do you allow fetal demise infants to stay with mother in her postpartum room?

Published

Hi all, I am the bereavement nurse specializing in fetal demise/neonatal death. Our hospital policy has changed to be more accommodating to our families that have fetal/neonatal loss. To facilitate the grieving process we allow the mother/family to keep the infant with them as long as they desire for bonding and to say goodbye. Most of the time a few hours is enough and the family is able to relenquish the baby to the morgue. We have on occasion had a mother want to keep her baby with her in the room until her discharge - this can be up to 4 days later. The issue is the staff nurses caring for these patients on the units. Many staff have given me feedback that they can care for and deal with the family - but NOT the deceased infant in the room for so long. These nurses do NOT have to do ANYTHING with the infant with the exception of placing it in a shrowd and calling for a runner to take it to the morgue if the parents request it. Do any of you have suggestions for teaching/training the nursing staff in the care of these special families. Since death is a part of life-should all the staff be "made" to take turns caring for these families or should it be on a voluntary basis unless no-one volunteers? Any feedback will be appreciated.:thankya:

I want to thank you all for your excellent advice. Some of you have given me perspectives I didn't think of regarding the possiblility of abnormal grieving. I've only had one patient requesting to keep her 21 wkr (who maintained a heartbeat up until delivery). for her entire stay of 48 hours. The infant was kept wrapped at all times. Parents are informed of the natural degradation process. This infants skin remained in good condition.

The parents of macerated infants are also informed of this process-but that it has already started days before-so the infant will deterioate quickly. All of the parents in this situation have requested the infant be taken to the morgue within a maximum of 8 hours-and that was to wait for family members to arrive. We have taken the infants to the morgue and have returned them to the parents when requested-although this is one of the sticking points-because no-one wants to go to the morgue to retrieve the infant.

Up Vote Up Vote ×
Specializes in er/icu/neuro/trauma/pacu.

I worked with fetal demise infants/mothers, we did the photography and allowed family to hold the infant. How far along do you consider allowing for this process? 12 weeks, 16 weeks, age is a consideration. We had a grandmother who insisted on holding a 10 weeker-Mom was bleeding heavily during the abortion(natural).

On another thought--how long are other deaths allowed to stay on the floors? Any loss, every loss is devastating to someone. Can the 80 year old widow stay with her husband of over 60 years, the mother of a 3 year old, the 10 year old child who just lost a mom? Maybe hospital policy can help direct your time frames.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Days? No, but hours to a day, sure. I do know, the baby's body is kept in our pathology room (cold storage) for a while for when the families do choose to see/hold their lost child. Usually this is only done for 24-48 hours, however. Not for days.

(For all the reasons already mentioned).

Every family should be given the opportunity to grieve and be linked with bereavement services/clergy at their choosing. Some need these services, others find they rely on their own resources at home. Either way, there is no right way to grieve, obviously.

Up Vote Up Vote ×

Im not a nurse .. but i think it is unhealthy to have the dead baby for days.. I cant imagine having your job... My friend had to abort her baby because it was very deformed.. I cant imagine how that feels.. its very sad.. I try to comfort her but i really dont know what to say.. anyways she got to say goodbye .. I think leaving the baby for days only prolongs the grieving process..

Up Vote Up Vote ×
Specializes in OB.

I am not sure that you can totally relate a stillbirth with that of another death. With a stillbirth one of the few memories that the family will have of that baby is the moment of birth and the few hours after, thats all! Other deaths people have good times, happy times to look back on and with a stillbirth you only have that moment, just "the goodbye". Remember this when taking care of these special families.

Up Vote Up Vote ×

I work in a smaller hospital - about 500 births a year. We really do whatever we can to accomodate families that have a fetal/infant loss. We allow the family to decide when and how long they want to see the baby, we give mom and other family members the option of participating in bathing, dressing, foot and handprinting etc... We have, I think, a very good bereavement program here.

We allow the infant to remain in the room as long as mom wants. We have kept infant in a curtained off area of the nursery for several hours with a radio tuned to a particular station as mom requested. On occasion, we have a mom that can't stand the thought of their little one going to the morgue, so we have put the bassinet in an empty room, turned off the heat and opened the windows (mid January in upper mid-west) - then would wrap baby in blankets from warmer when mom or family wanted to see the infant.

Most of our moms only stay less than 24 hrs. If by c-section, some only stay 24 hrs, some a little longer. We give them the option of staying in the birth center or going to the floor.

I think everyone grieves differently and needs as much support as possible from their nurses. We do not rush them to get the baby to the morgue, but because of the short lengths of stays, it's usually not a problem. We do tell them that if they decide to send baby to morgue, we will bring the baby back up anytime they want - this is usually the House Charge Nurse or Night Nursing Supervisor that does this.

We also have several nurses that do well with and are willing to take patients that have experienced a loss - we would never force a nurse into this assignment - it's just not good care for the patient.

Up Vote Up Vote ×

I'm not an OB nurse but experienced a neonatal loss my son was 18 days old. I would not want a nurse who couldn't or did not want to deal with loss. Even after having him the post-partum nurse was great my baby stayed in the NICU so even that feels like some sort of loss. Its not healthy to keep the baby for days after death, everytime mom would wak up the baby would not. thats my opinion

Up Vote Up Vote ×
+ Join the Discussion