¹ Layne, Linda, Motherhood Lost: A Feminist Account of Pregnancy Loss in America (New York: Routledge, 2003), 11Google Scholar.

² Christopher Pramuk, “A Hidden Sorrow,” America, April 11, 2011, 19–20. Pramuk's reflections draw attention to the toll that pregnancy losses can take on men as well as women, though the focus of my research remains primarily women's responses to losses.

³ The “Blessing of Parents after a Miscarriage or Stillbirth” from the US Conference of Catholic Bishops’ 1989 Book of Blessings is not part of the purview of this article, though tracing the etiology of that rite would be an interesting project in itself. The rite is now available on the USCCB's website at http://www.usccb.org/prayer-and-worship/bereavement-and-funerals/blessing-of-parents-after-a-miscarriage-or-stillbirth.cfm.

⁴ This is not to say that all interrupted pregnancies are grieved or experienced as losses. Eve Kushner observes, “After an abortion, some of us feel no loss at all—only gains.” Kushner, Eve, Experiencing Abortion: A Weaving of Women's Words (New York: Haworth Park Press, 1997), 63Google Scholar. Likewise, not all spontaneous miscarriages elicit a sense of loss or sadness from the once-expectant mother. It should be noted that “pregnancy loss” as I use it does not include infertility struggles within its scope. While the anguish and grief that often accompany infertility are undeniable and also deserve acknowledgment, they are different in nature from the anguish and grief experienced by women who are able to conceive yet go on to lose or terminate a pregnancy, and therefore I exclude them here. For a theological treatment of infertility, see Cox, Kathryn Lilla, “Toward a Theology of Infertility and the Role of Donum Vitae ,” Horizons 40, no. 1 (2013): 28–52CrossRefGoogle Scholar.

⁵ I am grateful to one of the anonymous reviewers for raising this issue.

⁶ Another resource that treats pregnancy loss from a theological perspective is Hope Deferred: Heart-Healing Reflections on Reproductive Loss, ed. Franz, Nadine Pence and Stimming, Mary T. (Cleveland: Pilgrim Press, 2005)Google Scholar, a collection of essays in which five female scholars reflect theologically on their struggles with infertility, miscarriage, and stillbirth. Articles in popular Catholic publications in recent years, like the Pramuk essay cited above, have broached the topic of pregnancy loss but rarely from the perspective of memorials and ritual remembrances unless they are making a direct reference to Japanese mizuko rites and the dearth of offerings like this in the Catholic Church. A number of other publications from the last thirty years do address ritualization following miscarriage, stillbirth, and infertility from the perspectives of different Christian communities; these publications include Miller, Melissa, “When Miscarriage Steals Pregnancy's Promise,” Vision 4 (2003): 41–47 Google Scholar; Ramshaw, Elaine, “Ritual for Stillbirth: Exploring the Issues,” Worship 62 (1988): 533–38Google Scholar; Gamble, Elette and Holz, Wilbur L., “A Rite for the Stillborn,” Word & World 15 (1995): 349–53Google Scholar; Westerfield Tucker, Karen B., “When the Cradle Is Empty: Rites Acknowledging Stillbirth, Miscarriage, and Infertility,” Worship 76 (2002): 482–502 Google Scholar, for example.

⁷ My research in the area of American Catholic pregnancy-loss memorials is part of a larger comparative project that also considers Japanese Buddhist mizuko (water-child or water-baby) rites that memorialize pregnancy losses due to miscarriage, stillbirth, and abortion. In both the American Catholic and Japanese Buddhist settings, my ethnography for the project goes beyond what is recounted here to include interviews with women who have taken part in these rituals.

⁸ By and large, I employ medical terminology in order to achieve a foundational level of precision and consistency in my discussion of the earliest stages of human life. Yet even the decision to refer to prenatal life in medical terms can be interpreted as a political choice. In the American antiabortion movement, for instance, the use of the terms “fetus” or “prenate” is often interpreted as a rejection of the personhood of the “child” in the womb. Or, my use of the term “unborn” might find resistance within the American abortion rights community for attributing too much autonomy to fetuses, thereby extracting them from the context of women's bodies. I try to honor individual communities’ preferred nomenclature when discussing the different memorials. So, for example, I rely on the terms “children” or “the unborn” more frequently in this article, since that is the language most commonly used by the groups and individuals that facilitate Catholic pregnancy-loss practices.

⁹ Jones, Serene, Trauma and Grace: Theology in a Ruptured World (Louisville, KY: Westminster John Knox Press, 2009)Google Scholar, xiii.

¹⁰ Ibid., 20.

¹¹ Ibid., 21.

¹² Ibid., 19, 15.

¹³ Morrill, Bruce, Divine Worship and Human Healing: Liturgical Theology at the Margins of Life and Death (Collegeville, MN: Liturgical Press, 2009), 55Google Scholar.

¹⁴ Ibid., 4.

¹⁵ Jones prefers the term “reproductive loss” to other similar terms for its ability to encompass infertility as well as problems during pregnancy. However, while still recognizing that life is much messier than her neat categories imply, she opts to bracket cases of abortion in her discussion of reproductive loss, and instead focuses on situations in which she says the “hoped-for child” does not come.

¹⁶ Jones, Trauma and Grace, 131.

¹⁷ Ibid., xiv.

¹⁸ In doing so, Jones rejects looking to Mary, the mother of Jesus, as a healing narrative resource for addressing reproductive loss. That is because, despite Mary's role as the Christian archetype of motherhood and the fact that she experienced the death of her son, reproductive loss is a wholly different experience than that of maternity and child loss. Because “the mother's barrenness and her bodily disintegration are not at issue” in child loss, the grief it produces has a very different texture than when pregnancies fail, bodies betray, and children remain unborn. Jones, Trauma and Grace, 144.

¹⁹ Jones, Trauma and Grace, 148.

²⁰ Ibid., 138.

²¹ More so than other health problems, reproductive troubles are experienced as an attack against one's identity and sense of self. Janet Jaffe and Martha O. Diamond, mental health experts in the area of reproductive struggle, observe, “If a patient had a broken arm or had to wear glasses, his or her reaction might be: A part of me needs mending, or a part of my body is weak. The client would go about correcting the problem, without feeling like something was wrong with his or her core identity. But with a reproductive trauma, patients tend to respond with statements that encompass the entire self.” Jaffe, Janet and Diamond, Martha O., Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients (Washington, DC: American Psychological Association, 2011), 60CrossRefGoogle Scholar.

²² Jones, Trauma and Grace, 146.

²³ Ibid., 128–29.

²⁴ A potential fourth category of memorialization could focus on feminist liturgical rites aimed at commemorating pregnancy losses and supporting abortion decisions. Examples of these sorts of liturgies include rites developed by Ruether, Rosemary Radford in Women-Church: Theology and Practice of Feminist Liturgical Communities (San Francisco: Harper & Row, 1985)Google Scholar or by Diann Neu, cofounder of Water: Women's Alliance for Theology, Ethics, and Ritual, in her book Women's Rites: Feminist Liturgies for Life’s Journey (Cleveland: Pilgrim Press, 2003)Google Scholar. Both Ruether's and Neu's pregnancy-loss rites are included in books of feminist liturgies designed to honor life-changing events in women's lives (e.g., menstruation, domestic violence, menopause, divorce, widowhood), but they are not tied as explicitly to mainstream Catholic theology and practice as the other categories of memorials I address.

²⁵ This is a marked difference from Japanese Buddhist mizuko rites, which purport to effect a change in the postmortem destiny of lost prenates that helps them attain rebirth in the Pure Land. In my broader comparative project, I refer to this as “ontological efficacy” in contradistinction to the “epistemological efficacy” discussed in this article.

²⁶ International Theological Commission (ITC), “The Hope of Salvation for Infants Who Die without Being Baptized,” 2007, http://www.vatican.va/roman_curia/congregations/cfaith/cti_documents/rc_con_cfaith_doc_20070419_un-baptised-infants_en.html. Important in the document is the affirmation of God's justice and mercy, which it acknowledges are sometimes difficult to comprehend with child loss, particularly when there is worry about the eschatological fate of the infant (§2). The document assures parents who did not have the opportunity to baptize their child that “God does not demand the impossible of us” (§82), and hence, despite their child's not being sacramentally incorporated into the faith, hope for their child's redemption is not lost. Nevertheless, the ITC makes every effort to ensure that the significance of baptism is not diminished as a result of the admission that there is reason to hope that unbaptized infants will not be excluded from the promises of salvation.

²⁷ Turner, Thomas, “A Rite for Miscarriage,” Modern Liturgy 13, no. 9 (Dec. 1986/Jan. 1987): 18–19 Google Scholar.

²⁸ Ibid., 18.

²⁹ Thomas Turner, interview by author, Kansas City, MO, August 26, 2010. Turner is no longer a priest.

³⁰ Turner initially planned to have a small number of votives available, but again, the sister working at his parish warned him that he would be surprised by the number of people in attendance and by the number of losses they had experienced. In the end, he placed 100 votives there just to be safe.

³¹ Turner, “A Rite for Miscarriage,” 18.

³² Ibid.

³³ Ibid., 19.

³⁴ Ibid. According to Turner, the mass was intended as an opportunity for healing and closure, particularly for those who had never felt as though they could mourn their pregnancy losses in the past. When I asked if attending this sort of liturgy should be a onetime event or an ongoing practice, he said he thought it would only need to take place once, just like there is only one funeral for a person. At the same time, he believes liturgies of this sort should become a part of the church's regular practice so that they can be done on request (like a funeral) “instead of playing catch up” by offering communal services like the one he developed.

³⁵ I have changed the name of this priest.

³⁶ The fact that this special liturgy overlapped with the Solemnity of Mary made it difficult to discern precisely how many of those in attendance were there for the purpose of memorializing a pregnancy loss and how many were there for the holy day of obligation. My best estimate is that of the sixty-five attendees, at least half were there because of the special focus of the mass.

³⁷ When I had the chance to look at these cards after the conclusion of the mass, I found twenty-three cards placed in the basket. About half of the cards identified personal names (e.g., Thomas, Marie Ann Martin), and some even listed dates going back to the 1970s. Most of the other cards referred to specific losses but without individual names (e.g., Baby Girl Williams, Two Johnson Babies). One of the cards even listed “Anderson babies 4, 5, 6, 7, 8, 9, and 10 lost through miscarriage.” (These names been changed from those written on the original remembrance cards in order to preserve the anonymity of the memorial participants.)

³⁸ Schechner, Richard, Performance Studies: An Introduction, 2nd ed. (New York: Routledge, 2006), 42Google Scholar.

³⁹ Layne, Motherhood Lost, 3.

⁴⁰ Maria McFadden, “Holy Innocents,” Human Life Review, Spring–Summer 2000, 54.

⁴¹ Church of the Holy Innocents, “The Shrine of the Holy Innocents,” https://shrineofholyinnocents.org/. “All day long people stop to pray. On the first Monday of every month, our 12:15 p.m. Mass is celebrated in honor of these children and for the comfort of their families. We pray that you will find peace in knowing that your child(ren) will be remembered at the Shrine and honored by all who pray here.”

⁴² This is meant as a substitute for a birth certificate, which is not always issued in cases of early pregnancy loss. It serves as tangible proof of life for cases in which there are often no other physical remembrances.

⁴³ Oblates of St. Joseph, “Patron of the Unborn,” http://www.osjoseph.org/osj/patron-unborn.php. The website continues, “No one can be a better defender of the innocent, helpless life in the womb. No one is a better model of fatherhood to parents of pre-born children. No one can more fittingly aid in the process of healing and reconciliation for those who grieve and agonize over having committed the sin of abortion. No one is a better image for women who have been hurt by men unwilling to accept fatherhood of the child they engendered.”

⁴⁴ In the process of researching the Patron of the Unborn memorial, I had the opportunity to interview the lay pastoral volunteer Susan Vega, who, along with the memorial's founder, Toschi, helped run the memorial. At the time of our interview, Vega had been a volunteer at the Shrine of St. Joseph for ten years, and typically she dealt with visitors or parishioners who wished to enter a name in the Book of Life or have a stone dedicated to a lost child. She put me in contact with Toschi, whom she called “the visionary” behind the memorial. Susan Vega, phone interview by author, November 24, 2010.

⁴⁵ He also referenced statements about the destiny of those who die before birth by John Paul II and in the ITC document “The Hope of Salvation for Infants Who Die without Being Baptized.”

⁴⁶ All quotations in this paragraph are taken from the website Oblates of St. Joseph, “Patron of the Unborn,” http://www.osjoseph.org/osj/patron-unborn.php.

⁴⁷ The involvement of the Knights of Columbus in these sorts of memorials is an avenue of research I am currently pursuing.

⁴⁸ “Post-abortive women” and the even less delicate “aborted women” are terms used by postabortion healing groups to refer to women who have had abortions.

⁴⁹ Though Verchio has retired as the director of Victims of Choice, she still spends time tending the memorial, particularly its overgrown ground cover. Watching her interact with the memorial is like watching someone tinker in her home garden. She looks at it as an insider who not only enjoys it, but also sees its flaws—dead foliage here, spotty soil showing there. As we spoke about the origins and design of the monument, she was constantly bending down to pick a weed or intercept creeping ivy.

⁵⁰ Elizabeth Verchio, interview by author, June 3, 2010.

⁵¹ Elizabeth Verchio, email message to author, June 2, 2010.

⁵² Bell prefers the term “ritualization” to “ritual” because the former encompasses a wider range of social actions within its scope. That is, it does not restrict ritual activities to an autonomous category of behavior. At the same time, “ritualization” does not go so far as to imply that all activities are ritualized either. Rather, it gets at what is distinctive about particular social behaviors, especially in the minds of the actors involved. Bell, Catherine, Ritual Theory, Ritual Practice (New York: Oxford, 2009), 69–74 Google Scholar. Bell explains, “In a very preliminary sense, ritualization is a way of acting that is designed and orchestrated to distinguish and privilege what is being done in comparison to other, usually more quotidian, activities. As such, ritualization is a matter of various culturally specific strategies for setting some activities off from others, for creating and privileging a qualitative distinction between the ‘sacred’ and the ‘profane,’ and for ascribing such distinctions to realities thought to transcend the powers of human actors” (74).

⁵³ The Sisters of Life also sponsors regular postabortion retreats called “Entering Canaan” as well as monthly “Days of Prayer and Healing. ” http://www.sistersoflife.org/hope-and-healing-after-abortion.

⁵⁴ United States Conference of Catholic Bishops (USCCB), Project Rachel Ministry: A Post-Abortion Resource Manual for Priests and Project Rachel Leaders, 2009 edition, viii, http://hopeafterabortion.com/wp-content/uploads/PDFs/ProjectRachelResourceManual2015.pdf.

⁵⁵ Rachel's Vineyard Ministries, “About Us,” http://www.rachelsvineyard.org/aboutus/index.aspx.

⁵⁶ The issue of postabortion trauma is a hotly debated topic. Those working within the postabortion recovery community fervently assert the existence of postabortion syndrome, which they liken to other forms of post-traumatic stress disorder. To date, however, the mainstream psychology community has rejected identifying a specific form of postabortion trauma.

⁵⁷ Promotional materials frequently quote John Paul II's “special word to women who have had an abortion” from Evangelium Vitae: “The Church is aware of the many factors which may have influenced your decision, and she does not doubt that in many cases it was a painful and even shattering decision. The wound in your heart may not yet have healed. Certainly what happened was and remains terribly wrong. But do not give in to discouragement and do not lose hope. Try rather to understand what happened and face it honestly. If you have not already done so, give yourselves over with humility and trust to repentance. The Father of mercies is ready to give you his forgiveness and his peace in the Sacrament of Reconciliation. To the same Father and his mercy you can with sure hope entrust your child,” Pope John Paul II, On the Value and Inviolability of Human Life (Evangelium Vitae), March 25, 1995, §99, http://w2.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae.html. Pope Francis reiterated his predecessor's message in promoting forgiveness for abortion as part of his Jubilee Year of Mercy.

⁵⁸ USCCB, Project Rachel Ministry, 62.

⁵⁹ USCCB Secretariat for Pro-Life Activities, “Suggested Prayers of the Faithful for the Third Sunday of Lent,” 2011, http://www.usccb.org/about/pro-life-activities/ (no longer available).

⁶⁰ It should be noted that Rachel's Vineyard offers interdenominational retreats in addition to their Catholic retreats. In the last decade, Rachel's Vineyard has expanded its ministry internationally and now holds retreats in countries throughout North and South America, Europe, Africa, Asia, and the Caribbean.

⁶¹ Kevin Burke, “Pregnancy Loss, Sexual Trauma, and Unresolved Grief,” Rachel's Vineyard Ministries training workshop, Timonium, MD, October, 9, 2009.

⁶² “Memorial Service,” Rachel's Vineyard Ministries, last revised 2008, http://www.rachelsvineyard.org/weekend/retreats/memorial.htm.

⁶³ Theresa Burke, PhD, “Pregnancy Loss, Sexual Trauma, and Unresolved Grief,” Rachel's Vineyard Ministries training workshop, Timonium, MD, October, 9, 2009.

⁶⁴ Of course, one wants to be careful not to equate aims and outcomes with regard to the question of efficacy. For instance, a 2010 study published in the Journal of Religion & Health found that certain types of religious belief and “continued attachment” following pregnancy loss are correlated with higher levels of grief one to two years in the future. I am grateful to one of the reviewers for bringing this research to my attention. Cowchock, F. S., Lasker, J. N., Toedter, L. J., Skumanich, S. A., and Koenig, H. G., “Religious Beliefs Affect Grieving after Pregnancy Loss,” Journal of Religion & Health 49 (2010): 485–97CrossRefGoogle ScholarPubMed.

⁶⁵ Tambiah, Stanley J., “A Performative Approach to Ritual,” Proceedings of the British Academy 65 (1979): 161Google Scholar.