Among Kathy Messner's many family photo albums, the one most cherished is the thickest and saddest. It contains dozens of images of her twin baby boys, Kyle and Brian, bundled in crocheted blankets and dressed warmly in baby suits and matching caps. The twins appear to be sleeping, but they are not.
Both had been dead a few hours from a rare placental disorder when the photos were taken by hospital staff. For Messner and thousands of other parents, such photos preserve memories of brief lives and help them heal from the pain of losing a child.
For others, however, the pictures have had the opposite effect--horrifying instead of comforting.
Scott Thornton and his wife were trying to get over the death of their baby girl, Hannah, last year when they were handed a large envelope from a nurse at Fountain Valley Regional Hospital and Medical Center. Inside were several pictures of Hannah taken shortly after her death from a respiratory ailment.
"I was shocked at what I saw," said Thornton, who recently filed a lawsuit against the hospital, seeking damages for the emotional distress the photos allegedly caused. "They're haunting to look at. She's posed as a doll or a puppet. It's spooky."
The Huntington Beach couple's case, one of a handful across the country, illustrates the delicate line hospitals walk in providing such sensitive services for parents. It also sheds light on a little-known aspect of the maternity process.
Providing grieving parents with such portraits has become a routine practice at hospitals across the country and is part of a "bereavement" movement that over the last three decades has changed the way people cope with the death of a child.
"Society often says that it is morbid," said Sister Jane Marie Lamb, a nurse and founder of Share, a bereavement support group that popularized the practice. "Most of the parents, however, will tell you: 'My baby is beautiful.' They see with their hearts."
Begun in the 1970s by a group of nurses, grief counselors and clergy, post-mortem baby photography is now practiced at many Southland hospitals and thousands across the country. The American College of Obstetricians and Gynecologists recommends it in "Guidelines for Perinatal Care."
A generation ago, grieving parents were often told by medical professionals to quickly accept a child's death and "move on." By immediately trying to cut emotional ties to a dead infant, the logic went, parents could focus their energies on other children, or on having another baby.
Today, however, many hospitals and counselors tell parents that remembering the baby is healthy as well as therapeutic.
The memory of the infant should be integrated into a family's everyday life and made more tangible, they say, through photographs--images that can be shared with siblings and other relatives.
"People do not detach from those they love. They preserve the relationship with their loved ones on a symbolic or spiritual level," said Robert Neimeyer, a professor of psychology at Memphis State University and the editor of the professional journal Death Studies.
Bereavement photography dates to the 19th century, when families with the financial means commonly kept pictures of their dead children and sent them to relatives who couldn't attend the funerals. The practice faded, however, as more births took place in hospitals instead of homes.
It reemerged nearly three decades ago as part of a larger effort to provide parents with certain "rights" when a baby dies. In addition to photography, the bereavement movement urges parents to hold deceased babies and bring home mementos such as locks of hair and hand and foot prints.
In some homes, pictures of deceased babies are now as common as images of other loved ones. They appear in collages that hang in hallways, or encased in memorial plaques over fireplaces. Sometimes, parents commission artists to paint portraits based on the snapshots.
To supporters, encouraging parents to bond emotionally with their deceased children is a major advance from the past, when heavily sedated mothers sometimes never even saw the babies to whom they gave birth. In cases of stillborn deaths, especially, babies were often whisked away to hospital morgues within minutes.
Sonya Palacio, a social worker at UC Irvine Medical Center in Orange, said her 75-year-old mother, Adeline Sazueta, still mourns the stillborn baby girl she lost 50 years ago. A photograph, she said, could have provided the all-important visual record that her baby did exist, and was "whole" and "beautiful."
The nurses "put a warm, wet towel over her eyes. She never saw the baby," said Palacio. "She still grieves on her birthday."
Bereavement services are now available to most of the nation's roughly 45,000 mothers a year whose babies are either stillborn or die within a few days.
Messner, a 38-year-old Brea homemaker, said she was shocked when told that hospital staff had taken pictures of her twin baby boys shortly after they died in 1995. Initially fearful, Messner decided to open the envelope and look at the pictures after talking with a social worker and her husband. Now she considers the lovingly arranged photographs of her twin baby boys so important that she keeps the negatives locked in a safe deposit box.
"I'm so grateful to have them. The photos are my link to my babies," she said. "That they did exist. That they were truly human beings."
For the Thorntons, however, viewing the bereavement photos only deepened their loss.
Scott Thornton, 36, said neither he nor his wife had heard of the practice when they opened the envelope given them by the hospital. He said the images of their daughter Hannah were disturbing.
Born with infantile myotonic dystrophy, a respiratory ailment, Hannah Thornton endured several operations and was taken off life support after about two weeks. The Thorntons said they took many photographs of the baby when she was alive, and assumed the hospital photos were taken before Hannah's death. Instead, they instantly recognized the photos were of their dead baby.
"Nobody asked our permission," Thornton said. "Had they asked for permission, I would have said absolutely not."
Thornton said hospital workers posed the baby in front of a velvet backdrop and placed stuffed animals around her.
Hospital officials denied the allegations but declined to comment further on the lawsuit. It is the hospital's policy to receive verbal consent from parents before taking photos and to have a counselor present when parents first view them, said Tereasa Brown, the bereavement support coordinator. The legal action, she added, has prompted the hospital to further review some of its procedures.
Bereavement experts say such lawsuits are rare. But recognizing how sensitive the practice is, hospitals and the companies that provide photo processing are becoming increasingly careful in the way they handle the service.
Ideally, Lamb and other counselors say, photos should be taken after all baby deaths. Some parents initially decline to receive the photos, only to request them months or years later, she said.
As a result, many hospitals do not ask for parental consent before taking the photographs and store the images for as long as three years, Lamb said.
But more hospitals are requiring that parents give signed consent before any pictures are taken--prompted in part by complaints from shocked family members.
Several Chicago-area hospitals, for example, began requiring written parental consent after the father of a teenage girl threatened to file a suit after viewing pictures of his dead grandchild, according to Mary Frances, the bereavement services coordinator for Christ Hospital and Medical Center in Oak Lawn, Ill.
Because dead babies live forever in photos, the nurses and social workers who take the pictures say they try to capture as tasteful a scene as possible. The goal is to hide or "soften" birth defects and make babies appear like any other sleeping infant.
Typically, the baby is washed and clothed, with booties put on. Sometimes the baby is wrapped in blankets, or a cap is placed over the head. To personalize the photo, toys, teddy bears, open Bibles or other items are often laid nearby. Sometimes a rattle is placed in the baby's hand.
Some parents give their post-mortem photos prominent display in the living room.
But others are much more private about the images, knowing that many people can't comprehend that the photos are therapeutic. Many parents were initially reluctant to take the pictures for fear of being judged by others.
Stacy Smith, an Orange resident, shows pictures of her stillborn baby boy only to family members and close friends who ask to see them. She said a friend took the photographs shortly after delivery.
The images, she said, represent invaluable visual memories of the baby, who died of a chromosome disorder.
"People who don't go through something like this don't understand," she said. "To me, [the photographs] are very important. They're the only pictures I have of my child."