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Meaningful Moments: The Use of Ritual in Perinatal and Pediatric Death

Kobler, Kathie BS, RN; Limbo, Rana PhD, APRN, BC; Kavanaugh, Karen PhD, RN, FAAN

MCN: The American Journal of Maternal/Child Nursing: September-October 2007 - Volume 32 - Issue 5 - p 288–295
doi: 10.1097/01.NMC.0000287998.80005.79
feature article

Rituals provide meaning and order to transitions, and symbolically connect people and events. Despite the prevalence of perinatal loss (miscarriage, stillbirth, and newborn death) and pediatric deaths, little has been written about the use of rituals surrounding these losses. The purpose of this article is to define the dimensions of a ritual as each pertains to perinatal and pediatric death, and provide concrete applications for use in clinical practice. Intention, participation, and meaning-making are the key dimensions of rituals that arise from clinical encounters. Initiating the discussion about ritual and the timing of the ritual itself are critical elements for the nurse who is caring for a bereaved family. Because of the paucity of research on using rituals in perinatal and pediatric death, nurse researchers should design studies that explore the outcomes of using rituals, both in the short- and long-term, following the death.

Rituals are used in all societies to help deal with grief and bereavement. These authors describe the rituals often seen in the care of families facing perinatal and pediatric death.

Kathie Kobler is a Bereavement Coordinator, Advocate Lutheran Hospital, Park Ridge, IL. She can be reached via e-mail at

Rana Limbo is the Director of Bereavment and Advance Care Planning Services, Gundersen Lutheran Medical Foundation, Inc., La Crosse, WI.

Karen Kavanaugh is a Professor, College of Nursing, University of Illinois at Chicago.

© 2007 Lippincott Williams & Wilkins, Inc.