Fetal Demise less than 20 weeks

SmilingBluEyes · Apr 29, 2005

We take care of all women experiencing demise after the first trimster and I believe that is how it should be ....

I lost pregnancies and got "stuck" on med-surg and was treated as a med-surg case, not a person losing a baby. It was painful to have NO ONE acknowledge my losses in anyway. Med surg nurses generally have no experience caring for patients experiencing later-term demise. These patients belong where they can get bereavement care, which is on OB. JMO.

babyktchr, BSN, RN · Apr 29, 2005

Oh my...I am like you sister. I feel pulled to these very special people also. You have to understand, this is not a pleasant thing to deal with, and it is really not something that everyone likes to do. A lot of nurses just don't feel comfortable...and that is fine. I do believe, however, that these patients do belong in L&D because of the care they require. Post partum wise, it really depends on the patient. I always ask if they want to stay on our unit, give them the option to move or to stay. Most go home relatively quickly and just opt to stay in L&D. I like when they stay actually.

If you are serious about doing this kind of "thing"..check out the RTS bereavement training course. It will teach you how to be a bereavement support person. Their site is http://www.bereavementservices.org

Hope this helps. Good luck to you

z's playa · Apr 29, 2005

I've lost 3 all under 18 weeks (but near). Two near deaths for me and all very upsetting. I'm gald I was on a Med floor. The other babies would have "killed" me.

Z

SmilingBluEyes · Apr 29, 2005

We put the women experiencing fetal demise FAR from the nursery/other babies. We have gyn surgical beds that serve the purpose very well.

z's playa · Apr 29, 2005

We put the women experiencing fetal demise FAR from the nursery/other babies. We have gyn surgical beds that serve the purpose very well.

Awesome..wish we did.

Zzzzzzz

Keely-FutureRN · Apr 29, 2005

My mom had a miscarriage before she had me and she was on an OB floor and she said it helped soooo much. They put her way down the hall from the nursery and put a picture of a leaf on the outside of her door to signal staff of the loss and to be sensitive. She said a nurse talked to her and really validated her and helpedl her work through her grief. I think it's a good idea for them to stay on OB because they did have a baby, and it's a real loss and a real person and OB deals with that, not med/surg.

Keely

z's playa · Apr 29, 2005

Well.....I was in the lounge with the other mommies who actually had LIVE babies to show for their pregnancy and like all happy mommies they asked "So what did you have?"

I answer deadpanned "A miscarriage".

It was pretty awful .I will never understand why a med floor with people trained and aware of the woman's situation isn't better. Why on earth would a mom who just lost her baby want to be near all the other mothers? A floor with trained nurses and such sounds waaay better to me. Crying babies next to me? Well wishers? Helping me cope if I'm acknowledged as a mom? Whatever......not for me or the other 37 mothers that lost their babies over the past 5 years who I;'ve known.

Kudos to all those who love the idea but i am not one of them.

SmilingBluEyes · Apr 29, 2005

z's I can relate .....what pains me, is my sister gave birth 6 mo ago to a baby due the day I was....it's so painful for me, even now. I can so relate to yoru pain, yet no one understands it, not even my dh. I hope I can use my pain to help others in the same situation and remember ALWAYS to be sensitive to their needs. I thank you for reminding me of this most important thing.

LeahJet, ASN, RN · Apr 29, 2005

Well.....I was in the lounge with the other mommies who actually had LIVE babies to show for their pregnancy and like all happy mommies they asked "So what did you have?"
I answer deadpanned "A miscarriage".
It was pretty awful .I will never understand why a med floor with people trained and aware of the woman's situation isn't better. Why on earth would a mom who just lost her baby want to be near all the other mothers? A floor with trained nurses and such sounds waaay better to me. Crying babies next to me? Well wishers? Helping me cope if I'm acknowledged as a mom? Whatever......not for me or the other 37 mothers that lost their babies over the past 5 years who I;'ve known.
Kudos to all those who love the idea but i am not one of them.

Z,

I can totally relate. I had a stillborn at 37 weeks last year and I remember the tightness in my chest and the stinging tears when well meaning family members of other patients asked me what I had. It was months before I could even see a baby out in public without crying. So yes, I believe a med-surg unit or a gyn only unit would be best.

Oh~ and I am pregnant again~ 24 weeks on sunday....=)

allnurses Guide · Apr 29, 2005

I don't work in OB, but I believe that my hospital gives mothers who have experienced loss, an option of staying on the OB floor or going to another floor to be cared for. Usually they seem to opt to stay on the OB floor; in fact in all the years I've worked here I only remember maybe one or two women who have came to our floor after losing their babies.

When I was in nursing school, I volunteered to care for a woman who had just lost her baby. Very sad case; the baby was term, and early on in the pregnancy, the parents were made aware that the baby had LOTS of problems and most likely would not survive birth. She opted to carry the baby to term. Unexpectedly, the baby was born alive... she let out one cry, and then soon died. Very sad. :crying2:

She stayed on the OB unit, and had a wreath on her door. My hospital puts wreaths on the doors of bereaved parents, and we also have special little white outfits that we put the babies in and take their pictures in, if the parents desire.

BETSRN · Apr 29, 2005

I'm still a student (14 days to go) and am precepting on a L&D unit (as well as antepartum) in a hospital that has about 300 deliveries per month. We have had quite a few FD's under 20 weeks lately that have been admitted for induction. The most recent were 20 weeks (possible demise at 16/17 weeks) and 17 weeks (possible demise at 16 weeks).
I feel a pull towards these patients and have had great relationships with them during my shifts. I feel that I have the right things to say (or more aptly, the things NOT to say) and they have been very open and honest with me and have thanked me at the end of the day for my kindness.
My question for discussion is this .... most of the nurses on the unit seem "upset" that they are even on our unit (they would prefer they go to a med/surg unit) at this early time and most of them would rather not be assigned to these patients. I don't feel that they are treated very well but then again I'm very sensitive and feel some sort of "pull" to these patients. Are the nurses right? Should they be home or on a different floor?
Sigh ... this is an area that I may do more research on. Just these few experiences have made me want to know more and to be able to do more for these patients, mentally, as much as physically.
What are your experiences with this? Thoughts, comments and opinions welcome ...

I definitely think a FD belongs on L&D. We always keep ours. They should NOT be on a med-surg floor. That's terrible. However, I have to say that I have never seen an induction for an early demise. Let it happen on its own. It usually does.