A winter's tale : a pastoral and theological exploration of the responses of families and their carers to pre-natal, peri-natal and neo-natal deaths.

The thesis explores, from a theological and pastoral perspective, the responses of individuals, families and their carers to the deaths of children in the pre-natal, peri-natal and neo-natal period. Setting the changes in both the theory and practice of bereavement care in their historical context, the thesis critically examines a diverse range of international bereavement literature, bringing them into dialogue with each other and offering informed reflection from both a theoretical/academic and multidisciplinary practice perspective which is of relevance to both clinical and non-clinical practitioners. Challenging the predominance of the medical model, the thesis argues that the needs of the bereaved are best met by a dialogical, holistic, person-centred, multi-disciplinary approach, which engages both virtues (particularly characterised by the notion of agape) and skills in reflective practice. Critical questions of identity, relationality and care are addressed not merely as theoretical constructs, but as part and parcel of human experience The first chapter outlines the major themes in the development of bereavement studies from Freud onwards, showing how early-life deaths only became the focus of serious attention relatively late in the twentieth century, and arguing that such early-life deaths are both 'like' and 'un-like' other forms of bereavement. The three following chapters look at miscarriage (and related issues), stillbirth, and neo-natal deaths respectively. Each chapter raises issues which are specific to these particular forms of bereavement and others which re-surface as common themes, extending the scope of the thesis from the effects of such deaths on the individual, to their effects on the family matrix and on caregivers. There is separate discussion of the effects of early-life bereavement on siblings. Finally, through a discussion of ritual and through the collation and analysis of a broad range of liturgical material, including rites concerning both the beginning and end of life, the critical relationship between liturgy and pastoral care is established as a key theme of the thesis