Stillbirths...

  1. I just wanted to touch on what you do as nurses when a pt delivers a stillborn, or is in labor with one.

    My very first doula delivery was a stillborn, last November, 3 weeks after my healthy son was born. It was tough. Things progressed normally until 39W6D when she went in for a NST and no HB. She was induced (wanted a repeat CS) and took her almost 24hrs to deliver.

    First, they were great to move the pt right to the end of the hallway, so she didn't hear babies or see mom's walking around in labor. They gave her an epi right away, and the nurse was super attentive. The nurse she had, was a nurse who had a stillborn baby herself many years ago, so she too knew the pain. I thought it was amazing that she got that 1 on 1, and with someone who 'knew' what was going on. When the baby was born, we got to take photos, they took locks of hair and footprints. They put him in a special gown and blanket that the pt got to keep. Polaroids were also taken, and I took a whole roll for the Mom myself. Both the nurse, OB and I ended up in tears and all holding hands while Mom and Dad bonded with him for a while. It was emotional.

    The nurse, even showed up to the funeral for the baby, which was on her day off, and to this day, the Mom tells me they keep in touch via phone. That is amazing nursing.
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  2. 5 Comments

  3. by   mark_LD_RN
    we do our best to comfort thr patient and family the best we can, usually freely medicate them for pain etc, after the delivery we clean the baby prepare it for viewing do the usually photos, foot prints, memory kit stuff, allow and help parent with grieving process consuld social services etc. it is very diffucult process to go trough
  4. by   OB/GYN NP
    I'm sorry for your client and for you. I'm sure that was a tough experience. You're so right about the nursing care. Sounds like she was blessed to have a great nurse. It seems like a simple thing, but not all nurses will let themselves get involved emotionally with a patient whose experiencing a stillbirth, because it's a difficult experience to open yourself up to.

    As far as the nursing care of your client, most hospitals do have a standard process of taking photos, taking footprints, and allowing the family time with the child if they desire. All of these things are optional, as the family desires. I have seen that giving the family time to grieve and attach themselves to the baby actually helps, and doesn't hinder, the healing process. It allows the family to have time to grieve, and so I think it quickens the healing process.

    Best of luck to you in your future as a doula, and to your client. Tough experience for your first time out, but it gets better!
  5. by   SmilingBluEyes
    We, also, give 1 to 1 care for stillbirths and D and E's (early losses). We post a discreet purple placard on the door of the patients room (as well as her chart), so all who work in our hospital know the sensitive situation they are about to become part of when entering that room.

    I have worked with many stillborn situations and they never cease to sadden and shock me. We, too, are VERY liberal with whatever pain medication choices that are made and encourage the mother to view and/or hold her baby after birth. It's up to her and the family. We take a lock of hair, if possible, and place it in a specially-labeled envelop in a memory box along with a set of footprints, for the family to remember the baby. We encourage them to experience the grief process as it takes its natural course and teach them what they may come to feel as they go through all its stages. We also call in appropriate and/or requested spiritual guidance/leaders and our Social Services Dept. gets involved early-on. We arrange for burial/cremation of their choice and there are even funeral homes in the area who may provide such services free of charge in situations like this. Also, we provide resources for ongoing support and counseling after they leave our care.

    It is NOT an easy situation for the family or the nurse/careworker and I for one, feel these losses deeply with them (maybe cause I have lost two, however early) myself. It 's a challenge and as a doula you may run into this several times in your career . I hope that wonderful nurse showed you some things that helped you to learn to cope in the future should you run across this sad event again!
  6. by   KELLYGIRL
    I WORKED AT A HOSPITAL THAT WOULD PLACE A WHITE BOW ON THE DOOR. ALSO, ONCE THE BABY WAS DELIVERED AND BATHED, THE NURSE BRINGS THE BABY TO THE MOTHER WRAPPED IN A BLANKET AND PLACED IN A SMALL "BABY MOSES BASKET". THEY GIVE THE PARENTS A TEDDY BEAR TO PLACE IN THE BASKET TO TAKE HOME. IT MUST BE SO HARD FOR THESE MOTHERS TO ARRIVE TO THE HOSPITAL WITH A FULL WOMB...AND THEN LEAVE THE HOSPITAL WITH EMPTY ARMS.
    ABOUT 25 YEARS AGO, MY MOM MISCARRIED A 4 1/2-5 MO OLD GIRL. TO THIS DAY, SHE GETS DEPRESSED IN AUGUST AND CRIES. I DON'T THINK MY PARENTS WERE GIVEN THE OPTION TO GIVE MY SISTER A PROPER BURIAL. MOM SAID SHE THINKS THEY JUST INCINERATED THE BODY AT THE HOSPITAL. THIS IS SO PAINFUL TO THINK ABOUT. AND TO MAKE IT EVEN WORSE... SHE HAD TO ROOM WITH ANOTHER MOTHER (OF COURSE WITH A NEWBORN BABY). SHE SAID SHE WOULD CRY EVERYTIME THEY BROUGHT HER ROOMATE'S BABY TO THE ROOM. YOU WOULD THINK THE HOSPITAL STAFF WOULD KNOW BETTER...OR HAVE ANOTHER OPTION FOR MY MOTHER'S ROOM.
  7. by   fergus51
    Our stillbirth care is similar. We also do 1:1, encourage the parent to hold the baby and make a memory box for them. We keep the memory box on the unit, even if the parents say they don't want it, so they always have the option of coming back and getting it if they change their minds.

    Unfortunately, we do place these women on a floor with moms and babies. The reason is the nurses there know how to deal with fetal loss, and the nurses on med-surg do not. This has been heavily debated, but the negative comments from med-surg nurses cemented the deal, along with the fact that we know these women will be exposed to babies as soon as they leave us. That said, if everything is alright physically with the mom, some of them just go home 8 hours after delivering.

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