Thoughts on working with a laboring patient with a deceased baby?

dansamy · Apr 30, 2004

I think providing emotional support for that family is far more important than 'giving them time to be alone'. BTW, my response isn't from any 'real world' experience. I'm a student-to-be. I just answered this on the basis of what I might want/need should a similar tragedy befall me.

fergus51 · Apr 30, 2004

I have actually volunteered to look after these patients before. It is heart wrenching, but I think it is so important to provide them with sensitive care that it's worth it. I have looked after maybe 10 families in labor with full term or near term losses.

I don't have any specific plan, but rather let the family cue me as to what they want. I do encourage them to hold the baby if they want as well as naming it and acknowledging it as a real loss. We have a standard bereavement package made up of pictures and such. Some families don't want it and I just make sure they know that we will save it if they should change their minds. Some families want their clergy involved, some want extended family and friends, some want no one else in the room. I make sure they are not bothered by medical and nursing students unless they want them. Basically, I try to make sure they feel in control of their experience same as my other families.

CCL"Babe", BSN, RN · Apr 30, 2004

Of course this was a long time ago, but my Mom still, on rare occasion will talk about how heart wrenching it was for her to deliver her dead daughter with no emotional support. She was young, my father was away with the Navy, and her parents were far away. She felt like no one knew how to deal with her so they all avoided her. No physician attended the birth.

imenid37 · May 1, 2004

Kar, I am glad the nurses were supportive. I think it's hard to care for a family/mom who's baby has died. We have great RTS people at my hospital. We have some really fantastic patients too who have donated many things in honour of their children or have been generous in sharing their stories w/ other patients. As everyone else said, I let the mom/family guide me in what I do and say. I am almost always amazed at the strength these moms have in the face of such a terrible loss.

CCL, your mom's story reminds me of a GYN patient we had who had lost a child 30 years before. She was ambulating in the hall w/ assistance and she say the leaf and teardrop we put on the doors of moms who have had a loss. She asked her nurse what it meant and the nurse explained how we care for moms who have had a loss. This lady asked to read some of the RTS literature and thanked the nurse who was caring for her for allowing her to remember her son in a special way. She explained that he was her child just as much as the other three grown children she had, but felt that no one else had ever told her it was okay to feel that way. When she had him, the mom was encouraged to "forget" about the baby she lost. No one in her family talked about the baby because they felt it was morbid. I think it's great that your mom can talk about it w/ you. It makes me sad to think of her all alone and I am thankful that others don't have to go through this anymore.

renerian, BSN, RN · May 1, 2004

About 15 years ago a friend of mine had that happen. The cord wrapped around the babies neck in utero and the baby was delivered naturally. He was beautiful and perfect. It was horrible. :crying2:

renerian

TDub, MSN, EdD · May 1, 2004

First of all, kar212, I want to say how sorry I am that happened to you. I can't imagine how terrible that was.

Our hospital is a tertiary care center so we get 2 to 3 dead infants a week. It is hard to work with the parents, but it's even harder for them. We encourage the family to talk about the baby if they choose, offer whatever burial options they want, provide as much privacy or counselling as they want.

Afterward, we take footprints and handprints, pictures with props (like teddies, hat, blanket) and give them a pretty box with the clothes from the pics, footprints, the pictures in a sealed envelope, a clip of hair if possible, baby id bands.

They get a couple follow up phone calls over the next few months and a card from the nurse at the 1 year anniversary.

We strongly encourage the family to hold and look at the baby if s/he's at all presentable. I've had numerous people came back and tell us they were glad they held their infant, none that complained. I have had parents come back and ask to see the baby long after s/he's been cremated and that is heartbreaking to have to tell them no.

I used to feel I couldn't show feeling and had to be calm and collected all the time. One time I broke down and cried and the mom told me it meant a lot to her that someone else was sorry her little girl died. After that I didn't feel stupid.

nurturing_angel · May 1, 2004

I have cried more than a few times with parents of stillborn babies or critically ill babies that must be transferred out. Sometimes I feel like I should be more "professional" but I have never had a parent criticize me for it. I know I have had parents who appreciated my concern as I have heard from them several years later and they still remember me. I know I will never forget them.

Browneyedgirl · May 2, 2004

My aunt suffred through this 8 years ago. Two months after her oldest son was killed in a car crash, she gave birth to a stillborn child.

The baby died in utero and the doctor induced her labor. She gave birth lady partslly. I have never been able to understand, in situations like these, why the doctors do not do c-sections?

fergus51 · May 2, 2004

My aunt suffred through this 8 years ago. Two months after her oldest son was killed in a car crash, she gave birth to a stillborn child.
The baby died in utero and the doctor induced her labor. She gave birth lady partslly. I have never been able to understand, in situations like these, why the doctors do not do c-sections?

Depends on the doc and depends on the patient. It is still safer to have a vag birth rather than a c-section and the recovery time is so much less. It sucks for these women to have to go through the pain of labor for hours, but if they have a c-section the physical recovery is weeks and weeks, not to mention the fact that they get to look at that scar for the rest of their lives. They also have to consider if the woman plans on having more children, if she does a vag birth is preferable.

It must have been a terrible time for your aunt. I can't even imagine.

Energizer Bunny · May 2, 2004

I was wondering about not performing c-sections as well. My Aunt had a stillborn baby 16 years ago and had never had children because of the heartbreak and the dr's mistakes. She gained close to 30 pounds in the last six weeks and her BP was up and they didn't recognize the signs of preeclampsia. Her baby died and they made her carry her for four days before inducing and delivering. It was sickening for all.....still is when we think about it. So, now my Aunt has me and my children to love and none of her own.

hock1 · May 3, 2004

My aunt suffred through this 8 years ago. Two months after her oldest son was killed in a car crash, she gave birth to a stillborn child.
The baby died in utero and the doctor induced her labor. She gave birth lady partslly. I have never been able to understand, in situations like these, why the doctors do not do c-sections?

C-sect is a major surgery.