Pastoral Care and the parents who have lost a baby.

INTRODUCTION: Richard Osmer in his book Practical Theology: An Introduction is talking about a bad experience when he was starting his ministry and trying to implement a Sunday school program (pp. 3-5). He didn’t know the importance of the Practical Theology and didn’t have any problems and mistakes in those years. This is a wonderful example about what happens if we don’t know what the importance of practical theology. Pastors, churches, faith communities and everyone involved in religion, all of us we are all related to practical theology in one way or other, wanting or not wanting, because practical theology is related to the all areas of ministry.

In this essay I want to talk about the pastoral care required to minister to the lives of those who have lost a baby, an expected baby with anxious anticipation and love, but they don’t receive the baby. So, we are going to apply pastoral theology in an area apparently outside of church, but related to the pastoral care. This pastoral care is given everywhere it is required: churches, hospitals, army, schools, factories, communities, etc.

The idea is to apply a method where we start with a specific theological concern or question or problem. The idea here is to describe the practice and make a reflection about this practice. Then, we need to see what resources are available to us and see how we can solve this concern. The last step in this method is to make a conversation between this practice and all the resources available, and then, see how we arrive at practical resolutions or actions to solve this concern.  

1 THEOLOGICAL QUESTION:

The theological question and concern I have identified is about the pain I have seen in many people when they have lost a beloved being, relative or friend. As Pastor I have been close to many people that have lost a family member, relative or a friend. Pastors, church members, friends, job partners, and other people, all of us, we are close to the people who had the lost someone, but what happens after the funeral? Does the suffering of these people finish with the funeral? How long is their mourning time and grief? How long will there be suffering? When will suffer finish?

Working in a hospital, many times, I saw a lot of mothers crying because they lost their babies and experienced a big suffering. In that time, my work as chaplain was to pray for the people there, mainly to take care of my unit, and fill out a paper form for our statistics, talking about all the people we served and how we did it. After that, we let the people return home and we never see them again. I have other questions here: Did their suffering go away when I prayed for them? What happened when they returned to their homes? Did their suffering disappear or is it still with them? Did I do my work when I prayed for them? Or do they need more help and support, now that they are home?

When I was thinking about the situation of these mothers and their husbands that lost their babies, and in all the suffering and struggles they have after they were released from the hospital. I decided these situations apparently aren’t my responsibility, but they continue suffering and as chaplains we are not there, to help them to ease the pain. This situation opened my eyes to another world. It is the world of the suffering, the world of the people that have had misfortunes and need more help and comfort than we could imagine. Inclusive this situation has many theological concerns: Is our work as caregivers finished when we pray for the people in the hospital? Does their suffering end when we pray for them? How long is the period of mourning and grieving? As chaplains, do we take pastoral care to the home where they live? How does suffering change their lives? When does pastoral care end? Also, if we think of the babies, why did the people lose their babies? Why did they die? Where is God in those moments? 

The idea of this paper, my theological question and concern is to talk deeply about the pastoral care given to the parents who have had a stillborn baby or the death of a newborn baby or a miscarriage (involuntarily abortion). Many Hospitals have special programs for the care of babies, but what about the parents who lose their babies? Do we give them pastoral care when they have been released from the hospital? What are their needs? Are there any follow-ups when they leave the hospital? Etc. The truth is that these people don’t receive spiritual support and care when they have been released from the hospital. There are a lot of questions related to this situation, but the focus of my theological concern is about the care that the parents and mothers have not received after they left the hospital.

2 DESCRIBE CURRENT PRAXIS:

I am reminded of the time when I was Chaplain in the Parkland Medical Hospital of Dallas TX, for a year, and each Friday I was the only chaplain in the hospital for 8 hours, between 3pm thru 11pm. At the beginning I thought everything was good because I enjoyed my time over there. After a few weeks, I began to see all the situations in the newborn Unit. When we had any newborn, all was happiness, but when we lost someone, I had to be there and console the parents, comfort and pray for them. Many times I see the pain of a mother that had a stillborn baby, other times they lost their baby in an involuntarily abortion or miscarriage.

At this point I think it is important to clarify that I am not talking about the voluntary abortion. Abortion is a legal right that women have to stop their pregnancy voluntarily, I am talking about the involuntarily abortion, or as a miscarriage. I found an Internet definition:

“Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently. Miscarriage is the most common complication of early pregnancy. Spontaneous abortion is a frequently used clarification to distinguish this natural process from an induced abortion” (http://en.wikipedia.org/wiki/Miscarriage). 

In my paper, I will be talking about the spontaneous abortion or miscarriage because the focus of this paper is related to the suffering or pain of the parents that had a stillborn or lost their newborn babies or premature babies, also called embryos or fetuses. I respect a woman’s decision or the parent decision, if the abortion was decided for both male and female, but at this point she or they are deciding on an abortion. Yes, there is pain in this situation, but it doesn’t compare with the pain and suffering of a woman or parent who are anxiously expecting their baby, and it doesn’t come, doesn’t arrive!  For that reason I will be talking only about the spontaneous abortion, also called miscarriage.

3. CRITICAL REFLECTION ON CURRENT PRAXIS:

I am talking about my experience as Chaplain in the Parkland Medical Center in Dallas TX, the General Hospital of that big city. Each hospital has an important place in a city because the people in need arrive to these places looking for healing. I saw that a hospital never sleep, because there is always movement in each Hospital. Doctors and nurses are very involved in their responsibilities and there are a lot of people in the hospital, including patients and their families. Also, much of the time there is no contact between doctors or nurses with the patients or their families. The reason is because a chaplain has a big responsibility because he is in the middle between medical workers and patients and their families.

Most of the hospitals have a Pastoral Care Department, or Pastoral Care Unit or office and through this office they offer pastoral care or spiritual support to all the patients and their families. Also, there is a chapel. It is a place similar to a Temple, sanctuary or cathedral, a spiritual place, where people could go with desire to spend time praying, or meditating or in the presence of his/her/their God, gods or themselves. Patients cannot go to these places but the chaplains visit them.  The relatives, families, or friends have the liberty to go and look for the spiritual support they need in those moments.  

Chaplains are the caregivers in the hospital. Talking about spirituality and support, chaplains have a big responsibility in the healing of the people. This area is under practical theology and people develop it with a rich spirituality. It doesn’t matter which religious tradition or denomination, they always will have people in the hospitals requiring spiritual support. Different beliefs and religious traditions are present in the life of a hospital and chaplains have the responsibility to minister to each person according their needs respecting their religion and spiritual practices.

The death of babies or people doesn’t respect religious traditions, ages, skin color or languages. The death of the babies is a cruel reality in the hospital and we have mothers and parent suffering for it. There are many theological implications in the death of babies, because a baby means happiness and hope for a mother and parents. Parents, mothers and husbands are anxiously expecting the arrival of the baby, and in this situation the baby doesn’t arrive because there were problems that were unexpected.

A pregnancy could be a difficult time for many women or couples, but the worse comes when they lose their baby. Many times there are problems since the first month, other times the problems arrive at the end of pregnancy, and in any of the cases they lose the babies before their birth or when it is born. This is a tragedy for the parents, mainly for the mothers. After the death of the baby, parents or mothers have to spend a short time in the hospital and prepare the funeral of their baby. This time in the hospital becomes one of the worst experiences of their lives. This is when the chaplains have to be present and give the help and support required for that situation. Parents that have lost a child unexpectedly need significant pastoral care to assist with grieving and support.

4 IDENTIFYING AND UTILIZING RESOURCES:

I will be talking about the resources available for the analysis, study, and the necessary solutions to this concern related to a practical theology situation. There are many kinds of resources: human resources, facilities, programs, spiritual o religious resources, etc. but I want focus my attention only in the next resources available for this praxis: Hospitals, Pastoral care departments, chaplains, families and relatives, churches, groups of support, sacred places and its leaders.

Hospitals are the place where many things happen. Many people arrive there with crisis, sickness, health problems, accidents, and with them arrive family members, relatives, or friends to accompany them in those moments. Yes, hospitals are meeting the medical needs of all the people, but also, they are doing more things. We cannot generalize, but most of the hospitals have an office for financial aid, they have translators, social workers, special support and help with nurses and other people. Also there are special programs in different areas, and many hospitals have a unit, office or department of Pastoral Care or Chaplaincy. This proves that hospitals are not only interested in the medical area, they also are interested in the complete healing of the patients.     

Many hospitals have a unit of Pastoral Care with many chaplains or caregivers of different religious traditions. All these chaplains or caregivers are ready to give the pastoral care and spiritual support to all the people inside of hospital. Chaplains have the responsibility to visit the people of each unit and see what are the needs of the people; also, they are there to help and support the people in their spiritual needs. Many of these people will die, and before they die they will require a lot of attention and support, as well as their families, who are suffering together with their sick people. Doesn’t matter what’s happening with the people, chaplains are there because they are a resource offered for the hospitals.

Many hospitals have a special program called Hospice, where they are offering care to people who are dying or are without hope or are hopeless for the medicine and doctors. The patients in this unit spend their last days of their life in that hospice unit or floor in intensive care. These people are dying and need care and their families need help and support. Hospitals through this program offer care to patient and their families in different ways. There are many hospitals that offer the pastoral care even when the patient could return home. Nurses and chaplains go to their homes and give them the care and spiritual support that they need. They are receiving spiritual support in the middle of their pain and suffering, in hospital or home.

A patient’s family and relatives are other resources available in this case. These people are with their patients all the time inside the hospital to give them help and support and accompany them in their last moments. In the book by Esteban Montilla and Ferney Medina, “Pastoral Care and Counseling with Latinos/as: Creative Pastoral Care”, (although it is focused to the Latinos), has many ideas that could be applied in the pastoral care to everyone around us, doesn’t matter the race or skin color or language. Montilla says that the family, relatives, friends, etc. the community around the care-seeker or patient, each of them are a healing agent (p. 43). This point is important because family and community are important in the recovery of the people that have had a loss and are in a grieving time.

Churches and faith communities are another resource. We call them churches, congregations, groups of faith, sanctuary, shrines, chapel, etc. but these sacred places are called to be a light for all the people who are suffering.  Mothers and parents that have lost a baby need the spiritual support of their own congregations. Each church has different programs according its own needs and focus of ministry. In these communities also we have leaders: pastors, priests, preachers, etc. all of them are religious leaders and have the ability for counseling. Also there are professional counselors and other resources in the community where the churches are, such as: psychologist, social workers, programs in the community, etc.  

5 CONVERSATIONS BETWEEN CURRENT PRAXIS AND RESOURCES:

I believe that we need to unify all the resources available and work together in the pastoral care and support needed for the mothers and parent that have lost their babies. When you have had a traumatic experience in a hospital or the loss of someone you will need a long time for recovery. Christine Longaker in her book Facing Death and Finding Hope: A guide to the Emotional and Spiritual Care of the Dying, show us her experience after her husband died, as the hardest period of her life (p. 12). So, can we imagine the pain of a mother that has lost her baby? Hospitals, Pastoral Care Units, Chaplains, Churches, religious leaders, family and community, each of them have an important role in the recovery of those who have lost their babies.

Carrie Doehring in her book “The Practice of Pastoral Care: A Postmodern Approach”, she mention that as caregivers we need to interpret the care-seeker’s emotional state 9p. 39). This point is important when we are working as chaplains in a hospital. If a mother lost her baby, we need to see what it her emotional state is and if she needs more help! Yes, she is going to go home, but she is not ok, she needs help! What are we going to do? Also she talks about a psychological assessment that we have to do so we can find the type of loss and the phase of grief (p. 71) she is experiencing. Then we must make a plan of care (p. 133). In this plan, these mothers or parents require more interviews, inclusive after these women leave the hospital. So, we need to find ways to help them in their grieving.

Rebecca M. Radillo in her book Pastoral Care: Contextual and Comprehensive (*), She talks about the meaning of the pastoral care, the function of the pastoral care, and talks about pastoral care in crisis times (p. 83). These topics are important in the developing and recovering of these women and parents who have lost their babies. When they enter a crisis time, they will need the help and perspective of a professional in the counseling area.

It’s good to know that hospitals are willing to help those who have lost someone, but it’s necessary to still do more. Luz M. Rivera Miranda in her book Institutional Chaplaincy: Basic notions of Chaplaincy (*), she talks about the importance of a chaplain in the hospice program, not only with patience, also with the family (p. 104). We need more programs as extension of the hospital, outside, in the homes of the people who are suffering.

Hospice is a wonderful program and could give us any helps to create special programs for these mothers and parents whom have lost their babies. These parents or women that have lost their babies, receive support only in the hospital. As chaplains we go to visit our Unit and pray for them, and then, these people leave the hospital to their homes, and don’t receive any more spiritual support or pastoral care.  This is the big difference between these people who lost their babies and the people in the hospice units of the hospitals. People under hospice and their families could have a pastoral care in their homes, but the people that lost their babies don’t receive the same support, they just leave the hospital and go to their homes and no one remember their pain and suffering again! Suffering and pain that continues for long time

Families, relatives and friends are important resources for the recovery of these mothers and parents, but all of these people need to know how they can help. Something that chaplains do under the hospice program is train all the people around the patient, when they are at home, so all of them know how they can help in that environment outside of the hospital. This is an example of one of the things needed for these parents and mother that have lost their babies. They need a warm environment where everyone around them help in the recovery and involve them in the daily life, with the rest of the family, children, relatives, neighbors and friends. Many times they just need to accompany the people in grief, and that is too much. Julie Yarbrough said in her book Beyond the Broken Heart: A Journey Through Grief, these people show denial, frustration and isolation (p. 42).    

In the book “Practical Theology: An Introduction” by Richard R. Osmer, I found a quotation that caught my attention: “Pastoral care, thus, does more than offer healing, sustaining, and guiding to individuals in need ... Rather, it attends to the web of relationships and systems creating suffering through ministries of compassionate resistance, empowerment, nurturance, and liberation” (p. 16). If we believe this, then we need to do more that we have done. I think the hospitals, chaplains, caregivers and medical systems needs to do more that they have been doing. The people need more; people require more pastoral care and we have to be ready for do it.  

At the conclusion of my workshop I have two proposals or suggestions. I say suggestions because I am not involved in the chaplaincy anymore. The first proposal is the designation of a chaplain to visit homes and make follow up to families, persons or people who have the loss of someone. In this point, I am including the women or parent that lost their babies, so they could receive the spiritual support and pastoral care they are not receiving right now in their homes. Obviously, this requires arrangements and more responsibilities for chaplains. If this implementation were possible, these women and parents would have more relief from their pain and suffering.

The second proposal is, chaplains in the time when they are praying for the woman or parents, could ask them any information about their religious tradition, home church, denomination, etc. So, when the woman who lost her baby leaves hospital, the pastoral care unit could call the pastor, priest, or religious leader and give them the information of the woman or parent, and these religious leaders could give the follow up, ministering to their own people in the worse time for these people.

Bibliography: 

·               Doehring, Carrie. The Practice of Pastoral Care: A Postmodern Approach. Louisville, Kentucky: Westminster John Knox Press, 2006.

·               Longaker, Christine Facing Death and Finding Hope: A guide to the Emotional and Spiritual Care of the Dying. London: Cox and Wyman, 1997.

·               Montilla, Esteban and Ferney Medina. Pastoral Care and Counseling with Latinos/as: Creative Pastoral Care. Minneapolis: Fortress Press, 2006.

·               Osmer, Richard R. Practical Theology: An Introduction. Grand Rapids, Michigan: Eerdmans, 2008.

·               Radillo, Rebeca M. Cuidado Pastoral: Contextual e Integral. Grand Rapids, Michigan: Libros Desafio, 2007. (* Pastoral Care: Contextual and Comprehensive by Rebeca M. Radillo). * Translated by Cesar M. Duran.

·               Rivera Miranda, Luz M. Capellania Institucional: Nociones basicas de la capellania. Serie Ministerio. Nashville: Abingdon Press, 2010. (*Institutional Chaplaincy: Basic notions of Chaplaincy by Luz M. Rivera Miranda). * Translated by Cesar M. Duran.

·               Yarbrough, Julie. Beyond the broken heart: A journey through grief. Nashville: Abingdon Press, 2012.