This study used a dialectical framework to examine the communication of family members who experienced the ambiguous loss of a premature birth. The parents' uncertainty about their baby's prematurity was exacerbated by contradictory feelings of joy and grief, and efforts to communicate the complicated experience to family members. As the parents attempted to manage this joy-grief contradiction, they experienced other tensions of acknowledgment-denial, control-helplessness, certainty-uncertainty, and openness-closedness. The parents of premature babies underwent various grief emotions as they mourned the loss of a full-term pregnancy and feared for their child's life and health. However, they were often unable to allow themselves to feel their grief and were unsure how to communicate it because their baby was still alive. The combination of dialectical tensions thus intensified the uncertainty and pain that accompanies the ambiguous loss of a premature birth. The dialectical tensions surrounding the ambiguous loss of a premature birth and the communication strategies used to manage them are examined.
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