The Sacred Liminal Time: Rituals For Termination For Medical Reasons (TFMR)

Termination For Medical Reasons (TFMR) is about love, life and death. TFMR is a medical intervention that may be needed to end a pregnancy due to a serious genetic or structural condition; or may be offered if pregnancy complications put a mother or baby's life at risk. TFMR is a sacred act, that is an expression of maternal responsibility; and not a failure of love.  Our culture & medical system needs ethical treatment of families to restore pregnancy termination to its proper dimension. The whole process, like birth, follows a medical model; but the family wounds tend to remain untreated. 

Infant and Pregnancy Loss Doulas can support families who are facing making this most devastating decision.  The context of the scope of service for support can include: acknowledging the complexities of terminating a wanted pregnancy for maternal health reasons, decision making, the liminal time between the decision and the procedure, the precious grief that arises after the procedure that stirs guilt and anguish, or reassurance & sharing of coping and resiliency techniques before, during and after this life changing transition. Companioning families through this time can also include creating a personal therapeutic and remembrance rituals. Participating in ritual breeds connection with their child; it allows for future recollection, memory, dreams, visions, sensations, or impressions that families can hold in their hearts and minds; not be continually searching for something that is lost or incomplete.  The ritual process offers a chance to engage with the polarity of feelings that come from terminating for medical reasons.

Here are some suggestions for healing and remembrance rituals:

Making Decisions: Lighting a candle is a ritual can shift focus and stimulate a parent/s courage to engage in the difficult work that awaits them. Simply just being with the decision that must be made, whatever they may be for the family; and lighting a single candle is a powerful ritual. Lighting a candle can bring forth some symbolic light within their lonely darkness. Surrounding yourself with a light of love and acceptance can keep parent/s centered as they make their decision.

Remembrance Ritual: Get a beautiful small basket. The family collects things in nature that reminds them of their baby; or honours their baby. Keep the treasures in the basket.  Parent/s can keep the basket beside their baby’s ultrasound photo or urn. It encourages communication, remembrance, and encourages them to look around and try to find beauty in each day.

Ritual for Connection: Parent/s can use an object to create a talisman to hold the energy of connection to their baby; or create a dream talisman to hold the energy of the dreams they have of their baby.

Self-Compassion Ritual: This ritual is well adapted to the circumstances that can help the family feel the love, sadness, and regret associated with an interruption of pregnancy.  On a small piece of paper, the parent can write down an intention such as “I wish to draw the energy of new beginnings into my life. May my heart be filled with love and compassion for myself and all beings.” Speak the intention out loud. Bury the piece of paper in a beautiful bowl full of salt. Place the bowl in a clutter free, sunlight filled area. Each morning they are encouraged to speak their intention aloud; and then spend 2 minutes meditating on that intention.

Creating An Altar or Memorial Space: Create a space that won't be disturbed & is free of clutter. The family can lay a beautiful piece of cloth on a flat surface. They can find something to represent each of the five elements & place them lovingly on display. For example, feather (air), vase (water) with flowers, stones (earth), and candles (fire), display an image of their Spirit Baby (ether) which can be the ultrasound picture or a drawing. They can write an intention to connect, display mementos, provide offerings to represent overwhelming feelings of guilt and regret. The goal of creating a memorial space or Altar is to design a tangible imprint that expresses the connection to this wanted child and the future that was envisioned; as well as the grief that this loss left in the family’s heart and mind. The family may want to create a new Altar or memorial space annually for TFMR Awareness Day which is May 4th.

Tomorrow I will continue to be. But you will have to be very attentive to see me. I will be a flower, or a leaf. I will be in these forms and I will say hello to you. If you are attentive enough, you will recognize me, and you may greet me. I will be very happy.  Thich Nhat Hahn

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Kelly Hurley is a HHA graduate and has an Infant and Pregnancy Loss Doula practice in British Columbia.  You can learn more about her at bio.site/withgracekellyhurley or https://www.withgracecranbrookfunerals.com/