Water or Saline Immersion Photography: Another Way to Capture Precious Memories After Baby Loss
Written by Siân Ness, CuddleCot Bereavement Consultant and Midwife
The purpose of bereavement photography is not to create a perfect image. It is to create a memory that can be cherished for years to come. It is also about capturing those intimate moments of love and raw emotion.
For some parents, a photograph may be the only visual record they have of their baby. It can capture tiny fingers, little feet and the intricate details of their baby’s face. It may become the image they return to on birthdays, anniversaries and milestones, or the photograph they eventually share with a sibling, grandparent or friend.
Memory-making following pregnancy and baby loss is about more than photographs. It is about providing opportunities for parents to spend precious time with their baby, express their love and create memories that will remain with them long after they leave hospital.
But photographing a baby who has died is not always straightforward.
This can be particularly challenging following earlier gestation loss, when a baby’s skin may be extremely delicate and vulnerable to handling, or when natural changes following death make conventional photography difficult.
Saline immersion photography offers an alternative approach that may help families capture precious details of their baby when traditional photography is challenging.
Although the technique is increasingly being explored in bereavement care, published research specifically evaluating saline immersion remains limited. It is therefore important to distinguish between findings from research, observations from practitioners and the experiences of bereaved families.
This article explores the technique, its potential benefits and practical considerations, alongside the deeply personal experience of one mother whose son was photographed using neonatal immersion photography following a termination for medical reasons.
What is Neonatal Immersion Photography?
Neonatal Immersion Photography (NIP), also referred to as water or saline immersion photography, involves gently placing a baby who has died into a clear container of liquid and taking photographs through its transparent sides.
The buoyancy of the liquid can alter the baby’s positioning and appearance, potentially making delicate features easier to see and photograph.
The technique can complement traditional bereavement photography and, with appropriate preparation, equipment and training, may be undertaken by healthcare professionals or specialist photographers in perinatal settings.
Water immersion photography was described in the peer-reviewed literature by Heather Duffey in 2014, who suggested that it could be particularly helpful following second-trimester fetal death, when conventional photography may be more difficult. The approach has since been explored further by specialist bereavement photographers, particularly in the United States.
Although water and saline immersion photography are related techniques, the liquid used may differ. Some practitioners use sterile 0.9% sodium chloride (normal saline), while earlier descriptions used water.
Normal saline is an isotonic solution commonly used in healthcare. However, it should not be considered an antimicrobial or preservation solution, and there is insufficient evidence to suggest that saline immersion delays decomposition.
Immersion photography is a memory-making technique, not a method of cooling or preserving a baby’s body.
Why might immersion photography be helpful?
The appearance of a baby can change rapidly following death, particularly at earlier gestations when their skin and tissues are extremely fragile.
Practitioners have described several potential visual benefits of immersion photography, including:
Changes in skin colour, sometimes creating a lighter or more natural appearance.
Softening of some visible changes associated with drying or early post-mortem changes.
Greater definition of facial features and small details such as ears, lips, fingers and toes.
Increased buoyancy, allowing the baby to rest in different positions with less direct handling.
An appearance that can evoke the baby’s intrauterine environment.
These are practitioner-reported observations rather than established clinical outcomes, and the effects may vary depending on gestation, tissue condition and individual circumstances.
For some families, however, immersion photography may offer an opportunity to capture images that would otherwise be difficult to obtain.
A mother’s experience – by Ren’s Mummy, Hannah The following is Hannah’s personal account of how neonatal immersion photography helped her family create precious memories of her son, Ren.
“I feel incredibly privileged to have spent much of my career as a midwife caring for families during some of the most vulnerable and heartbreaking moments of their lives. I never imagined, however, that I would one day find myself on the other side of that experience, navigating the loss of my own babies.
My most recent loss was my beautiful son, Ren, who was born at 16+6 following a termination for medical reasons (TFMR). It was one of the most difficult experiences I have ever had to endure.
I cannot fully explain it, but from the moment I discovered I was pregnant with Ren, I had a feeling that this pregnancy would be different. The five weeks that followed, filled with scans, appointments, diagnostic tests and uncertainty, felt like the longest weeks of our lives.
As the investigations progressed, we came to understand what the final diagnosis was likely to be. Ultimately, we had to make an impossible decision: to end our much-loved pregnancy and protect Ren from the suffering we feared he would experience.
Those five weeks were incredibly painful, but I also knew that they were the only five weeks we had left with him. I wanted to use them to prepare, to learn and to find every possible way of making memories that would allow us to know and remember our little boy for the rest of our lives.
As part of that preparation, I began researching bereavement photography and ways of preserving memories after birth. It was through Siân that I was introduced to neonatal immersion photography, something I had never encountered before and, at that time, was not routinely available at the Trust where I worked and intended to give birth to Ren.
I became determined to understand the practicalities and to make this possible for him.
Then, by an incredible stroke of luck, just one week before Ren was born, our Trust’s bereavement team introduced neonatal immersion photography. I was overwhelmed with relief. I knew that this would give us the opportunity to capture something incredibly precious: the tiny details of our son that we would otherwise have so little time to hold onto.
My delivery with Ren was fast, unmedicated, silent and, in its own way, incredibly beautiful. He was alive until the moment he was born, which meant that when I first met him, he looked absolutely perfect. He looked exactly as I had imagined my little boy would look.
As a midwife, I had cared for many babies born too soon and understood how quickly their appearance can change after death, even with the use of cold cots and CuddleCots. I knew that we had a very limited window in which to capture those precious details.
This was where neonatal immersion photography became so important.
We placed Ren into the water twice. The first time was to create photographs; the second was the following day, when we hoped to rehydrate his delicate hands and feet sufficiently to create casts.
The transformation when we first placed him into the water was extraordinary.
Almost immediately, his colour returned to a beautiful, natural peach tone. His features softened and became so much more defined. His little earlobes were visible. His fingernails and toenails could be seen. Even the delicate outline of his lips became clear.
The midwives who supported us were amazed by the level of detail that suddenly became visible. My husband and I were able to be involved in the process, working alongside them to create photographs that felt personal and meaningful to us.
We kept the setting deliberately simple. A plain bedsheet formed the backdrop beneath him, with a few delicate faux flowers placed into the tank to add depth and symbolism.
Nothing elaborate was needed. Ren was the focus.
The following day, we placed him into the water again. By then, his body had changed considerably. He had become very rigid and incredibly delicate.
After approximately an hour in the water, something remarkable happened. His body became more flexible, his hands and feet regained their natural shape, and they became less brittle. We were able to create beautiful casts of his tiny hands and feet, something we will treasure for the rest of our lives.
The photographs we have of Ren are priceless to us.
They show him peacefully, beautifully and exactly as we want to remember him. They allow us to remember not just that we lost our son, but who he was. We can see the tiny details that belonged uniquely to him, details that time would otherwise have taken away from us.
For me, neonatal immersion photography gave me something that I desperately needed at a time when almost everything felt beyond my control.
I could not change the diagnosis. I could not change the decision we had to make. I could not change the fact that I was going to leave the hospital without my baby.
But I could make memories.
I could preserve his little hands and feet. I could capture his face. I could make sure that, years from now, I would still be able to look at my son and remember every tiny detail of him.
As a bereaved mother, those photographs have already become an enormous source of comfort. As a midwife, they have changed the way I think about the care we provide to families experiencing pregnancy and baby loss.
I feel incredibly fortunate that this option became available to us in time for Ren’s birth. But I cannot help thinking about all the families who came before us, who did not have this opportunity.
For families experiencing the unimaginable loss of their baby, we cannot take away their grief. We cannot give them more time.
But perhaps, through neonatal immersion photography, we can help them hold on to the time they did have.
And sometimes, when a parent is leaving hospital without their baby, the smallest details become everything.
A tiny ear.
A little lip.
A fingernail.
A footprint.
A hand that once held their finger.
For us, these are not simply photographs. They are pieces of Ren that we get to keep forever.”
What does the evidence tell us about bereavement photography?
Research increasingly highlights the importance of photographs and other forms of memory-making following baby loss.
A 2023 systematic review and meta-synthesis exploring bereavement photography following stillbirth found that photographs could support parents both immediately following their loss and in the longer term. Parents described photographs as helping to validate their baby’s existence, preserve memories and share their baby’s life with others.
The review also identified that some parents who initially declined photography later regretted not having photographs of their baby. This highlights the importance of sensitively discussing the options available, without making assumptions about what families may or may not want.
However, the growing evidence supporting bereavement photography generally should not be confused with evidence specifically evaluating immersion photography.
Research into neonatal or saline immersion photography remains limited. Further studies are needed to understand its potential benefits, limitations, safety considerations and the experiences of families who choose it.
For now, it should be regarded as an emerging memory-making option rather than an established evidence-based intervention.
Offering immersion photography: individualised care and parental involvement
There should not be a rigid gestational threshold for considering immersion photography. Although it may be particularly helpful following earlier gestation loss, the decision should reflect the baby’s individual circumstances and the family’s wishes.
Parents may choose to have photographs taken by a healthcare professional, specialist photographer or themselves. Some may wish to participate by helping to position their baby, placing their hands in the water or being involved in the photography process. Others may prefer simply to watch, or may decide that immersion is not right for them.
Where parents wish to participate, the experience may offer another gentle opportunity to spend time with their baby and be involved in their care.
Consent should be informed and ongoing, with parents feeling able to change their minds or ask for the process to stop at any point.
The priority is not simply whether photographs can be taken, but whether the experience is safe, compassionate and meaningful for that particular family.
How might we introduce immersion photography to families?
The language used when introducing immersion photography is particularly important. For some parents, the idea of placing their baby into water may initially feel unfamiliar or even unsettling. Explaining the technique in a gentle, reassuring way can help families understand its purpose and make an informed choice.
Rather than focusing solely on the photographic technique, healthcare professionals may find it helpful to describe how immersion creates an environment that resembles the one their baby experienced in the womb, where they were surrounded and gently supported by amniotic fluid. The buoyancy of the water can allow the baby’s delicate body to rest more naturally, sometimes making their tiny features easier to see and photograph.
For example, a healthcare professional might say:
“There is another way we may be able to take some photographs of your baby, if this is something you would like to consider. It involves gently placing your baby into a small, clear container of water, creating an environment a little like the one they were in when they were growing inside you, surrounded and supported by fluid. Sometimes this can help us see more of their tiny features, such as their fingers, toes and little face, and capture some beautiful photographs for you to keep. We can explain everything beforehand, and you can be as involved as you would like to be. There is absolutely no pressure, and we will support whatever feels right for you and your baby.”
Practical and safety considerations
As with all aspects of bereavement care, appropriate infection-prevention procedures, environmental considerations, safe handling and local policies should be followed.
Particular care is needed when handling babies whose skin and tissues are extremely fragile. The baby should be gently supported during immersion and removal, with unnecessary handling minimised. The immersion medium, temperature, duration and equipment should be considered within an appropriate local protocol, recognising the current limitations of the evidence.
Care must also be taken around electrical equipment and the surrounding environment.
Can a baby return to a CuddleCot following immersion photography?
Immersion photography does not replace active cooling. A baby may return to a CuddleCot following photography, subject to appropriate assessment and local procedures.
Excess liquid should be removed and the baby dried as gently as possible, taking care not to damage delicate tissues.
Another choice for families
High-quality bereavement care recognises that every family’s needs are different. Saline immersion photography is not intended to replace traditional photography or other forms of memory-making, but to offer an additional possibility where it may be appropriate.
Hannah’s experience demonstrates how special that opportunity can be. While further research is needed to understand the technique more fully, her story reminds us why exploring compassionate approaches to memory-making matters.
When families have so little time with their baby, offering another way to capture the intimate moments they share and the little details they desperately want to remember may make a lasting difference.
References
Duffey H. Water Immersion in Neonatal Bereavement Photography. Nursing for Women’s Health. 2014;18(5):429–433.
Oxlad, M.J., Franke, E.F., Due, C. and Jaensch, L.H. (2023). Capturing parents’ and health professionals’ experiences of stillbirth bereavement photography: A systematic review and meta-synthesis. Women and birth: journal of the Australian College of Midwives, doi:10.1016/j.wombi.2023.03.001.
Remember My Baby. Bereavement photography and memory-making resources.
Where can healthcare professionals and photographers find more information?
Remembrance photography charity ‘Remember My Baby’ is currently exploring the use of saline immersion.
Neonatal Immersion Photography (NIP) is the practice of fully immersing an infant in water for the purposes of underwater photography after they have passed away
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