Non-viable baby, born alive -parent won't hold him, what do you do?

truern · Sep 19, 2005

I've only had a L&D clinical and didn't experience anything like what you described, but I'd like to think that I would have done the same thing. Life is precious, no matter how short.

LydiaNN · Sep 19, 2005

I remember this happening once at a hospital where I was doing a clinical. There were enough people on staff to hold the baby close until s/he died (I'm sorry to say, I can't remember which gender this baby was). I do remember them calling in both psych and the chaplain as reinforcements to the nurses and doc in encouraging Mom to hold this baby, though. This Mom is going to regret it for the rest of her life.

Edited to add: Maybe it wasn't psych, maybe it was Social Services, I can't remember...

fergus51 · Sep 19, 2005

We do just what you did. We hold the baby, try to medicate him/her if we can, keep him/her warm, sing to him/her, whatever. I have never seen an infant left alone to die. I don't think parents should be forced to hold the baby if that isn't what they want, so that is part of the staff's role when necessary.

mstigerlily · Sep 19, 2005

Gosh, how sad. That is amazing he lived for 3 hrs, no oxygen, not intubated, nothing??? And 1 lb? Are you sure he was only 21-22 weeks?

I couldn't leave him either. I would imagine someone with severe unmedicated schizophrenia was probably confused and not able to be reasoned with...I don't know what to advise.

Melissa

OK, so here's what happened - and it's not the first time we've had this dilemma. We had a pt come in with severe, unmedicated schizophrenia, homeless, and imminently going to deliver a 21-22wk baby. Well, she delivered the baby and he was alive. He lived for 3hrs. The pt only held the baby for a few moments and wanted us to take him away. To make a long story short, another coworker and I took turns so he wouldn't be alone for those 3 long hours.
What does your facility do in that situation - when a baby is not viable, but born alive, and the parent(s) don't want to hold the baby? I mean, this was a perfect little 1 lb baby, pink with a heartbeat. We couldn't just leave him on the counter in our back room and occassionally check for a heartbeat so time of death could be recorded. (!) At least, I couldn't. Anyway, just wondering how other units handle this. thanks, SG

fourbirds4me · Sep 19, 2005

I've never had one live that long at a non viable gestation. The only one similar to what you describe ended up in a battle between the dr and nurse about whether or not to try to resuscitate/ use heroic measures... all the while the baby lay alone on a cold isolette. I think it lived about 30min.

prmenrs, RN · Sep 19, 2005

We would have taken it to NICU, held it, photos taken, hand/foot prints or impressions, memory box, bed card w/length, weight, etc. A nurse might take the baby into a quiet, darker room and just hold it till it passed.

The social worker would have seen Mom, and given her options to hold, see the picture, take the memory box or not. She would also follow-up in a few days w/resources like Empty Arms or other support groups. Then again in ~ a month, she might make another phone call to see if Mom is ok.

We have also gone down to the morgue and retrieved an infant whose mom had changed her mind. Not the most pleasant of tasks, but if it helps her deal, we did it. Pictures would also be placed in her medical record so that, sometime in the future she wanted to see it, she just has to call the social work dept, and they can get it for her.

IMO, the important thing is to document as much as possible so there is something to say the baby was there--real, in other words.

cardiacRN2006, ADN, RN · Sep 19, 2005

I worked as a tech in L&D a few years back and a similiar situation happened to us. The baby was 23 weeks and was anacephalic. The mother was induced (theraputic ab) and did not want to see her child. I must admit, the memory of what she looked like will always stick with me. She still had a brainstem so her heart beat for a little while (not 3 hrs) but watching her try to breath was horrible. I wouldn't leave her side, and neither did her nurse. She was only 11oz.

kynurse117 · Sep 20, 2005

:blushkiss i just recently started woking on an l & d floor, in the nursery..i guess i would of done the same thing you did,,,you cant make a parent want their child although i wish you could...i have only been working for a couple of months and you wouldn't believe how many infants i'd take home with me...and i already have 4 kids...just love them the time that you have the experience with them...at least you gave them some comfort and let them know that someone cared for them...good job!!!!

ok, so here's what happened - and it's not the first time we've had this dilemma. we had a pt come in with severe, unmedicated schizophrenia, homeless, and imminently going to deliver a 21-22wk baby. well, she delivered the baby and he was alive. he lived for 3hrs. the pt only held the baby for a few moments and wanted us to take him away. to make a long story short, another coworker and i took turns so he wouldn't be alone for those 3 long hours.
what does your facility do in that situation - when a baby is not viable, but born alive, and the parent(s) don't want to hold the baby? i mean, this was a perfect little 1 lb baby, pink with a heartbeat. we couldn't just leave him on the counter in our back room and occassionally check for a heartbeat so time of death could be recorded. (!) at least, i couldn't. anyway, just wondering how other units handle this. thanks, sg

DutchgirlRN, ASN, RN · Sep 20, 2005

I was in a situation about 15 years ago where a young woman came in alone and delievered at 22 wks. It was about 0400 and myself and the other nurse delivered the baby. We were in a small rural hospital.

We called the ER doctor to come up stat. He picked the baby up from off of the bed and said to the young woman "I'm sorry your baby was born dead". He handed the baby to me and I was going to hand it to the Mom and he said "No clean the baby up first". The Mom was crying so hard she didn't say anything.

When I got the baby to the nursery I noticed that he was alive. I ran to get the ER doctor. He said to me in the hall. "I know the child is alive but he doesn't have a chance, Let him die, clean him up and let the Mom hold him. We don't need to get sued for doing nothing." I stayed with him for 4 hours in the nursery and rocked him until he died. I let one of the day nurses take him to his Mom and I went home.

The entire time I was rocking him I felt so guilty that it was me and not the Mom holding him. I've often wondered if he had been born at Vanderbilt would he have lived? I do know that if I had it to do over again I would have taken him to his Mama no matter what the ER doctor had said. At the time I was scared of doctors and was not the least aggressive as I am now.

lady_jezebel · Sep 20, 2005

I was in a situation about 15 years ago where a young woman came in alone and delievered at 22 wks. It was about 0400 and myself and the other nurse delivered the baby. We were in a small rural hospital.
We called the ER doctor to come up stat. He picked the baby up from off of the bed and said to the young woman "I'm sorry your baby was born dead". He handed the baby to me and I was going to hand it to the Mom and he said "No clean the baby up first". The Mom was crying so hard she didn't say anything.
When I got the baby to the nursery I noticed that he was alive. I ran to get the ER doctor. He said to me in the hall. "I know the child is alive but he doesn't have a chance, Let him die, clean him up and let the Mom hold him. We don't need to get sued for doing nothing." I stayed with him for 4 hours in the nursery and rocked him until he died. I let one of the day nurses take him to his Mom and I went home.
The entire time I was rocking him I felt so guilty that it was me and not the Mom holding him. I've often wondered if he had been born at Vanderbilt would he have lived? I do know that if I had it to do over again I would have taken him to his Mama no matter what the ER doctor had said. At the time I was scared of doctors and was not the least aggressive as I am now.

That is horrific & paternalistic. How dare the doc make such a judgement. I'm sorry you have to live with this. I am also a lot more assertive now regarding pt care.

prmenrs, RN · Sep 20, 2005

Dutchgirl: you don't need to feel guilty. @ 22wks, the baby was not viable. You did a great job. Sometimes, a baby is born @ that gestation and even cries. But lung buds are just starting to develop into airsacs--not really enough to ventilate. Vanderbilt couldn't have saved the baby either. You did fine.