Rethinking the Concept of Disenfranchised Grief in the Context of Perinatal Death: A Qualitative Study

S. Zeghiche (1,2), F. de Montigny (2), J. Lopez (1)

(1) University of Ottawa, (2) Université du Québec en Outaouais, Canada

1) Background: The concept of disenfranchised grief (Doka, 1989) has been largely called upon in the literature on perinatal grief. Despite this concept shedding light on the social norms that regulate perinatal grief, its static and binary nature nevertheless prevents us from fully grasping the complexity underlying the social (non) acknowledgment of perinatal grief. Moreover, having been uncritically overused, it can lead us to think of disenfranchisement as an invariable and as an unvarying component of perinatal grief. Objective: Stemming from a critical reflection on the concept of disenfranchised grief, this study examines the way social (non) acknowledgement unfolds in the context of perinatal death/grief.

2) Methods: Semi-structured interviews were conducted with 23 women in Quebec (Canada), who experienced a perinatal death (from the second trimester of pregnancy). Interviews were transcribed and coded with NVivo. Analyses were performed following the grounded theorization approach described in Paillé et Mucchielli (2012).

3) Results: Two axes of mediation (temporal and spatial) were found to modulate the social (non) acknowledgment of perinatal grief, both in its contents and in its form. It was shown that acknowledgment tends to decrease as we move along the temporal axis (i.e. the further away we move from the time of the perinatal death), and as we move along the spatial axis (i.e. more homogeneous in the medical sphere, less so in the family and social sphere, and often absent in the professional sphere). Tangibility, social scripts and empathy are three notions that have been found to help us make sense of these results.

4) Conclusions: Pitfalls of the DG concept can be avoided by highlighting the coexistence of areas of acknowledgment and areas of non-acknowledgment on each of the two axes (spatial and temporal), as well as the variability of (non) acknowledgment across these two axes.

Ethics statement: This study was approved by the research ethics committee of the University of Ottawa (#04-17-06). Confidentiality, anonymity, and the right to withdraw at any time were assured. The names of the participants were changed to pseudonyms, and the data were stored in a secure location with restricted access.

International Stillbirth Alliance, Annual Conference on Perinatal Mortality and Bereavement Care, Madrid, Spain. October 5-6th, 2019.

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