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 ...
Hello there. My daughter was stillborn at 27 weeks. I was placed in an antepartum room. I heard no babies crying and no hollering moms. Our baby was sick and we knew she was going to die, so her dying was not a total surprise. Relatively speaking, it was actually a little peaceful. The wonderful nurses that looked after me was one of the reasons for this.
This was my first chance to get back to the message boards and read the replies to my thread ... and, wow, what a response we received. It's wonderful to hear each persons experience and most of you seem to agree, as I do, that L&D is the correct place for them to be in most cases. As always, there are exceptions, and the patient should be included in these decisions so that they are placed on a unit that is most comfortable for them as they go through this process.
Thanks for the referral to RTS ... I wish they had classes closer to me ... I guess I will just have to figure out how to get out to a class when I can. We do have one RN who is RTS trained and she is exceptional, even coming in on her days off if she is available when there is a FD.
I'm touched by all of the personal stories here, especially yours, Deb. The strength and courage that you have and the graciousness that you show to all of us on this board is simply amazing. To everyone who shared their own story, thank you, you have given me more to think about and have broadened my previously "narrow" mind. :)
I know the classes are few and far between, but what you may want to do is contact them and find out if there is a RTS coordinator in your area that may be willing to teach the course for you and some others. It really is a great course and the bible you get from them is wonderful
I think everyone would agree that women who lose a child need to be placed in a supportive environment, wherever that is.
Working in a large facility, I found antepartum to be the best place (OB nurses were trained to deal with losses and no crying babies to be found). Barring that, in most hospitals I worked, L&D or PP seemed to be the next best place if the woman can be guaranteed privacy. They should have a private room and receive support from staff and family. If they want to go to med-surg, they certainly should be able to AS LONG AS the med-surg staff has been trained to deal with these patients. We had enough negative experiences with med-surg nurses in one hospital to bar all our women experiencing losses from being cared for there. Some of the nurses would make comments along the line of "Well, if you miscarried it must be for a reason. Maybe God doesn't want you to have children" or "Why would you waste such a pretty name on a stillborn?" or "You can always have another one".... We'd put them in PACU before sending them to med-surg. I think those comments were much more damaging than being on a pp floor with caring staff, even on the chance they would bump into another mother on the floor.
Hello there. My daughter was stillborn at 27 weeks. I was placed in an antepartum room. I heard no babies crying and no hollering moms. Our baby was sick and we knew she was going to die, so her dying was not a total surprise. Relatively speaking, it was actually a little peaceful. The wonderful nurses that looked after me was one of the reasons for this.
I was on the antepartum unit at the hospital I worked. The girls did everything they could to keep me away from rooms of women who were having fetal monitoring each shift.
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 ...
After reading all the responses it amazes me how hospitals vary in caring for pts. I hqve done L&D for 5 years now, and at our hospital we get everything that is over 16 weeks gestation on our unit. We have specially trained RTS nurses to care for them. We place a blue rose on the door so that all know it is a demise. When at all possible we try to keep them away from laboring pts. I have not trained in RTS, but care for many demises at night. And I am up front with them and ask them how they would like things to go. If they want to stay on the unit, go home, or to another floor. These decisions should always be the pts. as far as I am concerned. It is a difficult time in their lives ,why should hospitals and policies make it more difficult for them?
I was 16 wks pregnant and bleeding when I showed up at the maternity floor. I was rudely turned away and sent to the ER which, in typical ER fashion made me wait for ages, then saw the baby was alive on ultrasound (that image haunts me, he was sucking his thumb) then promptly send me home. Three days later I was back in same ER losing that baby. Now, maybe there was nothing that could have been done but I would have rather lost that baby with experienced L&D/postpartum nurses in the comfort and soothing pastel tones and private rooms on our women's unit rather in the bright flourescence of one of the ER rooms with a bunch of tough old ER nurses who, it must be said, were very competent - but not very skilled in their bedside manner.
I was 16 wks pregnant and bleeding when I showed up at the maternity floor. I was rudely turned away and sent to the ER which, in typical ER fashion made me wait for ages, then saw the baby was alive on ultrasound (that image haunts me, he was sucking his thumb) then promptly send me home. Three days later I was back in same ER losing that baby. Now, maybe there was nothing that could have been done but I would have rather lost that baby with experienced L&D/postpartum nurses in the comfort and soothing pastel tones and private rooms on our women's unit rather in the bright flourescence of one of the ER rooms with a bunch of tough old ER nurses who, it must be said, were very competent - but not very skilled in their bedside manner.
Melissa
I am so sorry to here of your story. This only reinforces to me how we do things. I think that women who have lost or are losing a baby need extra special attention. And at times that can only come from those who are trained to give it. I would never put down an ER nurse, they are wonderful nurses, but they are not trained in fetal losses, nor should they have to be. That is the great thing about the nursing profession, we all find our area of love, sometimes it just takes awhile.
I have had 2 late losses, one fetal demise found at 19 weeks and one at 14.5. The one at 19 weeks was a much better experience because of the love and support I recieved from the L&D staff. I stayed in L&D during the whole induction, and they were wonderful. As horrible as it is to lose a baby, it would be even more horrible to not have it aknowledged. The nurses let me hold my baby, took footprints and offered to take photos. They showed me pictures before hand of what I might expect the baby to look like, and sent in a pastor of my choice and a counsellor to talk and grieve with me. They sent me home with a little box with all the keepsakes, and a little bear to hug when I needed one. The second loss was in an ER, with the aforementioned neon lights and some ill mannered ER nurses. It made a terrible situation that much worse. I had passed the baby on the toilet at home, and brought it in with me. I actually had one nurse say to me "Are you sure it was the baby you passed?" and then shut her mouth quickly when I handed over the ziplock bag with my fully formed, but tiny baby in it. I think that late fetal demises should have the option to stay in the L&D unit if they choose. For me, it was really difficult to know where I was and hear crying babies- but in the same breath it was healing too.
We put the women experiencing fetal demise FAR from the nursery/other babies. We have gyn surgical beds that serve the purpose very well.
We do to. They go to obs rooms right outside of the entry to our c/s area. It's very quiet, far, far away from the regular L&D unit so moms won't be subjected to hearing other women in labor or the cries of newborns. In our hospital, the nursery is on the 2nd floor above L&D so they won't see newborns. They all get the universal "tear drop leaf" so the staff people know about the situation.
You know, that's been happening A LOT lately. It seems like every time I've been up there recently, there's been at least 1-2 IUFD's on the floor. Makes my heart break for them.
It took me forever to type this reply because my emotions kept getting caught up in what I simply wanted to say. So I will try again, the basics -
I lost my son at 30 weeks, so not the
I was in L&D the whole time and I can't imagine having a baby anywhere else because I did indeed have a baby. The room they put me in had nothing to do with the fact I had had a loss because they didn't know that when I was assigned a room. I stayed in the same room the whole time. I was there for almost three days. After the birth the doctor said I could stay in OB or I could go to Women's and Children...I told him 'I want to stay here because I know the nurses' I knew nobody personally, I just felt comfortable with them. They had no problem with that. The baby was born in the morning and I stayed that whole day til about 6. If I had wanted to stay another night they were going to move me to another room, I'm guessing a PP room by the way she said it, but I didnt' want to stay another night, I had already been there for two nights. I did hear some babies crying..at first I thought it was my imagination, but no, I'm sure I heard crying. It made me feel sad but not overwhelmingly so...if I had seen those babies however I'm sure tears would have been flying.
One thing that bothered me, and it seems so silly, but to this day the thought of how it made me feel stills makes my heart ache, was my L&D room had a bag of diapers sitting on the counter, diagonal from the bed, right in plain sight. It was like they were taunting me the whole time saying 'you're not gonna need us' I tried not to look at them but I knew they were there. After I couldn't take it anymore I asked my boyfriend if he could put them inside a cabinet or something - he did. I still knew they were there but I didn't have to see them, so it helped. It seems so trivial but it really affected me. The baby warmer thing sitting in the corner bothered me too...and it bothered me when my baby was in it but it wasn't 'on' also.
My nurses were all wonderfull, and all but one acknowledged that I had had a loss. I appreciated when they held my hand, or rubbed my arm, I didn't have any friends around, and I needed someone to just be there..I definately appreciated them. My favorite nurse was the one I had after the baby was born. She was my nurse and the baby's. She made sure everything happened that needed to happen. I really felt like she understood me, like she could read right through me. I think she is very preceptive, and I respect her for being able to read me, I am a hard person to read. I felt like I definitely needed the nurses more emotionally than medically. Medically, they screwed up my IV's..I was bruised for a month after where she popped right through my vein.. And different nurses had different ways of how I should take the induction meds and one way definitely worked best. But I didn't care, and don't care now, because they were awesome. They were awesome emotioanlly for me, and that meant more to me than what they were doing physically to me. Truth me told, I liked being bruised for a month. It was a constant reminder that what I went through was real, that it did happen, and I did loose a baby, and that it is significant. I was a little sad when the bruises finally went away.
I was given three different pain meds and an epidural (cuz the pain meds did nothing but go to my head) and I still felt the whole thing. At the time I really just wanted the pain to stop because I didn't want to feel this labor - not labor in general - just not this labor. The pain seemed senseless because I wasn't going to have a living breathing baby afterwards..the pain was hurting me more psychologically than physically...the nurse at the time didn't really understand that cuz she was hesitant to give me the meds for fear it would slow down my labor. Which I totally understand, but I wasn't happy she was hesitant because I already waited a long time to ask for them cuz I didn't want to explain the psychological pain to her. She didn't hesitate for too long though, they just didn't work anyways. I didn't need an epidural that's for sure...I wasn't really in a clear state of mind to agree to that, I shouldn't have been allowed... I was also wayyyy too close to delivering to have an epidural placed. They didn't check my progress before placing it..if they had I'm sure they woudln't have done it. All said and done...I'm glad I felt the delivery. I felt his head crowning and touched the top of his head, when nobody was watching, and it feels kind of magical to do that. I felt him coming out and it's an awesome feeling. The pain wasn't senseless, because feeling the pain allowed me to feel the delivery, and feeling the delivery was magical. I don't get to take a baby home and experience a lifetime of feelings with this child, so saying I felt him be born is special. I'm glad my pain meds didn't work!
The last thing I will say is..there were times I 'forgot' that I was there having a stillborn baby. Everything is so much like a 'real' delivery it's easy to forget. And coming back to reality after a moment of forgetting is the worst feeling. When he first crowned I said 'the baby' purely out of concern for his safety, then I realized that his safety is not really a concern. When they held him up and I saw my perfect little baby, I forgot that he wasn't alive, then realized that he was indeed not alive and I did not hear him cry. It's so easy to get caught up in the process, and you've been conditioned to associate the process with having a live healthy baby so when that's not the case, it's hard to come back from those lapses.
For me it was just little things that made a big difference. I am greatful I had wonderful nurses, and I am greatful that I have no big things to complain about in my experience because I am sure that would have made things worse.
we do have inductions for IUFD, in the second trimester. Also terminations in 2nd trimester for incompatible with life defects (anencephaly, recently). They are labored/delivered on our labor unit (which is a LDR, not a PP floor), in a room at the end of the hall, with a wreath on the door.
after they deliver, they can stay on labor and delivery and be discharged home from there. if for some reason we dont anticipate them going home in the next few hours (retained placenta, hemorrhage, had a c/section, baby born at 1am ) they can stay on our unit, go to mother/baby or go to the gyn floor (that also handles lots of other things, too, but tends to get most of the gyn patients).
we do the share program, take pictures, footprints, give them a keepsake pack with several things and some literature on grief, etc etc. we have lots of handmade blankets, and some amazing gowns for the babies made out of old wedding gowns that came from this organization. They are stunning!
some people like caring for these patients. Many don't. Not necessarily b/c we want to avoid the sadness, or dont knwo what to say, but b/c there is a lot of paperwork and stuff to be done that can be confusing if you dont take care of those patients a lot. we all do it, though.
we have between 4-8 a month. occasionally less than 4 or more than 8.
My hospital practice is in an early demise, we ask the pt. Some don't want to be on L&D unit. For Late term IUFD, we deliver then ask if they want to stay on our unit or go to med/surg.
This only reinforces to me how we do things. I think that women who have lost or are losing a baby need extra special attention. And at times that can only come from those who are trained to give it. I would never put down an ER nurse, they are wonderful nurses, but they are not trained in fetal losses, nor should they have to be. That is the great thing about the nursing profession, we all find our area of love, sometimes it just takes awhile. 
kar212
63 Posts
Hello there. My daughter was stillborn at 27 weeks. I was placed in an antepartum room. I heard no babies crying and no hollering moms. Our baby was sick and we knew she was going to die, so her dying was not a total surprise. Relatively speaking, it was actually a little peaceful. The wonderful nurses that looked after me was one of the reasons for this.