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

Specialties Ob/Gyn

Published

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

Specializes in Home Health Care,LTC.
"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."

I'm a third generation nurse. Many years ago (in the 1960's) I remember my grandmother coming home and telling me that it was as much a privledge and honor to be present at a persons death as it was to be present at their birth. With tears in her eyes she told a story of how she held a premie for several hours until she died.

I never forgot what she said... and I do feel honored that Our Lord picked me to be present at deaths as well as births. It is sad for all, but I get strength in knowing that I helped a family create a very special memory.

Every September our community has a balloon ceremony honoring our tiniest patients: miscarriages, stillbirths and neonatal deaths. It is well attended and many parents return to offer support to the newly grieved parents. This year we had almost 100 losses over 18 weeks. All parents experiencing a loss are invited (even first trimester losses). Balloons have the babies name, date of birth, date of death, weight, and any special verse the parents choose. It is a very sobering half hour.

Our patients will never forget our kindness and compassion. :balloons:

That is a great idea. I would attend as a nurse and as a mother who has lost a child and for support for other parents who still have to come to terms with their grief. It took me almost 4 years before I really came to terms with the loss of our daughter. Once again what a great idea.

Angie

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Not long ago we had parents of IVF 21 week twins who insisted we try everything. The doc was kind and informative but the mother was screaming that they would sue so the doc gave in but privately told us not to "hurt" the babies so although we did "bag" them, we really didn't, and the other nurse and I both stroked and talked to them in a quiet environment, then told the parents there was nothing more we could do, weighed and wrapped them out of their site ( just the way our rooms are set up), and handed them to them. They felt that measures had been taken, we knew they hadn't been hurt, and the parents went home starting their grief in a good way. I still feel badly about the entire episode, but the person who couldn't deal with it was the doc. I met him in the lounge in tears and had to comfort him as well...

Recent had a lecture in neural development and discovered that a baby born at 20 wks 5 days just celebrated his first birthday. Apparently no problems at this point...... Just FYI

Mike

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Recent had a lecture in neural development and discovered that a baby born at 20 wks 5 days just celebrated his first birthday. Apparently no problems at this point...... Just FYI

Mike

"Barrington says that in recent years survival rates for premature babies have increased due to the medical technology now available. At 28 weeks more than 96 percent of babies survive; at 24 weeks the rate is 50 percent; and at 22 weeks, two percent. At the MUHC the majority of parents of 24 week-old babies will opt for intensive care. The baby's condition is then reassessed on a daily basis to see if it is still appropriate to proceed. Barrington says most of the babies who are not going to survive die within the first 24 to 72 hours of being born."

http://www.muhc.ca/media/ensemble/2002june/premature/

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I am really skeptical on the dates when people say they have a 20 weeker survive with no problems.

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All of these posts made me cry my eyes out!! I just had my first baby in July 2005 (he is fine). I just noticed that since I have become a mother it is much much harder for me to hear stories or see children/babies in pain or suffering, etc. Before I had the baby, stories like these would upset me, but I actually feel the sadness in my BONES and deep in my heart now. Is this normal? Do others moms feel this too?

I am not a mother, or a nurse, but I don't think there's anything unusual about your reaction. I think that once you become a mother, you gain a whole new perspective because children are now a huge part of your life. I guess it helps you to truly understand what it's like.

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I am really skeptical on the dates when people say they have a 20 weeker survive with no problems.

ITA.

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I am really skeptical on the dates when people say they have a 20 weeker survive with no problems.

I was as well until the professor flashed the picture and newstory up on powerpoint during the lecture.

Mike

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I was as well until the professor flashed the picture and newstory up on powerpoint during the lecture.

Mike

But I still wonder if the dates were correct? I mean unless it was an IVF baby there is no way to be completely sure.

Shannon

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But I still wonder if the dates were correct? I mean unless it was an IVF baby there is no way to be completely sure.

Shannon

Absolutely, my concern (as a former L & D nurse) is that with the advancement of technology our personal views will have to be reevaluated.

I was pretty rigid with respect to my thoughts, but ever since I returned to school I have found how quickly technology is snowballing and what is actually possible.

Mike

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Specializes in Maternal - Child Health.
I was as well until the professor flashed the picture and newstory up on powerpoint during the lecture.

Mike

That it was a news story, and not a journal article would add to my skepticism! In my experience, reporters do precious little research to verify "facts".

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That it was a news story, and not a journal article would add to my skepticism! In my experience, reporters do precious little research to verify "facts".

Actually was a press release from a D.C area hospital. Whether or not it is factually based it does bring up some issues.

It is documented and verifiable that 2% of 22 weekers survive, how will that impact your particular thoughts and practice?

Mike

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Specializes in Maternal - Child Health.
Actually was a press release from a D.C area hospital. Whether or not it is factually based it does bring up some issues.

It is documented and verifiable that 2% of 22 weekers survive, how will that impact your particular thoughts and practice?

Mike

Probably not change much. It has always been my belief and practice that we are obligated to provide parents with accurate information regarding the likelihood of survival of their premature infants, as well as the risk of complications that may lead to life-long disabilities. Once that information is provided, it has been my experience that most physicans, NNPs and nurses will respect the parents' wishes regarding resuscitation, providing maximal treatment, and withdrawing life support, if and when that time comes.

Based on my professional experience, I would choose not to resuscitate my own 22 weeker, but it is not my plae to make that decision for someone else.

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