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

Cute_CNA, CNA · Sep 20, 2005

I deduced that non-viable means that the baby is probably not likely to survive, but could someone give me a better definition?

This thread made me cry. :bluecry1: :crying2: :sniff:

God bless you nurses. :icon_hug:

Jolie, BSN · Sep 20, 2005

Please, let's look at this from a parent's point of view and not be quite so judgmental about "not wanting" the baby.
I was a 25-year-old emotional train wreck when my full-term, 6-pound 9-oz. anencephalic daughter was delivered by C-section, many years ago. I couldn't handle the idea of seeing her, much less holding her, at that time, and while I wish to Heaven I'd been strong enough, I simply wasn't. My husband did see and hold her during her 7 hours on earth; he was also with the priest when she was baptized, and with me when my doctor came in to tell me she was gone.
I thank God he was able to deal, because I couldn't, and the guilt I felt then still is with me in some ways. But as much as I wish I could've done things differently, I've come to the realization that I did only what I could at the time.........if anyone had forced me to hold my dying child, I think I'd have literally gone crazy. I was young, emotionally immature, and I was so close to hysteria that I spent an entire night with the blankets over my head, screaming silently, wishing I were dead alongside my daughter.........the only thing that kept me from crying out loud was the desire not to end up in the psych ward.
So that's why I ask that you put yourselves in the place of a young mother for a moment and try to understand why one might not want to see or touch the baby. Yes, she may wind up regretting it---God knows I do---but everyone deals with things in their own way, and our job as nurses is to support them regardless of how we feel about their decision.
In the meantime, you're right about not letting babies die alone.......I thank the Lord that there was a nurse to hold my child as she took her last breath, and I bless that woman every day for being there for her.

May God bless you, your husband, and your precious daughter. Please don't think that we are being judgemental about parents not wishing to hold their dying infants. I certainly didn't mean to communicate that, and am sincerely sorry that I left that impression.

If not for my NICU work experience, I don't believe that I (as a parent) would be able to bring myself to hold such a fragile, dying child, either.

As a new graduate, I was assigned to admit a 32 weeker to the NICU. My preceptor and I expected a preemie with mild respiratory distress. Instead, we received a perfectly formed and beautiful newborn girl, who we would later learn had severely hypoplastic lungs. We struggled for about 45 minutes to care for her before she died. When it became apparent that she would die without the presence of her parents (who were several floors away), we baptized her (The parents had stated this preference.), wrapped her tight, and comforted her.

The next day, I had the privilege of meeting her parents. I felt I had the responsibility to assure them that she died peacefully, as I was one of only a few people to lovingly hold their child during her short life, a gift neither of them experienced.

Thruogh our grief support program, I remained in contact with the parents over the next few years. When they stopped calling, I assumed that they had moved forward with their lives, and no longer felt the need for my support. I still remember them and their daughter by name, and occasionally think of them.

I guess the point of this is to let you know that the nurse who held your daughter was probably very touched and felt privileged to have been part of her short life. I'm sure she thinks of you on occasion, and wishes you peace.

mattsmom81 · Sep 20, 2005

I was involved in this type situation as a student nurse. The baby had multiple deformities incompatible with life, including all its GI system outside the body in a sac (as well as a huge meningomyocele) The mother, bless her heart, just could not bear to look at it. Our hearts went out to her, and several of us offered to stay with the infant until it passed quietly...and stroked it and spoke to it as it was crying. She seemed comforted by that. I'm sure I can't fully comprehend how heartrending it must be to be in that mother's situation, but it is these situations where a nurses' sensitivity can ease the burden, IMO..

enfermeraSG · Sep 20, 2005

I echo Jolie's reply, in that I certainly don't judge these parents who cannot bear to hold their child during his/her last moments. I can't put myself in their shoes, because I am not. I also cannot judge the nurse who cared for the Mom I mentioned, and is the one who brought the baby to the back room and left him there. I don't know what her reason was for not dealing.

I am so relieved to hear that it is the norm for these babies to be held by someone until they die. I don't think anyone should die alone. It is amazing to me to experience the two most momentous events in a person's life within 3 hours - birth and death. SG

Oh and BTW, we did have an NNP come and determine that this baby was in fact 21-22 wks, non-viable. Just a strong little soul I guess.

sddlnscp · Sep 20, 2005

I too am extremely glad that most non-viable babies are held until they pass. My ultimate goal (for anybody that I haven't told a million times yet) is to work in a NICU and I don't think I could do it if I wasn't given the ability to love and comfort a baby that was not going to survive. Setting the child aside to die is just too disturbing, they need and deserve to be nurtured while they are alive, even if it is only a fleeting moment. This thread brought tears to my eyes, but in such a good way. If a baby cannot survive, I want to know that someone is going to take care of him/her until she is gone and I hope that someday that someone can be me.

gypsyatheart · Sep 20, 2005

Like the others have said, you did fine handling the situation. I have never worked anywhere where a little soul has passed alone. We usually take the baby to NICU for pictures and footprints, if possible and prepare a memory box, like someone else mentioned also.

Remember, however, this pt you describe is mentally ill, it's hard to say what kind of perceptions she was having or what was going on in her mind. Even the strongest of us can not handle the death of a newborn, pre-viable or not. We all handle grief differently. Especially when someone is struggling w/schizophrenia....they need support and caring, social service consult ASAP.

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

allnurses Guide · Sep 20, 2005

Like the others have said, you did fine handling the situation. I have never worked anywhere where a little soul has passed alone. We usually take the baby to NICU for pictures and footprints, if possible and prepare a memory box, like someone else mentioned also.
Remember, however, this pt you describe is mentally ill, it's hard to say what kind of perceptions she was having or what was going on in her mind. Even the strongest of us can not handle the death of a newborn, pre-viable or not. We all handle grief differently. Especially when someone is struggling w/schizophrenia....they need support and caring, social service consult ASAP.

Nice post . . actually everyone has some compassionate advice. I haven't had this happen except with a very early delivery where the baby had been gone for awhile and there was nothing to really hold. It was when I was first a nurse. I ended up staying the entire 17 hours it took to deliver the baby.

Bless you all.

steph

Brownbetty · Sep 20, 2005

ditto Premnrs post - we do the same thing in our NICU

PreemieNurse · Sep 20, 2005

For those of you beating yourselves up that you should've questioned resuscitating a 22 weeker, remember... the outcome would have been very poor. If indeed the infant you receive at delivery is alive, he should be weighed and further assessed for true gestational age. "Dates" can be wrong, give or take a couple of weeks... and babies can even be born smaller than their date would indicate... it's all in the assessment... remember that a true 22 weeker cannot even be intubated.. they end up being traumatized, have bleeding problems, and much, much, more. To the nurses who hold and comfort a dying infant when the parents do not want to... you are doing the right thing. We had an incident in our ER a few months back. The mother had taken a drug to self-abort... so she REALLY didn't want to see the baby. It really traumatized the ER nurses, who very seldom have this happen to them... but they held the baby until he died, which was about an hour or so.... very sad, but truly, no baby deserves to die alone.... KUDOS to your staff!

BittyBabyGrower, MSN, RN · Sep 20, 2005

Our L/D nurses will keep the baby over there and hold it. We don't bring them to the NICU at all if they are deemed not viable. I've seen some kids live that long, but it is an occassional gasp, HR not an active baby. It is very sad. Our whole natal floor does pictures, footprints, hair locks, etc. We all have digital cameras also, which is very nice.

Bless them for not reviving that poor baby.

lilpoo_1 · Sep 21, 2005

I give you all credit for being able to do such heroic efforts in L/D and NICU. Just reading these stories has got me crying my eyes out. I would never be able to function as a nurse in this capacity. So thank you all for the wonderous work that you do!

Cherry2 · Sep 21, 2005

*sob*

:crying2: