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  When a baby dies prior to birth, a woman and her family begin a life long journey of living and transforming with loss. The language used with families is important to reflectupon as language cocreates reality and has the potential to either add further suffering or enhance the family’s experience of grieving, health and quality of life. Words that affirm the baby and the meaning the baby holds for the family can provide comfort whereas words that objectify and disregard their loss can contribute additional suffering. Recognizing that healthcare professionals do not intend to harm families whose babies die prior to birth, we offer this paper as a vehicle for reflecting on the meanings words may have for the bereaved families. We further explore the role that the arts have to play in expressing loss and in helping others to understand.
T he language of loss when an infant dies prior to birth conveys many meanings. In title-ing this paper we wanted to be specific about the language that emerges when a baby dies prior to birth--language that either honors or dishonors the lived experience of loss of a baby. To be consistent with our views of language and meaning we needed to shift from the more common phrase, pregnancy loss, to language that acknowledges women who experience the loss of a baby. In our experience, some mothers experiencing the loss of a baby have been told by health professionals not to be upset because they lost a pregnancy not a baby, suggesting that a pregnancy is an object void of humanness and void of a sound rationale to grieve the loss. Of course most women do not experience pregnancy as an object. Indeed, the objectification of the baby disregards the reality and meaning of the lost baby which can intensify the suffering of parents. In addition, the objectification of the loss as a lost pregnancy conveys that parents should not speak of their loss as the loss of a child.  While much has improved over the past thirty years and perinatal death is no longer considered a non-event (Leon, 1992), speaking of a baby’s death is still taboo in society and in our experience, many parents are still silenced and discouraged from expressing the reality of their grief and sadness.
Language among humans is more than important -- it not only expresses personal meaning -- language creates meaning (Parse, 2002). A broad theoretical concept -- called languaging-- was created by Parse (1981, 1998) in her theory of human becoming. The concept languaging is “expressing valued images” (Parse, 1981, p. 46). Languaging is a concept from the first principle of the human becoming theory, “Structuring meaning multidimensionally is cocreating reality through the languaging of valuing and imaging” (Parse,1981, p. 42). Languaging is how human beings express meanings about what is important. Expression of meaning happens through speaking-being silent and movingbeing still (Parse,1998). Languaging also tells about the ways people structure their realities and co create human experiences. Thus, the words used to describe a baby who dies prior to birth express the meaning of that baby. These meanings can be very different among healthcare professionals, mothers, fathers and other family members. We do not believe that healthcare providers intend to harm through the use of language, but we are proposing that harm does happen because of the language used with parents. Indeed, we would like readers to consider the following two questions: What harm or additional suffering is cocreated through language used by health professionals? And, how can language enhance health and quality of care when a family experiences the loss of a baby prior to birth? We hope that this column will enhance awareness of the meanings of the language of loss, and that this awareness may help diminish unnecessary suffering for those who already suffer deeply.
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