Caring Through Cloth: Textiles and the Trauma of Stillbirth

Abstract

The Caring through Cloth project links rituals of sensing, caregiving, and making with baby clothes and related textiles to adaptive coping in stillbirth loss. Stillbirth is traumatic because it (a) disrupts the natural order of life, (b) is an ambiguous loss, leaving little tangible evidence to validate or narrate it, (c) is a cultural taboo and stigma, disenfranchizing loss, personhood and parenthood and (d) can lead to complicated grief. As such mourning stillbirth is challenging both psychologically and socially. Blankets, baby clothes and soft toys feature in clinically based stillbirth rituals which promote physical contact, caregiving, and memory making. Textiles form part of memory boxes and are often used to assist personal rituals. Arts projects and charities gift or support the making of textile objects to aid those who grieve. Despite this, there is limited analysis of the significance of textiles to mourning stillbirth and little exposition of the theories of meaning which are employed. This study adopts a psychobiological understanding of art and uses Dissanayake’s Artification Hypothesis and Gibson’s theory of Affordance, to examine the role textiles play in mourning stillbirth. This paper (a) reviews literature and contextual sources and (b) uses auto and sensory ethnography to investigate the relationship between textiles and mourning stillbirth. It identifies that baby clothes and related textiles afford rituals of sensing, caregiving and making that can be used to artify and express, through analogy, the needs and cares of parents who have experienced stillbirth. These initial findings have informed the design of a Caring through Cloth workshop, which seeks to support parents in their adaptive coping and collect qualitative data to further assess the adaptive significance of sensing, interacting and making with textiles in arts-based activities.

Keywords:

• textiles
• trauma
• stillbirth
• mourning
• ritual
• artification
• adaptive coping

Introduction: The Caring Through Cloth Project

The Caring through Cloth project links rituals of sensing, caregiving and making, with baby clothes and related textiles to adaptive coping in stillbirth loss. Stillbirth, defined as the birth of an infant that has died in the womb, typically born near or at term with no signs of life (Thornhill 2019), accounts for one in every two hundred births. It is a traumatic event, an ambiguous loss (Cacciatore, DeFrain, and Jones 2008) and a cultural taboo (Brierley-Jones et al. 2014; de Bernis et al. 2016). It disenfranchizes the personhood of the child, the status of parent, it silences, shames, and presents significant psychological and social challenges to mourning (Human et al. 2014; Brierley-Jones et al. 2014; Golan and Leichtentritt 2016). The Caring through Cloth project is informed by psychobiology and understands art as an adaptive, ritualized behavior (Dissanayake 2000, 2009, 2017, 2018a, 2018b). It is through this lens that the significance of ritualized interactions with cloth, in supporting those who mourn stillbirth, are examined.

In Section 1, this paper critically reviews relevant literature and contextual sources that discuss textile-based rituals that adaptively support parents who have experienced perinatal loss. Textiles used in clinical, post clinical and arts-based rituals are identified as (a) affording behaviors of touch, sentient experience, caregiving and making and (b) promoting adaptive coping through artifying, making salient and using analogy to express care and need in relation to perinatal loss.

In Section 2, the researcher Lisa Porch, a bereaved parent of stillbirth loss, undertook three exploratory auto and sensory ethnographies based on sensing, interacting, and making with baby clothes, muslin cloths and talc powder (maize starch) to support her adaptive wellbeing. It was found that these interactions afforded touch and sensory engagement, allowed for an exploration of proximity and contact, invited caregiving behaviors, supported remembrance, imaginative thinking, memory creation, meaning making and a reflection on lived experience in relation to the larger social and cultural context of perinatal loss. They gave the researcher a way to artify and express their care and need in relation to their experience of stillbirth using analogy. These early stage autoethnographic studies have informed the design of a Caring through Cloth workshop which responds to the lack of post-clinical stillbirth care interventions. The workshop sets out to assess the role sensing, interacting and making with textiles in arts-based workshops can play in supporting parents in their adaptive coping.

Materials and Methods

Section 1: Literature and Contextual Review

Textiles and Stillbirth: Afforded Touch, Sentient Experience, Caregiving and Making

This review examines literature and contextual sources within the fields of clinical practice, material culture studies, arts and health projects, and autoethnography that reference textiles in stillbirth rituals. The review identifies blankets, baby clothes, soft toys and healing art (textile) objects, used in clinical, post clinical and arts-based stillbirth rituals, afford behaviors of touching, sensing, caregiving and making. These behaviors present themselves as prime means of affirming personhood and expressing parenthood and bonds and as such support adaptive coping in perinatal loss.

In clinically based stillbirth rituals, holding and caregiving are often afforded by textiles. As part of The National Bereavement Care Pathway (NBCP 2020) care standards, parents are given informed choices about seeing and caring for their child and offered opportunities to make memories. These caring and memory making opportunities include parents holding, swaddling, touching, having physical contact, washing, and dressing their child. Blankets (Memory box | Sands - Stillbirth and neonatal death charity) and infant wrapping cloths (Nordström 2016) are used to afford and legitimize touch, physical contact, and intimacy. Touch and caregiving assert the stillborn child as an “individual to be loved and mourned” (Thornton 2019, 240) and baby clothes that are bought, made and gifted (The Still Remembered Project; Remembering Baby Reed, Whitby, and Ellis 2018; Amulet project, Marie Brett 2011) afford dressing rituals that index and draw attention (Iversen 2012) to the personhood of the child and the care of the parent. Textiles present themselves in the clinical setting as affording behaviors that can be used to support adaptive coping.

In post clinical stillbirth rituals, some parents use baby clothes, soft toys and textile material culture related to baby loss (Layne 2000; https://www.sands.org.uk/support-you/how-we-offer-support/memory-box; Molly Bears - Home; Project B.E.A.R. - Bringing Empty Arms Reprieve projectbear.com) to express and meet their need to touch, hold, sentient experience, perform caregiving behaviors and mitigate the “realness problem” and ambiguity of perinatal loss (Layne 2000, 321). To ease the pain of empty arms, Fiona Crack, Stillbirth: I am a mother without a baby—BBC News holds and embraces a cuddly toy, acknowledging, “My arms ached. I thought I had a blood clot, but the doctors told me it was normal - a biological response to the shock that there was no living child for me to hold.” Layne (2000, 339) says, “the physical, sensual aspects of mothering are sorely missed” in perinatal loss and “the sensual qualities of things” play a critical role in articulating and mourning this “lack.” Layne (2000, 324, 329) proposes that blankets, baby clothes, stuffed textile toys and quilted bedding share the affordances and homologies of “soft skin” and the “undeveloped musculature” body of babies and as such are “touched, held, caressed, hugged and gazed upon…cleaned, protected and displayed.” For some parents, textiles in the post clinical setting present themselves as affording behaviors that can support adaptive coping.

The review identifies a small number of textile arts-based rituals in which parents (a) make a healing art object with textiles and (b) interact with it to promote adaptive coping in perinatal loss. Through making and interacting with textiles the behaviors of touch, sentient experience, caregiving, care-full interaction, handling and manipulating materials, processes and artifacts, are afforded. In the Amulet project, the making and using of textile amulets in a hospital maternity setting were seen to support parents who had experienced bereavement and loss at various stages of pregnancy (Brett 2011). In the Sewing Comfort out of Grief project, Alden (2000, 43) made a perinatal loss grieving bag containing a fabric placenta, a tiny cloth baby and healing herbs to soothe and comfort, recognizing that, “Grief is easier to heal from with something to hold onto, look at and shed tears over.” Alden (2000) describes making the bags as a healing process which used the temporal, repetitive, meditative act of stitching to help sew comfort out of grief. In wearing the cloth baby next to her skin, naming, kissing, cuddling, protecting, and crying over it, the grieving bag afforded her sentient experience and caregiving behaviors that expressed her needs in relation to her loss. Alden (2000, 43) made and gifted similar artifacts to other bereaved mothers to “validate their pain” and provide “a tool to help them grieve.” Seftel (2006) identifies the therapeutic value of making and engaging with a healing art object, suggesting parents make a small textile pillow filled with herbs, sand, rice, a prayer, or poem to promote adaptive coping. As such, textiles used in arts-based rituals also present themselves as affording behaviors that can be used to support adaptive coping in perinatal loss.

In essence, textiles affordances: the things they allow bereaved parents to do and the behaviors they invite them to perform to meet their individual needs (Gibson 1979) can be seen to support adaptive coping in stillbirth rituals. Dissanayake (2018b, 96) describes affordance as “signs—things in our environment that contribute to our survival” that “usually have biological significance.” Nordström (2016, 146) in recognizing the significance of “what we do with our hands, and what the textile can do for us” identifies the relevance of textile affordances in perinatal loss rituals.

Textiles and Stillbirth: Artified Touch, Sentient Experience, Caregiving and Making

The ritual context in which the afforded textile behaviors of touch, caregiving and making take place, is key to understanding their adaptive significance. Perinatal loss rituals are widely acknowledged as meaningful, adaptive and able to promote “posttraumatic growth” (Cacciatore and Flint 2012, 158; Brin 2004; Seftel 2006, National Bereavement Care Pathway NBCP 2020). Arts-based activities including (a) perinatal loss participatory arts workshops and projects (Keena 2008; Brett 2011, 2013; Rice et al. 2019; Reed, Whitby, and Ellis 2018; STILL PARENTS | manchester-sands), (b) stillbirth autoethnographies that reference making (Foott 2017; Phillips and Foott 2017; Weaver-Hightower 2012) and (c) stillbirth arts therapy research studies (Speert 1992; Seftel 2006; Beaumont 2013) are also recognized as meaningful and adaptive. Despite its potential to explain how afforded behaviors with cloth are adaptive and meaningful in relation to stillbirth loss, artification (Dissanayake 2009, 2017, 2018a, 2018b) as ritualized behavior does not feature in the literature.

Artification, is understood as an adaptive human behavior which uses the multi-modal, rhythmic, temporal behaviors/esthetic operations of formalization, repetition, exaggeration, elaboration, and manipulation of expectation to express care and need through analogy (Dissanayake 2009, 2017, 2018a, 2018b). It uses “ordinary” behaviors and makes them “extraordinary” through ritualizing them (Dissanayake 2009, 2017, 2018a, 2018b). Ritualized sensing, touching and caregiving in stillbirth rituals present themselves as analogous signs, “correlative to” and “indexical” of (Dissanayake 2018b, 105) the need to sense, touch and give care. Nordström (2016, 146) alludes to the significance of analogy in describing how the familiar, everyday textile afforded behaviors of wrapping, dressing, covering, and folding are brought to the unfamiliar and difficult experience of death to make it real and tangible. Artification allows us to consider the performative temporal behaviors of touch, sentient experience, caregiving and making afforded by cloth in all stillbirth rituals (clinical, post-clinical and arts-based) as psychobiological artifications. Artification as an analogous, ritualized, embodied, behavioral expression has relevance to stillbirth loss which is (a) difficult to express in words, (b) limited by social stigma and taboo and (c) challenging to express if psychologically complicated, fragmented, dissociated, pre-narrative and unintegrated due to the trauma of the loss (Neimeyer, Prigerson, and Davies 2002; Van der Kolk and Van der Hart 1991).

Through artifying (ritualizing) behavior it is made salient and memorable (Dissanayake 2009, 2017, 2018a, 2018b): memory-making being a key adaptive purpose of stillbirth rituals. The behaviors of touch, caregiving and making (afforded by textiles) in stillbirth rituals are made memorable and salient through artification (ritualization). Memory making rituals are part of good bereavement care (NBCP 2020) and missed opportunities to make them are often grieved (Thornton 2019). Whilst clinically based stillbirth memory making rituals are time sensitive, new rituals and memories are often afforded in the post-clinical setting through consumption practices (Weaver-Hightower 2012, 476; Layne 2000, 339) memorial practices (Memory box | Sands—Stillbirth and neonatal death charity) and notably through arts-based activities (Weaver-Hightower 2012; Reed, Whitby, and Ellis 2018; STILL PARENTS | manchester-sands).

Described as a “bereavement support tool” in perinatal loss, art-based activities support memory making, continued bonds, integrating loss (Reed, Whitby, and Ellis 2018), meaning making, sensory engagement and making tangible (Phillips and Foott 2017). Whilst literature connects textile-crafts to positive wellbeing, adaptive coping, flow, mastery and control (Reynolds 2004) mental and physical fulfillment, social interaction and belonging, self-esteem, learning and growth, (Kenning 2015) esthetic and sensory pleasure, repetition and rhythm, coping through doing (Futterman Collier 2011) and art therapy for trauma (Garlock 2016), little is known of how textiles in arts-based activities adaptively support parents despite their significance and affordance in stillbirth rituals.

Artification, in signifying through “analogy” and “presymbolic, affect-laden, proto-aesthetic operations,” (Dissanayake 2018, 13 and 24) differs from a principally symbolic understanding of stillbirth rituals (Cacciatore and Flint 2012; Brin 2004) and arts-based rituals (Seftel 2006, Malchiodi 2002, Phillips and Foott 2017; Brett 2011, 2013). It also differs from The Green Room Project (Keena 2008) which uses the psychoanalytical writings of Kristeva to explore the maternal body as a language to articulate the embodied grief of baby loss. Whilst Keena (2008) like Dissanayake (2000) sees art as a behavior rather than an object, the project’s therapeutic value is seen as “real but…incidental” whereas in artification, adaption is the goal of the artified human behavior and is linked to arts, health and therapy (Bye 2012). Whilst many of the perinatal loss rituals identified in this review are considered symbolic, they have the potential to be understood as analogous. The “tactile language” and expressed “tactile care” afforded by Nordström’s (2016, 151) infant wrapping cloths whilst theorized by Hemmings (2018) as symbolic, could be understood as cloth affording the ritualized (artified) behavior of touch to express through analogy the needs and cares of the parent who has experienced perinatal loss. The behaviors of making and interacting with healing art objects (Alden 2000: Seftel 2006) whilst understood as symbolic, warrants consideration as behaviors that are afforded, ritualized, artifed and analogous.

Dissanayake (2004, 70) claims that the physical and emotional components of ritual behavior are present in craft and making and that artification (making special) can meet psychobiological need (Dissanayake 2000). In the Caring through Cloth project artification as an arts-based activity is considered in context to the adaptive needs of parents who have experienced stillbirth loss. In exploring Dissanayake’s (2000, 2018b) claim that mutuality is needed for subjective wellbeing, the Caring through Cloth project considers if textile affordances and sensory, interactive engagement with cloth can be used to artify through analogy the need of continued emotional bonds in perinatal loss. In identifying belonging as an adaptive need (Dissanayake 2000, 2009, 2017, 2018b), the social acknowledgment of personhood and parenthood in stillbirth loss and the need to share and integrate loss with others is seen. The adaptive need to make meaning and structure and story experiences and events (Dissanayake 2000) is evident in stillbirth mourning and explored in the Caring through Cloth project through artification and analogy. In identifying the significance of hands-on competence to adaptive wellbeing (Dissanayake 2000), the Caring through Cloth project explores the role sensing, making, and engaging with baby clothes and related textiles may play. In using textile-based arts activities to adaptively support expressions of care and need in relation to stillbirth loss the Caring through Cloth project applies Dissanayake’s (2000, 2017, 2018a, 2018b) thesis of the adaptive psychobiological significance of expressing and making salient our cares and needs. As such, it is the adaptive value of crafting, making, engaging and artifying with textiles by parents who have experienced perinatal loss that is of interest to this study. Consequently, the second half of this article uses sensory and auto ethnography as practice-based research to explore how the textile- afforded behaviors of sensing, touching, caregiving and making may support artification, analogy and an adaptive expression of care and need in relation to stillbirth loss.

Section 2: Auto and Sensory Ethnography

Textiles, Stillbirth and Auto and Sensory Ethnography

In the literature and contextual review (section 1) the themes of affordance, artification, and analogy present themselves as potential ways to understand the significance of textiles in mourning stillbirth loss. In response to these identified themes, I (the researcher, Lisa Porch, a bereaved parent of stillbirth loss) undertook three early-stage research, auto and sensory ethnographies. I used these to examine my personal experience of sensing, interacting and making with baby clothes, muslin cloths and talc powder (maize starch) and reflected on how these connected to my autobiographic experience of stillbirth loss, mourning and adaptive coping and the larger cultural themes and theories arising from the literature and contextual review.

Chang (2008, 43) describes autoethnography as a research method that uses personal lived experience and autobiographical data and engages in a cultural analysis and interpretation of it. Davidson (2011), Weaver-Hightower (2012) and Sell-Smith and Lax (2015) employ autoethnography as a research method to study perinatal loss. They draw upon their personal experience and provide insider accounts and data that more traditional research methods struggle to capture (Adams, Ellis and Stacy Holman 2017). They humanize the research, give the reader a sense of what the experience of stillbirth loss feels like and create and present knowledge in a way that is accessible to wider audiences. Chang (2008, 53) claims that autoethnographies can transform both the reader and the researcher and bring about self-reflection, cultural awareness and be a therapeutic process. Indeed Weaver-Hightower (2012, 464) describes his autoethnography of a father’s experience of stillbirth as “an attempt at healing.”

Autoethnography recognizes the value of the subjective, evocative, affective, and embodied experience and uses reflexive, analytical methods to explore and understand these. It connects personal research findings to larger social contexts, cultural themes and relevant research data and theories. As such, autoethnographic accounts written by bereaved parent researchers use individual lived experience to provide insight into the sociocultural phenomena of stillbirth loss. In recognizing that memories of stillbirth loss are often embodied, felt, and sensed (Davidson 2011), the relevance of sensory ethnography is also seen. Pink, (2015) describes sensory ethnography as a self-conscious, reflexive attending to sensory practice, emplaced experiencing and an interpretation of its cultural and biographical meanings. Pink (2015) also identifies the connections between arts practice and sensory ethnography which are relevant to this study which explores sensing, interacting, and making with textiles as ways in which artified, adaptive expressions of care and need can be afforded.

In undertaking the auto and sensory ethnographies, I explored the autobiographical meanings of touch, sentient experiencing, handling, interacting with and making with baby clothes, nursing cloths, needle, thread, and talc powder (maize powder). In the first study (Figure 1), I stitched (4 cm × 3 cm) oval shaped fabric bags, filled them with scented baby talc powder (maize starch) and placed them inside baby’s booties, socks, and scratch mittens. In the second study (Figure 2), I placed a larger talc bag onto a baby’s vest, then folded the vest around it, stitching the folds into place to encase the bag inside. In the third study (Figure 3), I repeated the process used in the second study, then pleated a muslin nursing cloth and stitched it to the folded vest so that it hung and draped freely. To the hem of the muslin cloth, I stitched a pair of baby scratch mittens. I interacted with all the textile objects I made.

Figure 1 Lisa Porch holding and cradling a pair of baby’s booties which contain talc (maize starch) filled bags. Photo credit: Oliver Cameron-Swan.

Figure 2 Baby’s vests wrapped, folded, and stitched to encase fabric bags of baby talc powder (maize starch). Photo credit: Oliver Cameron-Swan.

Figure 3 Baby’s vests wrapped and folded to encase talc (maize starch) filled fabric bags with pleated muslin nursing cloths added, one of which has a pair of baby mittens stitched to the hem. Photo credit: Oliver Cameron-Swan.

In handling and sensory experiencing baby clothes and muslin nursing cloths I drew upon the meanings of touch as “sign (seme) and sensation” (Cranny-Francis 2011, 463) to afford and artify my needs in relation to my experience of stillbirth loss. Cranny-Francis (2011) recognizes that touch helps us understand the world and our embodied subjectivity. As I examined and touched the vest and its features (sleeves, neckline, seams, bound edges…), I remembered, lamented and artified not having seen or examined my child’s undressed body; too scared to look or ask. Brierley-Jones et al. (2014, 15) found that mothers of stillborn babies feel they should know “…their babies in their entirety, knowing them physically, their whole body” and regret missed opportunities to do this. In turning the folded and stitched vest object in my hand, I examined it from different angles, traced its folded edges with my finger and used the palm of my hand to search for maximum surface contact and sensation. I was conscious of the gaps, spaces, and points of connection between it and the skin surface of my hand. My need to touch and experience contiguity with my child was expressed through the analogy of my sentient engagement with the made textile object. In affording touch, the baby clothes, muslin cloths and the textile objects allowed me to reflect on and emplace my embodied and autobiographical past experience of touch in stillbirth loss, into the present (Casey 1987, 194). It also prompted my reflection on the larger social and cultural significance of touch in experiences of stillbirth loss: the perceived rules of touch, the fear to touch, the temporality of physical contact, the use of touch to mitigate ambiguity, the role of touch in remembering personhood and parenthood and the way sentient experience connects physical touch to emotional expression and bonds.

In touching the baby clothes and made objects I experienced physical proximity and used this as an analogy to artify and mourn my lack of physical proximity and need of skin-on-skin contact with my child. Physical proximity is important to attachment, intimacy, and emotional bonds (Bowlby 1980), and touch “positions” emplaces, and provides an embodied, temporal experience, (Cranny-Francis 2011, 26–28) which mitigates ambiguity. In the auto and sensory ethnographies, I used the process of making to create proximity: I curled my fingers around the folded vest to embrace, secure contact and hold in position to stitch (Figure 4). I examined the size and scale of the made objects in relation to my own body and playfully explored how I could position, place, hold, embrace, nestle and achieve proximity to them as an analogy for my lack and need of physical and emotional connection with my child. I held the made objects in my hand, tucked them between my chin and chest, cradled them in my arms, draped them across my lap, used strips of cloth to bandage and bind them to my body, hid them in pockets, looked for contours and spaces they could occupy, pressed my face into them, and stroked and rubbed them against my skin (Figures 5–7). In reflecting on the larger cultural context of proximity (touching, holding, interacting with, keeping close and having skin to skin contact) in clinical and post clinical stillbirth rituals, proximity is used to construct physical and emotional bonds, mitigate the ambiguity of loss and promote adaptive coping.

Figure 4 Lisa Porch holding and stitching the folded baby’s vest. Photo credit: Oliver Cameron-Swan.

Figure 5 Lisa Porch holding, embracing, and cradling the made object. Photo credit: Oliver Cameron-Swan.

Figure 6 Lisa Porch holding, positioning, touching, and looking at the made object. Photo credit: Oliver Cameron-Swan.

Figure 7 Lisa Porch holding, draping, cradling, and looking at the made object. Photo credit: Oliver Cameron-Swan.

In making talc (maize starch) filled bags to place inside the made objects, the talc increased my sensory experience and afforded meaningful sensations and signs. The talc was immersive in its smell and my physical experiencing of it. I rubbed it onto my skin and observed how my clothes absorbed it. It created associations with caregiving and imagined experiences of powdering a bathed, baby’s body. Mourning the loss of future potential of a stillborn child and parenthood is described by Lewis (1979) as normal and finds expression through rituals. The smell of the talc comforted and soothed me like Alden’s grieving bags, that were filled with healing herbs. Fuller and Kuberska (2020) explains how the metonymic power of smell, held within a babygro that dressed a stillborn child, was lost and mourned through the unsolicited laundering of it; the link between sensing, knowing, and feeling made clear and exampled through smell.

In sensing, interacting, and making with the baby clothes I was aware of the shared homologies of (a) cloth and skin, (b) baby clothes/made object and a baby’s body and (c) puffed talc and breathe. I drew upon these homologies to express, through analogy, my needs and cares in relation to my experience of stillbirth loss. Layne (2000, 324) says bereaved parents of baby loss use the “physical and evocative homologies” of baby clothes and babyhood to construct the real social identities of personhood and parenthood. In the auto and sensory ethnographies, I was aware of how homology emphasized the absence of the real and created an analogy of need which prompted artification.

I identified the homology of the soft, new baby’s vest and a newborn baby’s skin without wrinkle or blemish to artify my need and longed for, imagined experience of touching such skin. My lived experience was different, my child’s skin was unstable, easily damaged and I was scared to touch and cause further hurt and pain. In smoothing and rubbing the textile made objects against my own skin I found a way to artify my need of skin-on-skin contact and remembered how I had longed for this physical contact as a primal need. In sensing the cool cloth against my warm skin, skin and cloth became differentiated through temperature and I was aware of how the borrowed heat of my own body had warmed that of my child.

In interacting with the baby clothes and made objects I was aware of the homologies they shared with a baby’s body in terms of form, size, scale, weight, stillness and movement. I used these homologies as analogies to artify my needs. The transformation of the empty unworn baby vests into folded vests filled with talc to create physical objects expressed my need to tangibly experience my child. This same need was also expressed through my engagements with the talc filled booties whose weight I felt in the palm of my hand. Côté-Arsenault (2003, 29) identifies the need of bereaved parents of perinatal loss to have “something to touch, to see, or to hang on to.” In folding the vest and stitching the folds into position to create the made objects, the homology of the unborn child in its fetal folded form, holding life and natal potential, not yet uncurled or stretched to embrace the world is artified. In the same act of stitching and folding, I artify through analogy, my own embodied mourning, folding my traumatized body in and on itself in a fetal position to maximize skin on skin contact, to comfort and sense that I am still alive. In perceiving the talc bag, sitting silently still, no wriggling or moving, and folding the vests to create a sense of movement and gesture, I use the homology of movement or lack of movement as an analogy to express my need of a living child. Through the homology of talc, exhaled into fabric bags, I artify through analogy, the absence of the first breath in stillbirth.

Through playful, improvised interactions I explored and responded to the affordance of baby clothes and the made objects to meet my need to interact with my child and artify my “proclivity to care for and parent…despite…[my] baby’s corporeal absence” (Jones 2020, 68). I walked the booties across the palm of my hand, bounced them up and down and held and squeezed hands with the talc filled mittens. I tested the capacity of the nursing cloth to be draped, cradled, and rocked. I responded to the affordance of the talc filled, folded vest to be handled, held, hugged, and smelt. I used temporal, rhythmic, and modal esthetic operations, repeating, exaggerating, and formalizing caregiving behaviors such as holding, cradling, rocking, hugging, and stroking to artify, adaptively cope, make salient, express, and mourn the unfulfilled potential and need to care for my child. Caregiving was also expressed through making which employed careful, neat, and precise stitching, fed cloth carefully onto the needle and assisted gathers to lay flat. Dissanayake (2000, 126; 2009, 2017) suggests that making allows for “engagement with the real world,” provides a way of knowing through using our hands and body and promotes an adaptive sense of competence and control. Making as artification assists meaning making and an expression of need and care (Dissanayake 2000). Making afforded me artification and an adaptive means of coping.

The sentient experience and caregiving behaviors afforded through my interactions with baby clothes were meaningful, connected to my lived experience, memories, and imaginings, and I used these to artify and express my needs and cares in relation to my experience of stillbirth loss. Seremetaki (1994, 7) describes sensory memory as a bringing the past into the present as a transformative, natal event. Sensory memories of contact and caregiving were remembered through new engagements with cloth. These engagements were made salient through artification and produced new memories, continued bonds and allowed me to express my parenthood. As well as sensory memory, sensory ethnography draws upon embodied experience and sensory imagination (Pink 2015, 120) which can in stillbirth loss, allow the loss of future potential to be reflected upon. In emplacing sensory and caregiving memories and imaginings in context to interacting and making with baby clothes, the potential to artify care and need in relation to experiences of stillbirth loss is explored.

The autoethnographies afforded me the time and space to explore, remember, be present to and reflect on my experience of stillbirth loss. However, in addition to this they provided an opportunity to explore imagined experience and create new memories through making and interacting with baby clothes and the made objects. The affordance of textiles and my afforded interactions with the baby clothes supported physical contact, touch, sentient experience, proximity and caregiving behaviors. These were meaningful as they connected to my needs and cares in relation to my experience of stillbirth loss and I used them to artify and express these needs and cares through analogy. As such, affordance, artification and analogy were significant ways of promoting adaptive wellbeing in the auto and sensory ethnographies.

Results and Discussion

The main results from the literature and contextual review and the auto and sensory ethnographies were the recognition of the importance of affordance, artification, and analogy to adaptive coping in stillbirth loss.

Adaptive Coping: Affordance, Artification and Analogy

Whilst baby clothes, blankets, soft toys and healing art objects made from textiles feature in clinical, post-clinical and arts-based stillbirth rituals and several studies connect textile-crafts to positive wellbeing, few have examined how textile affordances are relevant to adaptive coping in perinatal loss. Baby clothes, muslin nursing cloths and talc powder (maize starch) afforded the researcher a range of adaptive behaviors (touch, sentient experience, proximity, contact and caregiving) that were used to artify and express through analogy their needs and cares in relation to stillbirth loss. By understanding that all these afforded behaviors with cloth (not just touch) operate as physical sensation and sign (Cranny-Francis 2011), the researcher became aware of their meaning, significance, and analogous potential. In the researcher’s auto and sensory ethnographies, it was apparent that artification took place (a) throughout the making process, as playful, intuitive, and interactive engagements with material affordances were tested and explored to meet adaptive need and (b) in interacting with the made objects. Textiles in affording behaviors of sensing, caregiving and making, served to support memory retrieval, new memory creation, imagined experience and reflection on lived experience and the social and cultural phenomenon of perinatal loss. Through the affordances of cloth and the homology of baby clothes and babies’ bodies, the researcher was made present to the absence of their stillborn child, and this created an analogy of need which prompted artification.

Whilst artification (Dissanayake 2009, 2017, 2018a, 2018b) does not feature in the literature linked to stillbirth, by recognizing that behaviors can be ritualized (artified) to express care and need, a psychobiological understanding of stillbirth rituals presents itself. Whilst the adaptive value of stillbirth clinical and post clinical rituals that employ textiles is recognized, the potential of textile arts-based activities to support artified and adaptive expressions of care and need warrants further investigation. In recognizing the need to integrate loss both psychologically and socially (Gilles and Neimeyer 2006; Neimeyer, Prigerson and Davies. 2002) the value of embedding sensing, interacting and making with baby clothes (as explored in the auto and sensory ethnographies) into textile-based arts workshops where artified, personal and unique expressions of care and need can be shared in a collective setting with others, recommends itself.

The Caring Through Cloth Project: An Ongoing Study

This study is on-going, the initial findings suggest that baby clothes and related textiles afford behaviors of sensing, caregiving and making which are used by some parents of perinatal loss to artify (ritualize) and express through analogy, their needs and cares and as such support adaptive coping. If this is the case, the research has potential to (a) support parents who have experienced stillbirth in their adaptive coping (b) illuminate the adaptive role textile afforded behaviors play in the clinical, post clinical and arts-based rituals and (c) inform post-clinical care inventions and provision. Whilst the auto and sensory ethnographies in the study focus on stillbirth, the Caring through Cloth workshops may have a broader application to perinatal loss.

The Caring through Cloth workshop is this study’s proposed means of further investigating the adaptive significance of textile afforded behaviors in arts-based stillbirth rituals. The auto and sensory ethnographies which inform this study to date were undertaken by the researcher Lisa Porch who is a textile artist with a particular interest and sensitivity to textiles. The data collected from the auto and sensory ethnographies record her own personal experience of using textiles to adaptively cope with stillbirth loss. However, it is acknowledged that mourning and adaptive coping in stillbirth loss is individual, personal, and unique, therefore until qualitative data is collected from workshop participants, the claims of the study remain limited to the researcher’s auto-ethnographies.

Whilst the workshop has been granted ethics approval from Cardiff Metropolitan University Ethics Board, will be piloted with the Co-Chair of Manchester Sands, and will only be run with a trained Sands befriender present, there continues to be an awareness of the care needed around inviting bereaved parents to engage in a sensory and interactive experiencing of textiles to support an emotional expression of care. Care and transparency are needed in presenting the Caring the Cloth workshop as an arts-based workshop that seeks to promote adaptive coping. The relationship between artification, arts therapy, arts-based workshops and wellbeing warrant, further research within the study. The importance of signposting support organizations and helplines is acknowledged, not just in relation to the workshop, but in every iteration of the Caring through Cloth project.

The Proposed Caring Through Cloth Workshop

The proposed Caring through Cloth workshop aspires to support parents, who have experienced stillbirth, in their adaptive coping through textile-based art activities and responds to a lack of post-clinical care interventions for perinatal loss. As a research tool the workshop sets out to explore the results of the review and auto and sensory ethnographies and assess the significance of affordance, artification and analogy to adaptive coping in perinatal loss. Sensing, interacting with and making textile objects from baby clothes, as explored in the auto and sensory ethnographies, inform the textile-based art activities in the workshop. A care package (Figure 8) consisting of baby clothes, nursing cloths, talc powder (maize starch), needle, and thread will be gifted to parents of baby loss to use in the workshop to afford, artify, ritualize, express and make salient their needs and cares.

Figure 8 An example the Caring through Cloth workshop care package. Photo credit: Oliver Cameron-Swan.

A pilot study of the Caring through Cloth workshop has already taken place with Lucy Turner who runs the Still Parents project at the Whitworth, an art gallery in Manchester and Jo Richler, the Co-Chair of Manchester Sands (Stillbirth and Neonatal Death charity) who works in partnership with the Still Parents project. Still Parents is an award-winning arts workshop project that brings “bereaved parents together to explore - through art, craft and creative activities - their experiences of babyloss” (STILL PARENTS | manchester-sands). Following the pilot study, the Caring through Cloth workshop will be run through the Whitworth Still Parents project with volunteer participants from the project and will be supported by Manchester Sands. The workshops will collect qualitative data to further assess the significance of affordance, artification and analogy to adaptive coping in perinatal loss.

If you have been affected by this paper or the experiences it discusses and need to receive support or speak to someone please contact either the Sands National helpline 08081643332 or [email protected] or your local branch of Sands.

Acknowledgements

Lisa Porch would like to thank Lucy Turner, who runs the Still Parents project at the Whitworth, Manchester and Jo Richler, the Co-Chair of Manchester Sands who works in partnership with the Still Parents project, for all their support and guidance in the Caring through Cloth project.

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

Lisa Porch’s PhD studies have been supported by the Welsh Government’s Skills Priority Programme (SPP) and the Staff Development Fund (SDF) at Coleg y Cymoedd.

Notes on contributors

Lisa Porch

Lisa Porch is a PhD candidate in the School of Art and Design at Cardiff Metropolitan University. She is also a textile artist and a lecturer at Coleg y Cymoedd and Hereford College of Arts. Her PhD research study entitled Caring through Cloth explores the relationship between textiles and adaptive coping in mourning stillbirth. [email protected]

Keireine Canavan

Keireine Canavan PhD is Principal Lecturer in Textiles, Subject Head of Textiles (2004-2019) at Cardiff Metropolitan University and leads the Sustainability Curriculum (+Research) for Cardiff School of Art & Design. As educator, weaver and Research Fellow of the Al-Sadu Weaving Society, Middle East, she consultants on endangered traditional weaving techniques and advises as visiting scholar on sustainable cultural heritage projects for national and international museums.

Cathy Treadaway

Cathy Treadaway PhD is Professor of Creative Practice at Cardiff School of Art and Design, Cardiff Metropolitan University and is a Fellow of the Royal Society of Arts, Fellow of the UK Higher Education Academy, and a founder member of the CARIAD research group. She is an artist, writer, and design researcher with a background in design and digital technologies. For the last 9 years she has been leading international interdisciplinary research investigating how to design for people living with advanced dementia.

Clive Cazeaux

Clive Cazeaux is Professor of Esthetics in the School of Art and Design at Cardiff Metropolitan University, Wales, UK. He is the author of Art, Research, Philosophy (Routledge 2017) and Metaphor and Continental Philosophy: From Kant to Derrida (Routledge 2007), and the editor of The Continental Esthetics Reader (Routledge 2011, 2nd edition). His research interests are esthetics from Kant to phenomenology, and the philosophies of artistic research, audio drama and metaphor, especially the role metaphor plays in the way we carve up the world and think.