In MCN's two other special issues on perinatal and pediatric bereavement (2001) and pediatric palliative care (2007), authors contributed a wide array of articles on contemporary topics related to caring for dying children and bereaved families. We are grateful to journal editor Margaret Freda for determining that the time was right for another special issue. The topics in this 2014 special issue reflect a reconceptualization of perinatal bereavement into a field known for the broader domain of palliative and end-of-life care. The field now includes a number of national initiatives to ultimately improve care to families. A certification exam in perinatal loss care debuted in 2013 and one in pediatric palliative care in 2012. The Pregnancy Loss and Infant Death Alliance (PLIDA), a national organization of professionals and parent advocates formed in 2002, remains a vital group that provides position statements and a biennial conference. The Web site, perinatalhospice.org-a clearinghouse of information about perinatal hospice and palliative care-lists more than 200 organizations worldwide providing care for families. In 2011, professionals and parent advocates from 9 countries and 16 organizations collaborated to create an online position statement: Caring for Families Experiencing Stillbirth: a unified position statement on contact with the baby. Today, hundreds of researchers around the world are creating an evidence-based discipline.
The topics in this special issue reflect the complex, dynamic nature of end-of-life care as experienced by children and families from pregnancy through childhood. The lead article by Kathie Kobler brings to the forefront the often-forgotten experiences of grieving professional staff. With compassion and sensitivity, Kobler defines strategies for supporting others and caring for oneself. Black and Field then write of the death of a child of same-sex couples, who bear their grief within a culture that may not be attuned to their specific needs. They provide a richly nuanced framework for understanding and responding to lesbian couples with reproductive loss. Being sure of the inevitability of a miscarriage and of the treatment choice is the central finding in research reported by Limbo, Glasser, and Sundaram. This study adds to existing literature on miscarriage by describing women's experiences with the healthcare system and decision making.
Cote-Arsenault, Schwartz, Krowchuk, and McCoy identify an effective home visit intervention for women pregnant after perinatal loss. The nurse-delivered care, studied using a randomized controlled trial, underscores the growth of research design, the unique setting for care delivery, and the critical role of nursing in bereavement care. Brandon, Ryan, and Docherty report how an implementation of a comprehensive, family-centered, pediatric palliative care program can reduce moral distress among healthcare providers who care for acute and chronically ill children. Finally, Friedrichs, Kobler, Roose, Meyer, Schmitz, and Kavanaugh of the Alliance of Perinatal Bereavement Support Facilitators in Chicago describe how to develop and sustain a volunteer organization devoted exclusively to enhancing perinatal bereavement care through evidence-based education and collaboration.
The 2001 and 2007 special issues of MCN continue to be widely cited by researchers and clinicians who are currently publishing, a testament to the enduring nature of this specialized area and to the quality of the journal's articles. We are grateful to those who shared their expertise in this issue and look forward to their work being used for years to come by those committed to caring for families when a child dies.