Grief. According to Merriam-Webster’s online dictionary, the word “grief” is defined as “keen mental suffering or distress over affliction or loss; sharp sorrow; painful regret.”  Grief is most often associated with death—the loss of a loved one. Many psychologists consider the loss of a child to be the most difficult and intense type of grief. It may last longer than every other type of grief (Hendrickson, K., 2009).

With that being said, what about the loss of a child that is chosen? How does a mother reconcile herself with that complicated spin to her loss?

One of the most special experiences of my life was when I was able to be present at the hospital at the birth of my grandson. As I was holding him for the first time, his dad said to me, “How did you do it?”

“Do what?”

“How did you let me go? This little guy is only two hours old, and I would die a million deaths for him. I love him so much. I know you loved me the same way. How did you do it?”

I was so grateful that he understood the depth of sacrifice I had made for him and that he knew that my decision was not because I didn’t want him or didn’t love him but because I wanted him more than anything I had ever wanted but loved him more than myself.

While many people understand the initial grief and sacrifice of a birth mom, what is not widely understood or even known is that birth mothers die a million deaths over and over and over again. While it is true that the keen, all-encompassing, open grieving lessens a bit over time, the depth does not; it cannot. This is because of the very definition of grief. If grief is defined as “the keen mental suffering … over loss” then, for the birth mother, loss occurs over and over again.

In no way do I want to make light of or diminish the grief of a parent whose child has died, I simply want to give a little perspective of the particular grief of a birth parent.

“Descriptive written words are an inadequate means to convey the birth parent’s emotional and mental anguish and experience of separation and child relinquishment.  The grief reactions of birth parents have been described in the literature as being composed of psychological, physical and social-interpersonal reactions. Yet still, the breadth, depth and uniqueness of the grieving process of a birth parent is poorly understood, and even less acknowledged and legitimized. Several clinical studies have documented the persistent, negative effects birth mothers have experienced after placing a child for adoption. These have included unresolved, prolonged, unacknowledged, and complicated grief, shame, guilt, negative self image, difficulty in intimate relationships, challenges parenting future children, fantasies of reunion, anxiety, and trauma” (D’Arcy, C. C., 2012).

When a child dies, a parent’s grief is acknowledged and the parent’s feelings are validated and legitimized. This is true even if the baby lived very briefly. Family, friends, and coworkers rally to give many levels of support and love to the devastated parents. The emotional, mental, and emotional scarring is accepted and expected by loved ones and no one expects those scars to go away. People are aware that certain events or experiences may trigger grief feelings, and people react with sympathy and love.

When a birth mom chooses to place a child for adoption, the loss of that child is just as devastating. For birth moms who lived in the era of mandatory closed adoptions, as I did, the separation of mother and baby is just as complete as if the child had died. The difference occurs because much of the time, the birth mom’s grief is not validated or legitimized. In fact, it is often ignored or even forgotten.

About fifteen years ago, my 12-month-old nephew was killed by the stupidity of his daycare provider. As the family gathered in the mortuary with a much-too-small casket, I sat in the back and could not control my sobbing. My dear sister-in-law, whose son lay in that casket, came and said she was worried about me. I simply said that her baby’s death and triggered the emotions I felt when I had lost my son. She said, “Oh!  I didn’t know that you lost a child!” I gently reminded her about the son I had placed for adoption. She simply said, “Oh” and walked away. While she didn’t say the words, her look and her body language said, “That’s not the same. You chose that. It didn’t hurt like this does.”

That day, I grieved for my beautiful nephew, my own son, and for the loss of support.

Like a parent whose child has died, a birth parent’s grief is recurring. When the child would have been old enough to walk, you grieve over the loss of that experience. You grieve over the loss of the milestones of kindergarten, getting their first bicycle, watching them play on teams, graduation, and a wedding. Each milestone is its own loss that has its own grief. Psychologists and researchers have said, however, that the birth parent’s grief is more complicated and intense because the birth parent knows that their child exists and that there is the possibility that this grief need not happen. “Regardless of whether the birth mother participated in an open, mediated, or closed adoption, data analysis revealed the adopted child continued to be psychologically present for her, not only on special occasions such as birthdays, but as she went about her everyday life (March, K, 2014).”

One psychologist tried to explain by saying that birth parent grief and especially birth mother grief is like taking the continuous grief over the loss of a child and then adding Complicated Grief Disorder (CGD) AND Prolonged Grief Disorder (PGD) AND Post Traumatic Stress Disorder (PTSD) while being expected to deal with it all silently because it was a choice (March, 2014).

Open or partially open adoptions have the potential of lessening birth parent grief, but only if all sides of the adoption are extremely sensitive and diligent about the needs of all the parties.  In closed adoption situations, a positive reunion that results in close lifelong family relationships also lessens but does not eliminate the birth parent’s grief.

As I held my newborn grandson for the first time, I had tears streaming down my face not only because of the intense joy for being able to be part of his life, but also because of the grief I felt for not being able to have that with his dad.

I know that it is not possible that anyone could have taken away or lessened the complicated, prolonged grief of being a birth mother or the resulting PTSD.  What would have helped is a friend saying on Mother’s Day, “I know you love celebrating being the mom of your kids, but I bet you also hate this day because you ache for your other son,” or a card in the mail saying, “I know that November is a hard month for you because it’s your first son’s birthday. Please know that I love and pray for you.”  The simple acknowledgment, validation, and legitimizing of my grief would have allowed me to not feel so abandoned and alone.

I am so grateful that in today’s world of modern technology, birth parents can be part of groups of people who can understand and support during those hard days when the grief threatens.


Hendrickson, K. C. (2009). Morbidity, mortality, and parental grief: A review of the literature on the relationship between the death of a child and the subsequent health of parents. Palliative & Supportive Care, 7(1), 109-19. doi:

March, K. (2014).  Birth mother grief and the challenge of adoption reunion contact.  American Journal of Orthopsychiatry. 409-409.