience and <strong>the</strong> long-term effects that relinquishment can have. At this time <strong>the</strong>re are numerous articles that validate that birthmo<strong>the</strong>rs experience grief; however, <strong>the</strong>re are very few that recognize <strong>the</strong> disenfranchisement <strong>of</strong> that grief. It is very important for <strong>the</strong>re to be fur<strong>the</strong>r research that specifically addresses <strong>the</strong> disenfranchisement <strong>of</strong> birthmo<strong>the</strong>r grief; this type <strong>of</strong> work would inform health care pr<strong>of</strong>essionals, counselors, and family members about ways to reach out to birthmo<strong>the</strong>rs and assist <strong>the</strong>m in fully grieving <strong>the</strong>ir loss. 27
Page 2 and 3: Author: Davidson, Hannah M. The Gra
Page 4 and 5: The Graduate School University <str
Page 6 and 7: Chapter I: Introduction There are c
Page 8 and 9: 2. Loss not acknowledged: losses ar
Page 10 and 11: among the emotions
Page 12 and 13: disenfranchised grief situation fal
Page 14 and 15: Introduction to Grandparent Grief C
Page 16 and 17: Another important
Page 18 and 19: socially defined roles, rituals, an
Page 20 and 21: coined, Gyulay seemed to have recog
Page 22 and 23: contribute to feelings of</
Page 24 and 25: of worse because y
Page 28 and 29: Introduction to Grief of</s
Page 30 and 31: Doka (1986) found that the<
Page 32 and 33: Many bereaved ex-spouses repOli fee
Page 34 and 35: participants had attended t
Page 36 and 37: McRoy, Grotevant, & Bryant, 1997).
Page 38 and 39: papers like Aloi's, as well as empi
Page 40 and 41: References Aloi, 1.A. (2009). Nursi
Page 42 and 43: Hyrkas, K., Kaunonen, M., & Paunone

A Review of the Literature on Three Types of Disenfranchised Grief ...

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