sensitive, "morbid?" question for labor-delivery RN's...

  1. Hi,
    I am a nurse in a much different specialty, I have a question that seems a bit "morbid" to me, and do need some help with it.
    I recently had a patient that delivered a stillborn infant at 37 weeks. She was encouraged to visit, hold the baby after she delivered. This was very helpful, emotionally for the mom along with the rest of the family. I believe this is a theraputic practice, I don't have a problem with it at all. But here is where I get confused.......
    What do you to with the baby's body after the mom and family have had time with the child?? How much time do you allow for them, and when are they encouraged to say goodbye?? hours, days?? If days go by, where does the baby's body stay?? How much is this talked about on your unit?? Does the baby's body go to the morgue or stay on the unit until mom is discharged, where is the body if it stays???
    Please let me know what your thoughts are.....
    Thank you all so much...this is a tough one for me
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  2. 16 Comments

  3. by   CoffeeRTC
    There was a post about this a while back.
  4. by   DutchgirlRN
    Quote from michelle126
    There was a post about this a while back.
    And where is it?....The OP needs an answer. I'll see if I can find it for you hang on...
  5. by   DutchgirlRN
    \http://allnurses.com/forums/f35/stillbirths-27944.html

    This is back in 2002 but the info of course is still current.

    You could contact SmilingBlueEyes: http://allnurses.com/forums/private....18678She's an OB/GYN nurse and a moderator/administrator of the OB/GYN forum. I'm sure she would be glad to help you.

    Also PRMENRS: aka Antique Baby Nurse: http://allnurses.com/forums/private.php?do=newpm&u=7440 is also an administrator and I'm sure would be glad to help. Good Luck Hon.
    Last edit by DutchgirlRN on Oct 26, '07
  6. by   SmilingBluEyes
    This is not a morbid question but a darn good one! Grief crosses all lines and specialties. Any nurse providing patient care, deals with grief in their patients, family members and themselves. Nowhere is it more keenly and painfully felt than in OB when a pregnancy or newborn are lost. It disrupts what some think of as the "natural order of things"! We are really *not* supposed to outlive our children. And when a late-term loss happens, sometimes, there is no definite answer as to WHY. But always, we must encourage and offer the opportunity to mourn these losses. And many, many of our patients will tell us, holding and grieving, as well as saying "goodbye" to their lost children (and yes, they are children, no matter gestation) is one way to honor that grieving process and heal. Some will refuse, and we honor that too. But I have talked to people who did and regretted it.

    Personally, I Have lost several pregnancies and in only ONE case, was there a fetus to observe and mourn. In the cases where it was too early or surgically-handled, to this day, I feel sad that I had no one to hold and say goodbye to. I have chosen instead, to plant living flowers or trees in their honor. This is one way some cope. There are myriad others, all we must respect and encourage.

    You see, when we lose loved ones, we have to honor this grief that overcomes us in order to begin healing. Different people find different ways to do so. But when a baby is lost, it is so very important to the majority of grieving parents and family members to be able to hold their children and say goodbye. It's not morbid; it's honoring that person who was lost and giving some form of "closure" (I hate that word but lack for better) to begin with.

    I hope this makes sense; I am speaking from an emotional standpoint, not really a nursing one!
    Last edit by SmilingBluEyes on Oct 26, '07
  7. by   Finallyat40
    Not a morbid question at all.....I am going to answer this from a NNICU standpoint rather than L&D, but we work very closely in conjunction with each other in these situations. We will clean up, bathe and dress the baby and then give the family the opportunity to spend time with the baby......either in their room, or our family room (much of this depends on mom's situation regarding recovery.....I will give the familiy as much time as they need to spend with the baby.....I think the longest I've had a baby "out" was around 12 hours. Once the family has said their goodbyes, we will then prep the baby to go to the morgue. I will transport the babyto the morgue, where it will be picked up by their funeral home. Every once in a while, the family will request to see the baby again and the hospital chaplain will retrieve the baby for the family after preparing them for how the baby will be very cold and hard. Does this help?

    Jamie
  8. by   FlyingScot
    There is a company called "Now I Lay Me Down to Sleep" that has professional photographers who donate their time and talent to take really beautiful pictures of dead and dying infants. I believe the service is free. If your hospital does not all ready have a program this is very worth looking into. Web site is:
    www.nowilaymedowntosleep.org
  9. by   ElvishDNP
    Oooh, flyingscot. Great website. Just get a kleenex first.

    To the OP - this is a great question. I don't know any nurses who are completely 'comfortable' with fetal/infant death at any age or stage of gestation. So if this is you, you are in very good company.

    Most of our moms keep the babies with them anywhere from a few minutes to a few hours. If they want to keep the baby with them that entire time, they can. We get them a newborn crib (if a later gestation) or have a little blanket we wrap them in if they're earlier and parents want it.

    We look for cues that parents are finished saying goodbye: putting baby back in the crib, focusing attention on something else, or sometimes they'll come right out and tell you they're finished. If >20weeks, baby goes down to morgue until the funeral home comes for him/her. If family wants to see baby at any time before they leave, we call the chaplain, who goes to get baby & bring him/her to them. If <20weeks, same deal if family plans on burying baby at home. Sometimes baby gets sent to pathology (very cold-sounding, I know) if under 20 weeks.

    Occasionally, though, you will have a mom/family that wants to keep their baby in the room for their entire stay. This is their right and a perfectly acceptable way of dealing. Just know that it's not easy sometimes, as the baby will start to decompose and leaking liquid from his/her skin, and blood starts seeping as well. I'm not trying to gross anyone out nor make anyone uncomfortable, and certainly NOT trying to clinical-ize anyone's previous loss. I'm just letting you know what to expect should that ever happen.

    This is a great topic, and I don't think you can ever talk about it too much. Preparation is power.
  10. by   FlyingScot
    Quote from Arwen_U
    Oooh, flyingscot. Great website. Just get a kleenex first.
    Sorry I should have warned you first. They update their images fairly frequently(go to Our Work and click on gallery) and the stories to go with the pictures are enough to make even the hardest of hearts cry. But what a phenomenal service they provide.
  11. by   Marie_LPN, RN
    Quote from FlyingScot
    There is a company called "Now I Lay Me Down to Sleep" that has professional photographers who donate their time and talent to take really beautiful pictures of dead and dying infants. I believe the service is free. If your hospital does not all ready have a program this is very worth looking into. Web site is:
    www.nowilaymedowntosleep.org
    I second the Kleenex-warning. Beautiful site, though.
  12. by   crissrn27
    I work with Arwen now, so that is how we do things there. The other hospital I worked at, we had a small refrig. on the unit that we kept the babies in, between visits, even if the mom was there for days.

    Another thing I think should be mentioned is, even if the baby is born severely decomposed, third-spacing, very early, severe deformities, etc, the parents still should have the option to see their baby. I have found some nurses/docs, will try to spare them from this, and won't let them see the baby, and this is not helpful. Just prepare the parents for what they will see, and try to point out the beautiful features the baby has.
    Last edit by crissrn27 on Oct 26, '07
  13. by   bagladyrn
    The way you handle the baby can mean a lot to the family. I handle the baby gently when washing and wrapping and prefer to carry the baby to the parents cradled in my arms to hand to them. I try to find positive features to comment on at any gestation - beautiful hair, pretty features, or even "see he has long fingers just like his daddy's".
    If a baby has been taken to the morgue and then brought back, if possible I take a few minutes to place the baby under the warmer in the nursery and wrap him in a warm blanket so the family doesn't have to experience that chill.
  14. by   RainDreamer
    I agree that 'Now I Lay Me Down to Sleep' is an awesome service. We call them in when we have a demise ....... they take great pictures and are extremely good with the families.

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