Ritual Pathways: Mizuko Kuyō and Memory Making in Perinatal Loss

Perinatal loss represents a profound challenge for parents, not only emotionally but also socially, as it is often accompanied by silence and lack of recognition. In recent decades, healthcare systems have developed practices of Memory Making (e.g., memory boxes, photographs, handprints) to validate parental grief and foster bonds with the deceased child. In contrast, Japanese Buddhist traditions, particularly the Mizuko Kuyō ritual, provide a spiritual and communal framework in which unborn children are honored through offerings, statues, and symbolic acts of care. This study combines a narrative literature review with a micro-ethnographic visual analysis of ritual spaces in Tokyo and Nagano, and in three Italian hospitals. Field observations and photographic documentation highlight how symbolic elements—such as the red bibs and caps of Jizō statues, windmills, toys and offerings—express both remembrance and social acknowledgment of unborn children. The findings suggest that, despite their cultural differences, both Memory Making practices and Mizuko Kuyō share the function of legitimizing parental identity and creating what bereavement research conceptualizes as a Continuing Bond. However, they diverge in their frameworks: medicalized and individualized in Western contexts, spiritual and collective in Japanese practice. By comparing these approaches, the study emphasizes how rituals of remembrance serve as crucial social acts that counter silence, reduce stigma, and recognize perinatal loss as a legitimate form of bereavement. It also calls for greater attention to cross-cultural perspectives in designing bereavement, bridging anthropological insights with psychological and clinical implications.