In Your Eyes; The Caregiver and Bereavement Photography
By Todd Hochberg

A bereft mother and father sit side by side, tenderly cradling their dead baby in their arms. A photographer, present at their request, opens and closes the shutter of his camera, capturing and infusing the energy of the moment on to a light sensitized silver-coated copper plate. One hundred and forty years after that daguerreotype was made, we can feel that couple’s grief.

Thanatologists have posited and studies have shown that photographs can be helpful for grieving parents. Photographs of babies, some with their grieving parents, are valuable emotional touchstones and mementos for many families. For the past couple of decades, hospital bereavement programs have used photography in the protocol for care of these parents.

My documentary style bereavement photographs are made after delivery, in the hospital labor and delivery area or in the neonatal intensive care unit, during the private time parents have to hold their dying or dead baby. I work to create photographs that can serve as a gentle link to memories and feelings pertaining to the precious short time spent with their baby. Working unobtrusively as a willing participant, I make images about this experience without posing or staging. Though the images typically show mom and dad with their baby, often other family and caregivers are included, and religious rituals may be performed. These significant caring relationships and rituals are important to render and I also strive to elucidate the emotional and spiritual energy in the room.

During more than five years of this work, I’ve learned from parents that the photographs facilitate their grieving by:

- making their baby’s life and death real for them--a significant issue with perinatal death and an acknowledgement so important for parents;

- validating their feelings, both at the time of their baby’s death and up to the present;

-being an affirmation of parenthood;

- providing a tangible record of their time with their baby, including cherished close-up details of their baby's physical features and evidence of loving familial bonds;

- allowing them to connect with the many feelings and memories that may have gotten lost in the torrent of overwhelming grief at the time or in the weeks since;

offering them an illustrated narrative of "their story" for themselves and the loved ones they choose to share it with, fostering greater social support and connection.

Here are some recommendations from my documentary approach to this work for caregivers who also take pictures as part of their care of grieving families. I emphasize the word “part”, as I know that picture taking for some is an item on a checklist. I suggest that this activity can be much more than a dreaded task. While many of my suggestions are tangible, others are more philosophical and as important.

When making photographs for parents as they hold their babies in their arms and hearts, my challenges are similar to those of other caregivers. We all struggle with time constraints, moving through our day with lots to accomplish. When I come to these sacred places with grieving families, I need to exclude those myriad busy thoughts and hold mindfulness for “this” moment. I must slow down and throw away expectations and judgements. I strive to be open to the emotional energy and the visual information I find in the room “now.” Only then am I prepared to make the most meaningful photographs for grieving parents. When I am successful, the images seem to make themselves. This presence brings me closer to the family; I become more engaged personally, thereby infusing the photographs with collaborative energy-- theirs and mine.
In practice, we might be reluctant to get close to these emotionally challenging situations and/or struggle with the camera; a cumbersome, technically demanding machine…read on.

Feeling in the moment
Consider what happens when parents attend their child’s school play. When the child appears on stage, the impulse and likely response is to bring camera up to one’s face and capture this beautiful, momentous milestone. I believe that for most of us, we lose the precious emotional content of that time. The camera can isolate us from significant experiences. We certainly want to record these events but are often lost in the “doing” of picture taking and so we do not really experience for ourselves a presence in these moments before committing them to posterity.
With grieving families, when you take the time and devote emotional energy to being present and to seeing fully, you can more effectively and completely record these significant moments. You likely already have a trusting relationship but spend some time connecting (needn’t be verbal) with the family before and while using the camera. This devotion of energy enables us to collaborate with families to make more meaningful images.

Making pictures, telling a truth
Because I am primarily there for support, I do not engage parents with the camera-- no posing or directing in any way. I do not use electronic flash, but use high-speed black and white film to accommodate the low light situations I often encounter. I intend my photographs to be not only about the baby but also about parents’ and caregivers’ relationships to the baby and each other. These are the images that parents respond to most favorably. I want the images to be touchstones for memories and feelings that parents can later come to and reconnect with their baby’s life and their loss. This documentary approach results in a truthful telling of parents’ stories through the photographs. Yet it will always be a subjective truth-- photography is a powerful medium this way. There is no absolute truth. The truth presented in a photograph is influenced by many factors;

- The photographer’s own emotional history and worldview

- Camera perspective (lens choice, angle of view, position relative to subject)

- Point in time

The viewer of the photograph adds yet another layer of influence on the perceived truth.
So, all the more reason to be in league with both your own and parents’ feelings in order to tell a truth that reflects and supports parents in their grief.


Process it…not just the film!
Whether you are using a 35mm film or digital camera, a point-and-shoot or a SLR the following concepts apply. I do not recommend using Polaroid cameras except as in addition to 35mm or digital as it’s image quality is inferior, is not reproducible and will only last a few years. However, Polaroid offers immediacy, an assurance that you have an image and that parents will leave the hospital with a photograph.

For specifics on focus range and flash usage consult your owner’s manual as these vary among cameras.

- Consider making black and white (B&W) photographs; B&W lends a special quality to these cherished moments revealing the elemental aspects of the experience more effectively than color film, Additionally, many of these babies have discoloration or bruising; color film often accentuates these qualities. Kodak makes a B&W film that is processed the same as other 35mm color negative films at your standard photo-processing lab. It is called B&W + 400 –BWC 135-24.

- Photograph in as much light as possible, being mindful that parents often prefer to keep lighting low during these intimate times. The ISO 400 film I recommend will allow you to shoot in low light, perhaps even without flash, a real plus when our goal is to be supportive not intrusive.

- Get closer! The focus range of most point-and-shoot cameras starts at 2-3 feet, so you may get this close. Providing you’ve spoken with parents about photographs, move in closer for some pictures. Parents trust you in your role as caregiver by this point and are focused on their baby and their grief. Vanity is not a factor so don’t fret about hair, clothes or tears. These pictures are about their love!

- Vary your perspective. Move slowly through the room, finding vantage points that speak to what you feel is important moment by moment. For instance, the best position may be on the floor shooting up.

- Look for that which is not obvious; an embrace from behind, a baby’s gown lying on the bed. These may hold subtle metaphoric meaning for parents.

Always keep awareness of self and sensitivity to parents’ emotional and physical space. As each situation is unique, be ready to adapt.

Giving it away / Getting it back
My first experience making photographs for grieving parents was six years ago when, after a discussion about making memorial portraits, I accompanied a chaplain friend on a visit with a couple in the NICU whose baby was dying. We offered that I might make photographs for them, they consented, and I returned minutes later with my camera. It was very quiet and I felt a heavy energy in the room. I was fearful, sitting with much unknowing. I witnessed an unfolding of a story of love and loss that was larger than I could hold, indeed larger than the room could hold. I felt reverence and honor for the privilege of being invited to this sacred place. I carry this same sense of awe with me each time I am with babies and their grieving families. Recently I attended the wake and funeral of a stillborn baby. In the open casket, set beside this boy, was one of my 8x10 photographs taken in the hospital; parents and two siblings holding baby James. This photograph was buried with James. I am grateful that I am able to offer help toward healing through grief with my photographs. Yet I am very clear, as many caregivers will agree, that what I receive in trust and connection with families far outweighs all that I can give them.

Bereavement photographs play a significant role in helping parents grieve and heal. As time passes, the images enable parents to hold onto precious memories even as they move forward in their lives. Photographs also help parents find the treasure in their adversity. They are an affirmation of these beloved babies’ lives, and held dear by bereaved parents.

To see some of Hochberg’s photographs and for more information go to www.toddhochberg.com

Todd Hochberg is the Creative Team Lead-Photography for Advocate Health Care in Chicago, IL. He has contributed to the bereavement program at Advocate Lutheran General Hospital for the past 6 years making photographs for parents experiencing perinatal loss, as they say goodbye to their babies. Hochberg brings his 19 years of photographic experience in health care at LGH to this work. His bereavement photographs are part of the permanent collection of the George Eastman House International Museum of Photography. He has received an International Center of Photography Infinity Award nomination for 2001 and was a finalist in the W. Eugene Smith Grant Competition in Humanistic Photography for 2003. His bereavement work has been featured in Life magazine, Photo District News, the Chicago Sun-Times, the Santa Fe Center for Photography web journal and the Association for Death Education and Counseling’s journal The Forum. Todd presents to a variety of groups nationally and locally.