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

The only thing that I have to add to this is that at my hospital the babies are kept on the mbu unit. In a fridge, ready for the parents at all times. we get the baby and wrap it in warm blankets. I think that having it so close makes it easier on everyone.

We would do "everything"----e.g. NRP. And if "everything" could not be done (not allowed) i would take and hold that baby in a blanket and rock him/her myself.

You have to respect their wishes.....

Respect the wishes of the patient, and do proper postmortem care and preparation. We have had patients change their minds, after the baby has been taken to the morgue. We have made sure they were presentable as possible and brought them back when they changed their minds.

Everyone grieves differently. Respect their wishes and make yourself VERY available and willing to listen. And be ready for anything---their emotions and reactions can run the gamut from anger to deep sadness to near catatonic-like states. Just be there, and respect what they wish. that is my best advice as an OB nurse and also as aperson who has had losses of her own.

What a rough situation for you. I am so sorry this happened, for all of you.

deb

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.

I think you are right! Thanks for the response. :)

Specializes in Cardiac.
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

I know this is off topic, but yes, you can definitively pinpoint conception without it being IVF.

I too, doubt the dates if they say it was a 20 weeker that survived.

I know this is off topic, but yes, you can definitively pinpoint conception without it being IVF.

I too, doubt the dates if they say it was a 20 weeker that survived.

Curious at to how one can do that? When I got pregnant with my son...I don't know when he was concieved since hubby and I were trying to get pregnant and taking every opportunity to get the job done. How can that be pinpointed?

I know this is off topic, but yes, you can definitively pinpoint conception without it being IVF.

I too, doubt the dates if they say it was a 20 weeker that survived.

Just another FYI, I went back to the lecturer to double check and it definitely was 20 weeks and 5 days. (Background, I attend some of the same courses as the medical students and this came from a MD/PhD OB-GYN lecturer.)

Mike

Specializes in Cardiac.
Curious at to how one can do that? When I got pregnant with my son...I don't know when he was concieved since hubby and I were trying to get pregnant and taking every opportunity to get the job done. How can that be pinpointed?

It doesn't matter when you have sex, it matters when you ovulate. The day you ovulate your egg either gets fertilized within 12 hours or it dies. That's the day of conception. Many women chart their cycles and know exactly when they ovulate (some down to the hour). I could write a book on this-but thankfully it's already been written (Take charge of you Fertility). Are you trying for another??? I've got some great tips!

It doesn't matter when you have sex, it matters when you ovulate. The day you ovulate your egg either gets fertilized within 12 hours or it dies. That's the day of conception. Many women chart their cycles and know exactly when they ovulate (some down to the hour). I could write a book on this-but thankfully it's already been written (Take charge of you Fertility). Are you trying for another??? I've got some great tips!

It's pretty accurate for women with consistent cycles and those that are paying attention. I've worked in mat-child too long to think that it's the case for all women. I can't tell you how many "42 weekers" I've seen come out with vernix and how many "24 weekers" come out looking much older.

Specializes in Cardiac.
It's pretty accurate for women with consistent cycles and those that are paying attention. I've worked in mat-child too long to think that it's the case for all women. I can't tell you how many "42 weekers" I've seen come out with vernix and how many "24 weekers" come out looking much older.

By no means do most women chart their cycles. Those that do know more than you would ever want to know about their personal fertility. You don't need to have regular cycles though, just a thermometer.

I am also suprised that people don't know that they are pregnant or how far along they are. The wheel that they use to determine dates is only accurate for a very small amount of women. So women will go in and find out they are pregnant, a doctor will spin the wheel and base it on a 14 day ovulation and give the woman her due date. Those are rarely accurate.

Not a nurse yet but I just wanted to add my .02 on the dating.

I charted/used Taking Charge of Your Fertility with my pregnancies. With my DD I knew I conceived 2 weeks later than my doc calculated due to delayed ovulation. When I brought it up with docs I was told that I was wrong. DD arrived 14 days after my due date...

This time I know my due date is accurate based on my charting.

I know most women don't use this method. In fact most people say "You check your own cervix!!???!" but those who chart should be pretty accurate.

By no means do most women chart their cycles. Those that do know more than you would ever want to know about their personal fertility. You don't need to have regular cycles though, just a thermometer.

I am also suprised that people don't know that they are pregnant or how far along they are. The wheel that they use to determine dates is only accurate for a very small amount of women. So women will go in and find out they are pregnant, a doctor will spin the wheel and base it on a 14 day ovulation and give the woman her due date. Those are rarely accurate.

Specializes in Cardiac.
Not a nurse yet but I just wanted to add my .02 on the dating.

I charted/used Taking Charge of Your Fertility with my pregnancies. With my DD I knew I conceived 2 weeks later than my doc calculated due to delayed ovulation. When I brought it up with docs I was told that I was wrong. DD arrived 14 days after my due date...

This time I know my due date is accurate based on my charting.

I know most women don't use this method. In fact most people say "You check your own cervix!!???!" but those who chart should be pretty accurate.

Definately. Unless a woman has a perfect cycle with no chance of stress in the last month or illness and she always ovulates on day 14 there is a big chance that the doctor who uses the wheel is inaccurate in their due date estimation. And yes, this is just an estimation, but it can vary by several weeks, especially if the woman had implantation bleeding and irregular cycles. This can change the dates by up to 6 weeks.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

You guys, I am weeping - God bless you for what you do - not letting them die alone (and I really wanted to do maternity at one point - my hospitals said you had to have L&D experience)

I don't know how you do it - so sad - I wouldn't be able to let them be alone either. God bless you guys and thank you so much for being there!

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
wow. thank all of you for being angels on earth. you truly are what makes this world great. i don't have the courage that which you do. thank you. :kiss

Shannon

Shannon

-Loving wife to Zechariah

-Mommy to Kayla Maylin born April 3, 2005 7 lbs. 3 oz. Had two strokes at birth due to the a high homocysteine level caused by the MTHFR genetic mutation. And she is absolutely PERFECT!!! Kids have strokes too! All life is fragile...

-and future CNA and Nurse!

{{{{{{{{{{{{Kayla}}}}}}}}}}] that is a hug but also a prayer hedge of protecton - she's a tough girl, huh? Bless you Mom and Dad

+ Add a Comment