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Transitional Objects to Faciliate Grieving Following Perinatal Loss

LeDuff, Lawrence D. III MSN, RN, RNC-NIC; Bradshaw, Wanda T. MSN, RN, NNP-BC; Blake, Stephanie M. DNP, RN, NNP-BC

Section Editor(s): Ahern, Kathy

doi: 10.1097/ANC.0000000000000429
Ethical Issues in Neonatal Care

Background: Parents who experience a perinatal loss often leave the hospital with empty arms and no tangible mementos to validate the parenting experience. Opportunities to create parenting experiences with transitional objects exist following the infant's death.

Purpose: This article offers suggestions for staff in units where infant loss is possible to best assist parents in optimal grieving through the offering of transitional bereavement objects.

Methods/Search Strategy: CINAHL Complete, MEDLINE, and the Cochrane Database of Systematic Reviews were searched using the following key words—perinatal bereavement, grief, perinatal loss, transitional objects, bereavement photography—and the search was limited to 5 years and the English language.

Findings/Results: Recommendations exist and are well supported by leading neonatal and perinatal nursing and medicine organizations for the use of transitional objects to facilitate healthy grieving when parents experience perinatal loss. Transitional objects are mementos that validate the meaning of parenthood—even if the physical act of parenting was brief. Nursing and medical staff have significant roles in guiding parents to a healthy state of bereavement and ultimately managing long-term grief.

Implications for Practice: Transitional objects can be provided by staff that are low-cost or free, such as taking photographs for parents, or they can involve purchased products from perinatal bereavement programs. In the latter case, funding needs are a consideration for budgeting decisions.

Implications for Research: Immediately following a loss, parents experience a brief sense of healing after receiving mementos of their infant. However, further research is needed to assess long-term effects of receiving transitional objects following perinatal loss.

Duke University School of Nursing, DUMC, Durham, North Carolina.

Correspondence: Lieutenant Lawrence D. LeDuff III, MSN, RN, RNC-NIC, Nurse Corps, US Navy, Duke University School of Nursing, Box 3322 DUMC, Durham, NC 27710 (

Work occurred: Duke University School of Nursing, Durham, North Carolina.

There are no commercial interests or financial disclosures to report.

There are no conflicts of interest.

The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government. “I (Lieutenant Lawrence D. LeDuff III, Nurse Corps, US Navy) am a military service member (or employee of the US Government). This work was prepared as part of my official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the U.S. Government.’ Title 17, USC, §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.”

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

© 2017 by The National Association of Neonatal Nurses