“While grief is the unavoidable consequence of tragedy, the wall of silence makes everything worse.”
What is TFMR?
TFMR, or Termination for Medical Reasons, has often been referred to as the decision that isn’t a decision at all. TFMR Mamas refers to it as “A decision made with the most love and the biggest heartbreak.” It refers to the ending of a pregnancy due to health concerns for the mother and/or the unborn child.
These losses often get shrouded in the silence, stigma, and shame that surround other pregnancy losses, and get additionally stigmatized by the virulent politicization of abortion. Termination is a hot button topic, especially in North America where legislation around reproductive health care is changing rapidly. It’s so important to create spaces for TFMR parents to openly grieve and acknowledge their individual experiences and stories.
We’ve created a TFMR Ceremony in our platform to support individuals, families, and communities who are grieving this unique type of pregnancy loss, while also grappling with all of the other emotions that can show up. You can create a ceremony at any point in your journey, even if your loss happened many years ago. A TFMR ceremony can offer individuals and/or their community to come together to acknowledge the love they held for their baby, while also grieving the loss of their child and their future stories as a family.
The reasons someone would seek TFMR are as complex and varied as the parents who ultimately endure this heartbreaking loss, and TFMR parents may not always feel like there’s a place for them in the pregnancy loss community. Language is often used in pregnancy loss support groups that’s not always inclusive of the TFMR experience. This type of loss can present a unique and complicated grief that’s often overlooked or misunderstood.
There is a general misconception that pregnancies that end in termination for medical reasons are extremely rare, or an exception to certain rules and regulations surrounding reproductive rights. In reality, it is much more common. In addition to the loss of a child, it’s often the lack of support, the cultural expectations to move on, and not having a designated grieving framework that can make this experience so difficult.
PILSC explores some common emotions that often surround TFMR, including how to prepare for it ahead of time, questions that arise, what to expect, and what happens after.
How can we use ritual to reframe the story?
Providing a framework for grief and rituals to honour the life of a deeply loved child can help individuals and parents integrate their loss and begin envisioning a path forward that is inclusive of their grief. Rituals and ceremony creation can serve as a jumping off point to begin creating discussions around memorializing such an intense loss. They can point to beauty in deep pain, highlight life as it exists alongside death, and honour who this child was and their identity as a parent.
Many factors influence whether or not the birth of this child was recognized as a birth, or if rituals commonly associated with funerals and death are offered. In spite of what is formally offered by a hospital or medical provider, creating unique ways of honouring life and acknowledging this birth can be powerful ways for parents to see the life that also existed as opposed to blending together the life and death of their child into the label of tragedy.
There are more than 40 universal rituals in our TFMR Ceremony, guiding you get to choose the ones you connect with most and curate a ceremony that meets your needs. Here are a few of them:
Date of Birth ritual:
If there is no official certificate of birth or loss, it can be helpful to create one. You can order a template online or design your own as a way of acknowledging your baby’s date of birth. Creating a certificate of life can be a powerful gesture and symbol to hold onto.
To Hold ritual:
Having something to tangibly hold can help with the primal instinct that comes when a child is born. While some hospitals provide grief support baskets, which include bears, for TFMR loss parents this might not always be an option. Finding something to hold that honours your loss can be a meaningful act of self care.
I Carry Your Heart ritual:
Create your own heart ritual to express the love and grief you are holding in your heart in different ways, such as making hearts in nature, collecting heart rocks, or drawing a heart in the palm of your hand during a tender grief moment. Consider opening with the poem I Carry Your Heart With Me to set the tone.
Parenting doesn’t stop just because there is no living child to parent. Instead, we should offer ways to support the relationship between parent and child, even when that child is no longer here. We need to reshape our stories around “the impossible decisions” and find ways to walk with our grief as a community.
In a world that doesn’t understand termination for medical reasons, or how to support parents who face this heartbreaking loss, it is other parents that have come up and offered out hands to one another. As in raising a living child, other parents in similar stages of life serve as a support network, understanding the pain in a way no one else can. More and more trained TFMR doula and practitioners are creating offerings in this field, cultivating a sort of field guide for others who feel lost. Here are a few of the people we know:
- Jane Armstrong with Both/And Therapy
- Dr. Erica Rozmid with Clarity CBT & DBT Center
- Emma Belle with TFMR Mamas and the founder of TFMR Awareness Day
- Pregnancy & Infant Loss Centre ~ workshops and support groups
- Butterfly Run ~ a community of support
- Ali Hiebert ~ ritual and ceremony support and guidance
TFMR is a decision that isn’t a decision at all, a choice no one wants to make and a journey no one wants to walk through. One of the only rays of light in this dark time is that no one walks alone. There is a community waiting to embrace you, to validate your parenting experience, to say the name of your child and celebrate their life, and to remind you there are many different ways to tell a story.