stillborn births

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I don't know how you OB guys do it. I had my 1st stillborn delivery about 12 hours ago. I got to the delivery room @ 2240. Pt's membranes ruptured @ 2247 with thick mec. I was having trouble finding fetal heart tones. (that's because there wasn't any). Contractions petered out, so we start to Augment with Pit. We tried to put a scalp clip on, to no avail. Babe was born @ 2303, no heart rate or spontaneous resps and had obviously been deceased for several days. We are a rural hospital and our docs have recently given up on doing deliveries because we don't do that many in a year. This girl was literally driving through town and stopped by. We had to transfer her to another hospital due to a retained placenta. The Dr and myself went in the ambulance, just in case something went more wrong. I got back to home base @ around 0300 and walked around in a daze. I feel so sad, I don't know that sad is even the word. A couple of people have told me "there's nothing you could have done." I know that, but it still doesn't make me feel better. I am still crying for the mom and babe. Sadder still is this mom phoned a hospital a couple of days ago and said she was having decreased fetal movement. Hospital said "oh, its just because there isn't enough room in there, and not to worry.

sorry, forgot to say, mom was G2 P1 and 36 4/7 weeks. There was 1 nuchal cord, could this be the cause of death. Unfortunately, there will be no closure for the staff that was on because she is not local and she ended up in another hospital.

I don't know if I will be able to sleep today, I keep seeing the baby's face. What do you OB guys do the decompress.

Sorry for the long post, but thanks for listening

shearernurse

Jo Dirt

3,270 Posts

Has 9 years experience.

Precicesly why I could not work in OB.

As for the mom calling the hospital to report decreased movement and being poo poo'ed away, I hope the nurses who accuse expectant moms who come in to the unit concerned about their baby of trying to manipulate the system to get induced early or to get attention or to take away care from those in obvious need...I hope they will consider this next time a mommy comes in concerned about how her baby is doing. As I sit here holding my 3 week old I can't imagine anything worse happening. No matter how silly it may seem at the time, an expectant mother should always be taken seriously.

I'm terribly sorry this happened. That baby was just called back to be with God before it was time to be born. I like to believe everything happens for a reason, maybe this little soul came into that body for the purpose of teaching a lesson to others by teaching them about the experience of feeling so sad that sad can't even describe it. I know it doesn't make it any easier, sorry for all involved.

cheshirecat

246 Posts

Specializes in midwifery, gen surgical, community.

Do you have community midwives in USA? If mum phones to say she has decreased movements over here, a midwife would go out to her home and listen to babies heartbeat and access the situation.

One of the hardest things about being a midwife was when we had a foetal deathl.

crysobrn

222 Posts

Specializes in OB L&D Mother/Baby. Has 7 years experience.

Very sad. Stillbirths are very hard. This is why I always tell my moms to come in when they call concerned or questioning. I'd rather have them come in and have it be nothing than have them stay at home and have it be something. Will anything come of the call a few days earlier, do you log calls, keep track in any way who talked to who??

CEG

862 Posts

Do you have community midwives in USA? If mum phones to say she has decreased movements over here, a midwife would go out to her home and listen to babies heartbeat and access the situation.

One of the hardest things about being a midwife was when we had a foetal deathl.

Unfortunately not :( No postpartum home visits, nothing. I have a good friend who returned to her home in England after giving birth here and said it was like night and day. I would love to be a community midwife- I may have to move to England.

MrsMommaRN

507 Posts

Specializes in orthopaedics. Has 2 years experience.

so sorry you are having a hard time with this. i can't imagine what you are feeling. it sounds like you gave her excellent care. the baby had been gone for awhile. my thoughts are with you.

justme1972

2,441 Posts

As a patient...I went to my OB a few times over silly things I over-reacted to, and every time I found out it was nothing, it was very comforting to hear, "I would rather examine 1,000 'nothings' than miss one critical event that turns out to be something we would rather not have."

THAT is when you know you have a good OB.

KJRN79

138 Posts

Specializes in OB/peds (after gen surgery for 3 yrs).

I was an OB nurse for about 10 years. Yes, you cry. You are supposed to. I don't remember my "first" anymore. I do remember two and that was because I had worked with the mom for the singleton and the other mom delivered triplets at about 22 weeks. You feel for the moms, you think about it all of the time, until you don't think about it any more. You grieve and usually you don't get the answer to "why?". Those babies are still precious. That mom is going to remember you, as being there to help her through that horrible night. Take comfort in knowing the baby's face WILL fade. I promise. As far as decompressing? Coming here. Talking to others who were there with you and maybe some who weren't there too. Taking a shower. Flipping through a magazine. The usual stuff. I hope you feel better soon. ~~Karen

33-weeker

412 Posts

Has 20+ years experience.
Unfortunately not :( No postpartum home visits, nothing. I have a good friend who returned to her home in England after giving birth here and said it was like night and day. I would love to be a community midwife- I may have to move to England.

When I called my midwife because I wasn't feeling twin A move much that day, she actually left her Christmas shopping and met me at her house/office to listen with a doppler. He turned out to be ok - thankfully. Talk about service! I felt bad for messing up her plans.

And people wonder why I prefer midwives to OBs...

vandermom

62 Posts

Specializes in L&D, NICU, PICU, School, Home care. Has 42 years experience.

Dealing with a fetal death is a challenge and tests our strength to our very soul. I work in a small unit so we don't see many. This year has been tough because we have had a full term and a 36 weeker within a couple of months. The fact you feel so bad usually means you have great compasson for your patient.

I have been the one to care for most of these pt as I can "handle it". I think my co-workers (some) just don't know what to say or do for the patient. What I have found is that the patient will have an easier time of it if you can hold it together until the end. Then you can cry together. TALK to the patient. Tell her (and her support) what to expect. What her choices are as far as holding, the baby etc. Let her know that she will be able to hold her baby if she wants and that you will stay there for her. Let her know it is ok to change her mind.

What I do fo rmyself to "get me through" is prepare a memory box for this family. The usual footprints, crib card, ID bands, and photos are important to this famiily. But also I have created a "Certificate of Life" that acknowledges to this family that this was a life they treasured. (Our state does not issue a birth certificate unless it is a live birth). I put a lock of hair on this (if possible). I make small blankets to wrap these babies in and also crochet oneies. Most of the moms keep the blankets next to them after the baby has be taken to the morgue. I also use some of the baby wash on the baby just to provide them with the "baby smell". We baptize if requested and provide a certificate for that also.

A while ago one of my co-workers found a poem called Fringerprints written by Tom Krause in 2001. I read this each time I put it in the box for the family. Makes me cry everytime but helps me through. We wrote Mr Krause and recieved permission to print it and give to the moms.

All of these things help me to get to a good place knowing I helped them through this horrible time in their lives. The faces do fade but the memory of helping the families linger. The biggest reward is when they come back and ask if you will help them through the birth of their next baby and get to celebrate the life with them.

lovemyjob

344 Posts

I can really relate to how you feel right now. I work NICU and lost a patient a few weeks ago. After the familyt left (I had been by the mothers side for 9 hours) I finally cried. The next day I was SO depressed. I was in a fog. I couldnt stop thinking about the family, how they felt that morning waking up knowing he was gone, how they felt going back to the hospital to finish filling out paperwork, how theyt felt on the drive home (5hrs) how she would react when asked about her baby in the coming weeks, months. I felt like I had to remind myself that it was not my baby that died.... I was grieving like I had just lost a family member. Then I realized. During the 2 days I spent with this mom, her and the baby became family.

The next day I went shopping for a journal, bear, and card for the mom. I took several days to think about what I wanted to write. I felt a huge sense of relief to know that I could send something to her letting her know that I was till thinking about her aznd her baby.

If you think it woud be helpful, find her address in the hospital record and send her something.... a journal is always helpful. Or, write her a letter expressing your feelings and hold your own little vigil and burn the letter you wrote.

Still, almost a month later, I still think about this particular family almost daily. But, after sending her something, I feel a lot better.

I wish you the best. You have a kind soul..... that is what makes you such a wonderful caring nurse. The mother and baby were lucky to have you for their nurse.

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