Shaken baby syndrome/abusive head trauma (SBS/AHT) is the number one cause of child abuse related deaths in the United States. This study, based on qualitative interviews with 35 birth parents of SBS/AHT survivors, employs grief management and dialectical theory to explore the ambiguous loss experienced by parents. This study finds parents experience dialectics of acknowledgment-denial, control-helplessness, certainty-uncertainty, guilt-innocence, and openness-closedness, which prevent them from fully experiencing grief due to the ambiguity of the loss. Because their child is still alive, and the loss is the experience of raising a formerly healthy child, the ambiguous loss experienced, complicated by dialectics of grief, prevent their fully dealing with the grief. Grief management tactics that impact family communication are explored.