When a Baby Dies: Psychotherapy for Pregnancy and Newborn Loss: By Irving G. Leon. Foreword by Erna Furman. New Haven/London: Yale University Press, 1990. 230 pp.

Leon's book is based upon his work with a clinical sample of forty cases in which perinatal loss was the main focus of his therapeutic endeavor. It is the first book on this topic, and the related literature has been extensively researched. Although Leon discusses miscarriage, abortion, and stillbirth as different aspects of perinatal loss, the stage to which the fetus has matured before the loss has a vital part to play. Perinatal loss at a time when the pregnant woman has felt the baby active and moving within her body, and has anticipated its birth and becoming its mother, concerns not only the physical death of the child but also the death of the baby as an active focus in the mother's conscious and unconscious fantasies, hopes, and daydreams. It is a very different experience from loss in earlier stages, when the baby has not been physically felt. The author states that mourning a perinatal loss is very difficult because there is little or no tangible evidence of the child's existence. My clinical experience cannot confirm this. For a woman who has felt full and now has to return to emptiness, the loss of the baby within her is a palpable loss.

In my experience, pregnant women are very aware of the possibilities of life and death for the fetus and are conscious of their own responsibility for its survival. Yet conscious and unconscious maternal