A Hospital Tradition Remembers the Youngest Patients

By Wendy Cadge | April 26, 2016

(AP Photo/Corpus Christi Caller-Times, Michael Zamora) A woman looks through a grief box she received after her miscarriage.

(AP Photo/Corpus Christi Caller-Times, Michael Zamora) A woman looks through a grief box she received after her miscarriage.

“How many children do you have?” I asked a colleague as we started to get to know each other a few months ago. “One,” she replied, “and I lost a second pregnancy at six months last spring.” “I’m sorry,” I replied and listened as she shared more. Her experiences reminded me of a woman who wrote about her son Sam, who was stillborn more than ten years earlier. Before Sam’s mother left the hospital, she wrote in the hospital’s thick, wood-covered memory book: “I will think of you every day for the rest of our lives and I will be with you again some day. You are an angel in heaven watching what Mommy and Daddy and S [older brother] do.”

Sam’s mother had joined my colleague and hundreds of others who remember infants they lost before, at, or shortly after birth. Frequently overshadowed by baby showers, pink and blue parties, and the multiple ways families in the contemporary United States celebrate births, many of these families grieve quietly, isolated from others who are not sure how to be of support. It is in the formally secular spaces of hospitals that the newly bereaved begin to wrestle with deep spiritual and existential questions of why and how and what next.

Sociologist Nicole Fox and I learned a little about these struggles through our study of parents’ entries in the memory book at one urban hospital. Most hospitals have chaplains who work with families at these tender times. Some nurses also prepare memory boxes for families with photographs, handprints and footprints and other reminders of the lives of these babies. A few, like the hospital where we did this work, have a memory book that chaplains and nurses share with parents and loved ones when babies die. Families are invited to write an entry at the time or months later and to read entries written by others. As we read and absorbed the entries in this book, we saw that rather than seeing death as an end, many parents imagine it as a beginning of a continued relationship with their child, now in heaven.

We saw parents creating these beginnings in several ways. First, they opened their entries with descriptions of their children that connected them physically. Nicknames like “precious,” “perfect,” “angelic,” and “dearest” were common, as were detailed physical descriptions—real or imagined—of the child. Some mentioned specific body parts—“your fingers and toes were perfect” —or described a “long torso, long arms and legs.” Close to three-quarters of families included some kind of photo with their entry that ranged from an ultrasound image to photos of the infant after death to photos of other living family members. Many of these descriptions mirrored characteristics of the parents. The parents of a stillborn daughter wrote—after listing her name, weight, and birth date—that she “had curly hair and blue eyes. She was a real combination of both of us with [Dad’s] beautiful white Irish skin and a touch of my Asian eyes.” Another mother, writing on her son’s “supposed due date,” drew similar connections: “Looking at your father—your red-haired twin, always reminds me of how tall and handsome you would have been someday.”

Parents also created ongoing linkages to their children through naming. Given names linked children to beloved parents or grandparents and signified messages or hopes parents had for their child. “Your dad and I want you to know your name was very special, just like you!” This mother wrote her daughter’s name in all capital letters at the top of an entry in the memory book with the date and time of her birth just underneath. “Part of you will always belong to your mother, the other part to your dearly departed grandmother,” she told her child in regard to her namesake. Parents connected with their children through phrases that named the children as family members. The child who died will be “our first born forever,” “will always be our child,” and “will always be Daddy’s little girl, you are my daughter forever.” Parents saw their children as part of nuclear families and emphasized how special they were and the permanent places they would occupy in the family.

While some parents wrote just once, others returned as their relationships changed. A mother first wrote just after her son died, telling him about herself, his father, and their family. “You will always be my baby boy,” she wrote, adding, “I sometimes feel I can still feel you swimming around in my belly.” She closed quoting from Robert Munsch’s children’s book Love You Forever, saying that she will always be his mother and he, her son. She returned to the memory book one and three years later to remember her son on his first and third birthdays and to give him updates about their family. In each entry, she affirmed that she loved him, that he would always be her son, and that he had a special place in her heart and in the family.

Many families described their children in this book as in heaven as angels incorporated into heavenly families closely connected to those on earth. One mother and father wrote, “You are in heaven right now with God.” Another mother called her son “our Gift to God” writing that he “went up to heaven an hour and a half” after his birth after 24 weeks of pregnancy. “You got to go to heaven without ever having to know pain or evil,” this mother continued. “You are nothing but pure and good.” For some, heaven was safe because family members who already died were there, waiting for or already caring for the child. Rather than seeing heaven as a separate set-aside place, many imagined it being much like earth, where relationships and activities continue. In one entry, carefully handwritten by a mother who also drew a heart with her daughter’s initials inside it, were the words, “I am thankful you are in heaven with so many others who will love and take care of you until I arrive hopefully many, many years from now.” And in another entry, “When you reach heaven, your great grandma will be waiting on you.”

Most saw heaven as safe because they believed God was there with their children—now angels—who would help to protect and guide family members on earth. Many believed their children were hand-picked by God and gained special abilities or powers from being with God in heaven. They asked their deceased children to watch over and guide them. “Shine your starlight in the heavens and guide us,” one entry read. Another mother wrote, “I want to ask the man upstairs why … but they say don’t question him. Let him do his work. I hope you watch over us forever.” Some parents seemed to be seeking support through divine attention while others framed it more as a way to stay connected to their child. “You will always be with us in heaven as on earth,” one family wrote on a memorial card they placed in the memory book for their son. “Please watch over your brother.”

As parents described children as angels with God and predeceased family members, they experienced communication as possible—there was just a thin divide between heaven and earth. In heaven, parents imagined their children as children or at least retaining child or human-like attributes. One mother asked her son, “How is heaven? We hope you are working hard on your basketball game,” while another father depicted his son as “busy” in heaven. Others portrayed their deceased children as needing to be parented in heaven. “Please behave and be a nice baby boy, don’t misbehave ok?” “Be good, no fighting.” “Have fun with the angels and save a hug for us.” In seeing children growing up in heaven with predeceased loved ones, parents assumed communication between heaven and earth could go in both directions. As one mother and father wrote, “Dear M and J, We heard you’re happy and are with wonderful people. Love, Mom and Dad.” Not only does this entry presume that the children can hear the parents, but also it illustrates the parents having heard—in some way—from the children after they died.

Such images of heaven were relatively consistent across entries, reason for pause in a book that contains thoughts and feelings from people from a range of racial and ethnic backgrounds and countries of origin. While many writers seemed to be Christian or used language that reflected Christian assumptions common in the United States, their emphasis on beginnings and ongoing connections challenge scholarly approaches to death that focus on the stages of grief or endings alone. While death ended the biological lives of these children, their parents’ experiences began ongoing relationships with them here and in heaven.

Relationships cultivated by the living with the dead have a long history, of course: Nineteenth-century Spiritualists sought communion with dead relatives, including infants and young children; so too have believers in many other times and places. Robert Orsi, writing of religion as relationship, offers similar analysis of Catholic prayer to saints. But it is rare, and almost uniquely poignant, to find written records of such longings, especially notes written directly to a parent’s beloved offspring. What does it say about American religion today, that in these medical, ostensibly secular hospital spaces, bereaved parents are encouraged to write loving notes of reassurance to their dead children? Is this a “religious” practice?

Perhaps most like the private mourning diaries kept by some in earlier centuries, these entries provide glimpses of the thin line between the living and the dead in the early phases of grief. These notes remind us of the spiritual and existential realities that lurk all around grief’s edges and the ways people use spiritual and religious languages and ideas—here mostly about angels and heaven—to begin to cope with loss. This book helped facilitate connection among those with similar experiences, inviting them into a community of mourners.

As I reflected on this book with my colleague who lost her pregnancy at six months, she shared a quote from an unknown source that often helps her. “When a baby is born, it’s a mother’s instinct to protect the baby. When a baby dies, it’s the mother’s instinct to protect their memory.” All of these memories are living, breathing experiences deeply tempered with love. And they offer what all of us surely want in the aftermath of a beloved’s death: connection to the loved one as we begin to grieve and continue to love.

Wendy Cadge is a professor in the sociology department at Brandeis University. To learn more about her research, see her academic article, “‘Watch Over Us Sweet Angels’: How Loved Ones Remember Babies in a Hospital Memory Book.”

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