I'm new to this site, so I apologize if what I write has already been discussed.
I am currently a nursing student, and I hope to work in L&D once I get my degree and get my license.
Anyway... I am a mom to three kids here on earth, and two in heaven.
I had a stillborn baby at 26 weeks (no known cause), and a second trimester miscarriage at 16 weeks (no known cause) where the baby passed lady partslly, and I had a d&c after b/c of the placenta which remained attached.
ANYWAY...I know in both of my experiences the nurses were pretty unsure as to how to treat me. I felt like I had the plague, and no one wanted to talk to me or get near me.
I have since been to many support group meetings for moms with prenatal/neonatal losses, and the bottom line is we all want everyone to acknowledge our babies, no matter what the circumstances were around their arrival.
Please remember your bedside manner, and please remember even with s/b babies, or babies w/ severe defects, they are still very loved and usually their families want memories of them.
I understand that it is an uncomfortable subject, and sometimes parents don't want to see their baby right away...but from what I've seen/learned over the years people who don't do anything to remember them have deep regrets. Often they choose not to see their baby at first, then later they want to, but are too afraid to ask.
With my first baby, I really wanted her handprints and footprints, a photo...something, but I felt like people would think I was morbid if I asked, so I didn't. I have nothing to remember her by and it kills me because I was afraid of what others would think.
With my second baby, I took a photo of his tiny hand on my finger. He was only a 16 weeker, so he was less than desirable to look at, but he was still my baby and I wanted something.
If you can do one thing for a mother, may it be a handprint, a photo...even just a card with her baby's name on it. SOMETHING she can take home from the hospital...it will be a great help. There is NOTHING worse for a mother than to walk into L&D pregnant, and walk out with nothing.
I know many hospitals have 'memory boxes' and such for babies who are stillborn at full or near full term. With my 26 weeker, I got nothing, w/ my 16 weeker, I got less than that, and I thank God I just happened to have my own camera in my purse that day.
Encourage your patients to give their baby a name... Let them know they have the right to bury/cremate their babies..and often funeral homes will do it free or at a reduced rate. Even if they'd rather have the hospital take care of the remains, they can still have a memorial service, plant a garden, buy a tree in the rainforest, adopt a star in the sky...they can do SOMETHING to memorialize their babies.
These are all things I had to find out on my own, and when you're grieving AND recovering from a birth, it stinks when you have to do all the research yourself.
Anyway, if you made it this far thanks for reading, and please remember this next time the unfortunate happens at your hospital.
WE have a program called Healing through hope that was started by some NICU nurses. There is a memory box, handprints, pictures, clothing that is placed on the baby for pictures, they get the armbands, etc... Seems like alot of L&D nurses don't know how to deal with fetal demise, they are accustomed to getting a baby out and rescuscitating it, but that's not always the case. I saw a set of 19+5 twins stillborn the other week (one passed while the other had FHT's for a while) and they looked good. Mom wanted to look at him and I am sure they did footprints, etc...
I am a L and D nurse and I do not have any personal experience with loss. I appreciate you all sharing and letting us know what helps you all in your times of need. I think at times I don't know what to say, and I feel inadequate because I cannot imagine there is anything I can do or say to help...if that makes sense. I do not avoid, I try to be there and I do take pictures, allow parents to hold the baby, bathe and dress the baby and most everything that is listed above. We have memory boxes and do the lock of hair too. We have a check list that we follow to make sure we dont forget anything.
But I feel lost when I don't know what to say.."I am sorry" seems inadequate...I feel like I am invading their space when family in there and I ma in the room..if that makes any sense, like it is a private time and I am an outsider...?? If they come in for decreased fetal movement and I dont see FHTs on US, and have to call in a doc to confirm...what do I say..I say "I don't see a heartbeat...." I dont want to say the baby has died..what if I am wrong, what if the doc finds it..I second guess. It is a difficult time for the family and they are waiting a horrible eternity for the doctor to get there...what can I do to help???
I am a L and D nurse and I do not have any personal experience with loss. I appreciate you all sharing and letting us know what helps you all in your times of need. I think at times I don't know what to say, and I feel inadequate because I cannot imagine there is anything I can do or say to help...if that makes sense. I do not avoid, I try to be there and I do take pictures, allow parents to hold the baby, bathe and dress the baby and most everything that is listed above. We have memory boxes and do the lock of hair too. We have a check list that we follow to make sure we dont forget anything.
But I feel lost when I don't know what to say.."I am sorry" seems inadequate...I feel like I am invading their space when family in there and I ma in the room..if that makes any sense, like it is a private time and I am an outsider...?? If they come in for decreased fetal movement and I dont see FHTs on US, and have to call in a doc to confirm...what do I say..I say "I don't see a heartbeat...." I dont want to say the baby has died..what if I am wrong, what if the doc finds it..I second guess. It is a difficult time for the family and they are waiting a horrible eternity for the doctor to get there...what can I do to help???
I think "I don't hear/see a heartbeat" is probably the best response. NO ONE wants to hear the word 'dead' from anyone...even if they know it's true.
Even now I never think of my babies as "dead". I say "their heart stopped beating", "there was no heartbeat", or "they are in Heaven". "Dead" is never a word I would use in that situation...and I was horrified to read the previous post about the doctor telling the mother that her baby was dead. How cold and calus.
As far as what to do while waiting for the doctor to confirm??? Well... unfortunately I don't think there is much you can do/say. I certainly wouldn't give false hope. I know w/ my 16 weeker, the nurse kept telling me "well, they're still small at this stage, I might just be missing it". But, I had had h/b checks a zillion times in weeks prior, and from 10w on there was never a problem finding it...so I knew she was just trying to make me feel better...but it didn't work.
Be honest. Either just say "I'm sorry I didn't have any success, all we can do is wait for the doctor to come" or "Is there anyone you would like to call while you wait?" (I was alone when I found out our news, and I would have LOVED to have called my husband).
Also, if you are able...print out a u/s photo, and give it to the mother. I know w/ the u/s the confirmed my dd's heart stopped, I really wanted that last photo, and I was afraid to ask for one.
Never thought about a photo...great idea. No, I would not tell them the baby had died. Even when I was telling my friend that our other friend lost her baby at 10 weeks in utero, I said that the baby no longer had a heartbeat. I just imagine the poor mom hearing those words over and over for the rest of her life...
I'm sorry to hear of your losses and appreciate the advice you are offering.
I did want to point out that 'all generalizations are wrong, including this one'.
You stated that your "all the women in your support groups wanted acknowldegement" of thir losses. Please note that you groups are a 'self-selected' groups.
Every woman and family should be evaluated for their needs and those needs met. We make a keepsakes for all our losses but I have found that some definitely do not want them. We keep them anyway, for years, in case someone changes their mind later. Still, some people most assuredly do not want a memorial.
I hope I'm not sounding contrary. I'm just trying to say that no one way is right for everyone.
I don't think I said anything about everyone wanting something (other than acknowledgement that their baby was 'real'). I meant that most people don't know that they can have things (memorials, photos etc) because no one tells them it's ok.
All I'm saying is that it should be offered, and options should be clear.
When I had my first loss, the first thing they said to me was "what would you like us to do with her?" I was hurt, sad, angry, confused, not in my right mind etc...and I had NO idea I had options. What I 'wanted' them to do was make her alive! (which obviously wasn't an option, but remember when you're going through this you're not thinking clearly)
To me, that question was absurd at the time.
I'm in no way implying everyone should or will choose the options given...all I'm saying is every mother should know that there ARE options.
To this day I don't know if the hospital took photos of my baby. They said they would, then when she was born I was rused for a d&c so I didn't see them take any...and no one told me if they actually did or not, and even now 16 months later I'm too embarrased to call and ask...
I just think there should be direct info given out as to choices, options etc.
If someone opts not to use any, that's their right.
"Five years ago, my 25-year-old son was killed in a boating accident. It was a very difficult time, as you can imagine. He was engaged to be married. His fiancee has since moved on with her life, and I have come to terms with my son's death.
My problem is that the mother of one of my son's close friends continues to remind me of this. She calls me every year near the anniversary of his death and wants to take me out to dinner. She always talks about what a "wonderful young man" my son was, how tragic his death was, etc.
Abby, I really can't stand this type of behavior. This year, she presented me with a photograph of my son that her son had taken about a year before his accident. When I saw the picture, it was like a knife in my heart. All of the horrible memories came flooding back.
I think that in some sick way, this woman thinks she is doing a good deed. I didn't want to hurt her feelings by telling her this, but I see that I am going to have to because I can't stand another year of her morbid behavior. Someone who has lost a child doesn't need reminders. We all grieve in our own way.
M.A.R., in Marlton, N.J."
Every individual situation should be evaluated individually.
Please do contact the social service department of your hospital, if you feel like doing so. We keep our memory boxes for 15 years.
"Every individual situation should be evaluated individually"
I agree, and I'm certainly not arguing that point... All I'm saying is every mother should be INFORMED of what choices she may have, and acknowledged that she lost a child, not to be made to feel like she has the plague, or that her feelings (no matter what they are) are unjustified.
I think the people who have sufferered losses who posted here, second that point.
Delivering a stillborn or having a miscarriage is MUCH different than losing a 25 y/o son with whom I'd assume one would already have memories of.
I'm sorry to hear of your losses and appreciate the advice you are offering.
I did want to point out that 'all generalizations are wrong, including this one'.
You stated that your "all the women in your support groups wanted acknowldegement" of thir losses. Please note that you groups are a 'self-selected' groups.
Every woman and family should be evaluated for their needs and those needs met. We make a keepsakes for all our losses but I have found that some definitely do not want them. We keep them anyway, for years, in case someone changes their mind later. Still, some people most assuredly do not want a memorial.
I hope I'm not sounding contrary. I'm just trying to say that no one way is right for everyone.
There are some cultures (I ran into this situation once) that they do not believe in memoralizing the deceased. Everything was collected anyway, per the norm-just in case, but when it was mentioned they were horrified. It was a cultural thing in that case.
There are some cultures (I ran into this situation once) that they do not believe in memoralizing the deceased. Everything was collected anyway, per the norm-just in case, but when it was mentioned they were horrified. It was a cultural thing in that case.
Do you remember which culture this was? It would be really good to know this for future reference. Thanks.
First off and most importantly, I want to extend my condolences to each and everyone of you who have suffered these losses, even those of you reading, but unable to share for whatever reason.
I am a L&D nurse in a very high risk hospital where unfortunately we see more than our fair share of IUFDs, ectopics, and losses of all types. I want to thank each and everyone of you who have shared your stories, both personally and through L&D experience. Especially thanks to NHmommy for starting the thread. I cannot tell you how invaluable this has been to me.
I unfortunately have never had the opportunity to experience pregnancy and have had a total hysterectomy with bilateral oopherectomy three years ago. I am in this line of work because I truly love nursing and the wonder of birth. I am totally enthralled each and every time I am involved with the birth process (I am starting my third year in this specialty). Even with my most difficult patients, I enjoy being involved with the birth.
I hate to admit it, but I am one of those nurses who never knows what to say. I appreciate everyones candor on this issue. It might help in the future. In one of the posts, someone said she feels she is protruding on a private moment. I guess that is one of my problems. I never know what to say. (This has been a problem recently because one of my moms asked another nurse why I wouldn't talk to her when I came in to chart; thankfully she told her that I was a big crybaby who would start crying at the drop of a hat..I think that helped her understand me, but more importantly it helped me see that I have to learn to handle these situations better.)
Our hospital use the memory boxes; we have the regular ones with room for a gown and blanket for the full term babies and smaller ones for the early losses. We have a group of smockers locally who make smocked gowns for us to take pics with and to put in our memory boxes (FT losses). We also put in the ID bands we make, tape measures, anything we would normally use with a birth that we think the moms might like later. We take pictures of all the babies, no matter how early. We take one for our charts, of course, but we try to take a few tasteful ones for our moms; we place a gown on the baby (or over if too small). I try to make sure you can see the feet and hands in the picture. We were using poloroids when I first started, but now we use digital and print the pics in the charge nurse office.
We also supply a folder with literature that is handpicked for the particular situation (early loss, teen mothers, families with other children, dads dealing with grief, grandparents). We have illustrated books for the children. We also have all this information provided in Spanish.
My personal choice for the pictures is to place them in the box underneath the other items. I let my moms know the pictures are there for them to see when they are ready to see them, not the first thing they see when they open the box. That way, the moms that aren't ready to deal don't have to be scared to open the box. (The pictures are a personal pet peeve of mine; I want them to be something that can be looked at without horror and can be shown to family and friends who might want to share in the experience with them. I tell the other nurses, especially my orientees, to please think about what the mother will see when she wants to look at the pictures...don't be clinical.)
Another thing is the paperwork. They want us to have consents signed as soon as we can (autopsy, burial, etc), because the patient cannot sign these until 4 hours after the administration of pain medication and pathology/morgue cannot pick up until it is complete. However, most people do not want to deal with making decisions as soon as we admit them; they are dealing with a shock and have not had time to process, let alone make these kinds of decisions. They also usually want to talk to their family members. Of course, after they deliver, we transfer them to our antepartum floor for their postpartum care and our AP nurse claim not to know how to deal with the papers. This is very frustrating and leads to making the L&D nurses look like insensitive clods for trying to get it done.
I am glad that you addressed the early miscarriages and ectopic losses. I admit that we don't deal with these well. I am printing off several of the posts so that I can share them at work. I think we also have a problem with how some of our residents deal with the moms, like some of the others have noted.
Another thing that I would like to address is placing pregnant moms on the fetal monitors. In the triage area, I like to get the blood pressure first on the monitor so that I know what mom's heart rate is. In L&D, I know some (well, most) of the moms don't like having the BP cuffs and EKG leads on all the time, but I will tell you why I think it is so important. We have had more than one instance of documented FHR that was actually maternal (yes, mom's was running in the 110s or 120s); then the families don't understand how the baby can be gone when it was on the monitor. Then I know when I get the FHR it is actual if I know what mom's is running. If mom is running a high HR and the FHR I find is close to the same, I keep looking and/or I call for a resident with an ultrasound.
Also, I like the idea of printing an US pics for the moms with losses. I am going to make that suggestion.
I know this has been long and I appreciate the opportunity to be able to share. I think maybe I have rambled and it is not in any kind of order. I just wanted to make sure that I addressed everything. Thanks again for the insight. I hope this will help make me (and my coworkers) better able to deal with the families with fetal losses.
Specializes in MedSurg-1yr, MotherBaby-6yrs NICU 4/07.
I have suffered 3 pregnancy losses. One at 12 weeks, one at 13 weeks and then a hydatiform mole which later turned to trophoblastic disease requiring 3 months of Methotrexate treatment. The 2nd miscarriage was the worst because I developed bleeding after assisting a falling patient to the floor at 9 weeks. I had a blood clot behind the placenta and the Dr.'s watched it for the next 4 weeks when I began to bleed and subsequently lost the baby at home. Even at 13 weeks you could see his hands, feet, etc... and although he was not pretty, he was my baby. I wish the hospital had offered to let me bury him or take pics, but I went to the ED and the nurses treated me horribly. I didn't pass the placenta so I was on Pitocin drip, and when my husband asked for pain meds for me they told him it was in my IV. Too bad they didn't know I was a nurse and knew better! Anyway, the Ob on call wasn't my usual Dr. so he didn't know my situation and was so callus. The ED Dr. was actually the most compassionate person. He was the one who looked to see the gender of my baby, I didn' think to look at that at the time I lost him. Anyway. All the cliches about you are young, you were early, you've got plenty of time- really anger me still when I think or hear them. :angryfire And I have since had 2 healthy children. (Just celebrated the baby's 3rd birthday on Friday!) ---All that being said, our hospital does a really good job with our demises, ectopics, etc...( I lost my first 2 babies at the local hospital, I drive 45 minutes to work at my facility) Like a previous poster stated, you really do start thinking pink and blue when you see that line on the pregnancy test. It is a baby from that moment on. And everybody does grieve differently. At the time of my losses, I would have never thought I would want a momento, a memorial, or to actually have a gravesite for my babies because I was so early, but now, even 6 years later, I mourn them, and wish I had something. My first baby would have started 1st grade last week.... It is still hard to swallow. Even after all this time. Sorry for the long post. Thanks to the one who started it and all that have posted. It is always nice to know you are in good company.
Pedi-ER-RN, RN
103 Posts
WE have a program called Healing through hope that was started by some NICU nurses. There is a memory box, handprints, pictures, clothing that is placed on the baby for pictures, they get the armbands, etc... Seems like alot of L&D nurses don't know how to deal with fetal demise, they are accustomed to getting a baby out and rescuscitating it, but that's not always the case. I saw a set of 19+5 twins stillborn the other week (one passed while the other had FHT's for a while) and they looked good. Mom wanted to look at him and I am sure they did footprints, etc...