Experts: Rick Santorum Grief Is Typical, But Taking Body Home, Unusual

Psychologists say parents need rituals to grieve a preterm pregnancy loss.

Jan. 6, 2012— -- Republican presidential candidate Rick Santorum has evoked squeamishness and ridicule for retelling the story of the death of his son, Gabriel, at 20 weeks gestation and the family's unconventional response -- taking the body home from the hospital and allowing their other children to cuddle the corpse and say goodbye.

The Internet lit up with comments this week after Santorum's meteoric rise to second-place in the Iowa caucuses, nearly tying him with presidential candidate Mitt Romney. Some described Santorum's story as "weird" or "horrifying."

Gabriel was the couple's eighth pregnancy and he survived only two hours. In her book, Karen Santorum wrote about bringing the body home to their other children.

''Elizabeth and Johnny held you with so much love and tenderness," she wrote. "Elizabeth proudly announced to everyone as she cuddled you, 'This is my baby brother, Gabriel; he is an angel.'''

But some mental health experts believe the Santorums may have been ahead of their time by ritualizing their son's death in order to exorcize their grief, though they say taking a body home is unusual and not recommended.

In the context of the times -- the year was 1996 when the family buried Gabriel -- their behavior was understandable, according to Dr. David Diamond, a psychologist and co-author of the 2005 book "Unsung Lullabies."

Helen Coons, a clinical psychologist and president of Women's Mental Health Associates in Philadelphia, said couples are not encouraged to bring a deceased fetus home.

"If a couple chooses to do a burial or memorial service for a third-trimester loss, funeral homes will assist in a caring manner," she said.

Radio host Alan Colmes criticized the conservative candidate, who is Catholic, for "playing" with a dead baby. In an interview, Fox News reporter Rick Lowry responded, "You are mocking him."

"I think it is showing a certain unusual attitude toward taking a two-hour baby home who died to play with his other children," said Colmes, who later called the Santorums and apologized, according to his Twitter feed.

Of the nearly 6 million pregnancies each year in the United States, about 15 percent end in miscarriage, according to the Centers for Disease Control and Prevention.

In about half the cases, a cause cannot be determined. Among the conditions usually linked to miscarriage are a woman's age, chromosomal abnormalities, structural problems, infections, autoimmune disorders or a condition that causes the blood to clot in the placenta, known as thrombophilia.

Technically, because it occurred after the 20th week in the second trimester, the Santorums' loss was a pre-term delivery, which is less common than a first trimester miscarriage.

Medical experts regard it as a fetus, because it was born before the third trimester, when it is viable. But medical experts say the loss is still emotionally devastating.

Couples have different ways of coping, and grief experts say that rituals are often important in healing.

"There are some who choose to move very quickly from the loss and others who find holding a third-trimester baby in the hospital very helpful," said Coons. "Some find it helpful having a ritual on an annual basis, making a contribution or saying a prayer or planting a tree or flowers. Others have a need for private ways to remember the loss."

Washington Post columnist Charles Lane described today his own experience nine years ago with his stillborn son, Jonathan, chastising critics who called the Santorum's response to Gabriel's death as "weird."

The baby's heart stopped in utero just prior to a scheduled Caesarian at 33 weeks.

"Next came hours of induced labor so that my wife could produce a lifeless child," Lane writes. "I cannot describe the anxiety, emotional pain and physical horror."

Santorum Ritual in Pregnancy Death Not Usual

Although Lane said he hesitated to hold the lifeless body, which nurses had wrapped in a blanket and cap like a newborn, he eventually cradled Jonathan in his arms and said goodbye.

"I am glad that my love for the dead overcame my fear of him," he writes. "We, like the Santorums, took a photograph of the baby -- lying, as if asleep, in Cati's arms. We have a framed copy in our bedroom. It's beautiful."

The body was then circumcised and buried after a Jewish service.

"Jonathan's death was probably the hardest moment of my life," writes Lane. "But actually touching his body was a source of comfort and the first step in going on with life. Not weird."

Psychologist Diamond, who is co-director of the Center for Reproductive Psychology in San Diego, wrote about loss couples feel, even in the context of embryos early in the infertility treatment process.

But he did admit taking the body from the hospital into the home is unusual, and parents must always be sensitive to how their other children might react.

None of the health professionals ABCNews.com talked to could say if health regulations today would bar a family from taking a dead body from the hospital to their home.

"We recommend taking into account the ages of the other children and their maturity if you are going to expose them [to a corpse]," he said. "Others in the family need to have their own choices also [on] how to handle it."

A fetus at 20 weeks is fully formed.

"All its body parts are there and it looks like a baby," said Diamond.

Babies, like his own twins who were born at 28 weeks, can survive in the third trimester.

"Originally through history, these losses -- miscarriages and stillbirths -- were not regarded as losses, especially the earlier ones," he said. "Through our research we have increased awareness that these are real losses and people become attached to the pregnancy and the baby long before it is born."

Diamond said that 20 years ago, around the time that the Santorums suffered their loss, professionals encouraged their response.

"It was getting to be more in fashion," he said.

"The trend was, rather than ignoring, to help people with their grieving and make it a real loss rather than something stuck in their minds and imagination for years," he said. "Even before that, they allowed families to hold the dead infant or fetus and spend time with them -- as much as they wanted."

A corpse was not often taken home, but might be kept in the refrigerator for "a couple of days," so the family could have access, according to Diamond.

"It was kept in the hospital, but of course you can't do that for too many days," Diamond said. "But there were cases were they basically allowed the family to handle and be with baby and say goodbye."

His best advice to medical professionals is to "be flexible" to a couple's requests and feelings and not to push any agenda on the family. He does recommend naming the baby, if that is desired.

"Make the loss something real they can grieve and have recognition around and not be ashamed or ignore it."

"It's really up the parent," he said. "We shouldn't insist or push too hard. That can be more traumatic."

As for Santorum's own ritual so many years ago, Diamond said, "In this context, it isn't a very big deal. It's not far out of the norm at all…There is nothing pathological about it or particularly alarming. I suppose for people who believe life begins at conception, maybe it's even more understandable."