The silence of fetal demise

[GrammaKay]

I know that I am not alone here, I know that there are nurses out there who can relate to the title I gave this and the heart wrenching feelings that come with it.

Sometimes we have that gut feeling that tells us that something is wrong, sometimes not. I didn't want to work this final weekend at my job. Only two nights left to my contract and for some reason I dreaded it. But I went, I felt an obligation to the staff I have been working with and my patients. I had an easy assignment, one s/p c-section and one cervical ripening.

At 6:30 am I woke my patient once more and said, up to the BR and then I can remove that cervidil. We both laughed and off she went to the BR, telling me she had actually woken at 4 am and it fell in the toilet, I was busy with my other patient and she hadn't wanted to bother me. Playfully I chastised her for not calling me.

When I did Leopold's I felt something was wrong, when I placed the us on her abdomen there was silence, I adjusted the volume, no placental sounds, no fetal heart tones, I checked the monitor again, as I reached for the phone it rang and the CNM was on the line, I said "come in now", I called the Resource nurse to get me the ultra sound machine at bedside, things were happening at the desk as I sat with my patient and listened to the silence.

The silence, I felt a tear slowly moving down my cheek and my patient chatted about how stubborn this baby boy was. She didn't understand, how do you tell someone?

The silence... the ultrasound showed us a vertex position fetus, we viewed the ribs and looking inside at the heart that sat motionless I felt the weight of my own in my chest.

The story continues, but for now I am dealing with the silence, and the sadness. I am reaching out to others that have heard it and can relate. Please share with me..

[classicdame, MSN, EdD]

I never worked L&D, but I did work Pedi and had to pass some LDR rooms to get to work. The hospital had a falling leaf sign placed on the door to indicate fetal demise. It reminded staff to act appropriately when in the room. There were no words on the sign - what words would suffice? I would feel so sad walking past that sign. Every death affects us all.

[Jolie, BSN]

Our world is a tiny bit smaller, poorer and harsher for the loss of this precious baby. You can't help but feel that. Thank you for your compassion. Bless you, this baby and his grieving family.

[babyktchr, BSN, RN]

I was drawn to your title, and I thank you so much for your post. This is the part of OB that isn't what everyone talks about. Please know that I am relaying an internet hug to you right now.

This silence is quite powerful. While most welcome silence, this type of silence envokes powerful physical and emotional reactions upon hearing it. It is unlike any other silence I know.

I am a bereavement counselor for my unit and have been present for too many of these occasions. It is a struggle to find the right words of comfort when you know there just could't be anything that you can say to make this better. The shock and the horror, especially in this situation that you described, must be totally overwhelming. One thing I have learned is that most who have suffered a loss will always appreciate the nurse being human....and if that means you cry with them, or just sit with them, hug them, or simply giving them a tissue when they cry....this is what they need. They simply cannot wrap their head around what is going on. It does not reach the places where reason lives. This is not a reasonable event. They need control. It is heartbreaking.

Grief reminds us that we are human. It is part of the circle. I always remember a line from one of my favorite movies...STEEL MAGNOLIAS. It simply says, "That which doesn't kill us, makes us stronger." I think that is so true. We need grief in our lives to remind us that happy is just that. There are many reasons a baby dies. There are times there aren't reasons.

The silence touches all of us in different ways. I am thankful that you were there with that family, and you were able to touch them in some way, that they will remember once that pain dissipates just a bit. You were there for a reason. The silence you feel is that of being human. And that is ok.

Do something for you. Get a massage. Get your toes done. Hug your child (or someone elses). At this time of year especially, be thankful for what you have, and pay it forward. That in itself, heals.

There is so much I want to say here, because this topic is so special to me. I work with bereaved parents because I believe that I am meant to. It touches me, gives me something because I give to them. Maybe it just simply reminds me that I am human. I feel for you, dear heart, and in time you will hear more than just the silence. If you ever need, please feel free to message me.

[PinkNBlue, BSN, RN]

Oh gosh I am so so sorry. Hugs to you.

I usually have no idea what to say when patients who have had fetal demises are transferred to our floor (mother baby). We do have a little leaf with a tear drop on a piece of paper that we put on the door so other people know not to expect a baby or ask where the baby is. I know the nurses in L&D do foot prints of the baby in cement as a keepsake for mom and dad. There's also a company called 'Now I Lay Me Down To Sleep' http://www.nowilaymedowntosleep.org/ that our hospital may use if the parents agree. It is really so important to have pictures of the baby to remember. There's so much going through mom's head at that time.

I am sorry you had to experience that. I honestly don't know what I would do in that situation yet because I'd be crying right there with mom.

[jrring1019]

I am an OB nurse who lost 2 babies. I found the absent fetal heart tones myself, both times... There is nothing like that awful silence. When it was confirmed by the doctors, by u/s, it is absolutely indescribable to see your own baby with no heart motion.

As the mother, you never forget what is said and done during those moments by the drs and nurses. Every moment of both inductions stays with me.

Each time I put someone on the monitor and there is a moment when I can't find the heart tones my stomach sinks. I have never found absent fetal heart tones on a patient, but I have cared for them after. In 12 years, I have never had that experience from the nurses standpoint, but it was MORE than enough to be the mom and discover the silence myself.

[Elvish, BSN, DNP, RN, NP]

I am so so sorry for this lady's loss.....and for yours. There is nothing like it in the world. Hugs to you.

[SmilingBluEyes]

I, too, am am OB nurse who knows the personal and dreadful pain felt when you lose a child, whether born or not. Thank you for the poignant post. I hope it helps to begin your healing.

I know you must understand, it's never easy. I had a horribly sad, devastated lady and her boyfriend undergoing induction for a very late term fetal demise just about a year ago. I cried with her, held her, listened to her and did all I could to be there for her. I felt woefully inadequate and helpless. But I did my best.

HAPPILY she became pregnant again very soon and I was priveleged to be her nurse when she gave birth to a healthy girl just a couple weeks ago. She was so happy to see me; I was surprised as I must have served as a horrible reminder of her loss. But I was wrong; she said she was comforted and helped so much by me and felt she wanted to share her joy with me this time. She remember me only as being kind to her during her difficult situation just a year before. THIS made my day and helped me to realize our being there is about all we can offer, but it is SO MUCH to those folks losing babies.

Please, never lose sight of the importance of our presence and active listening when such patients come into our care. We really do affect them more than we can possibly realize. This gal helped me see that and I am glad she did. It's neither easy nor comfortable, but sometimes, we are all they have to help them cope. We need only say we are sorry and open our arms, ears and hearts to them.

NEVER lose heart, nor hope.

[MrsMommaRN]

:icon_hug::icon_hug::icon_hug:

[mom2bnrs]

I am a farily new-grad; I've only been out of school for about a year now and I have had this experience also.

I can never seem to find the words to say to these mother's or father's, but I realize I never will.

I love my job, but I will never get used to having to go through this kind of situation.

I'm sorry to hear about this story.

[prmenrs, RN]

Sometimes, stuff happens @ work (whatever specialty we're in) that reminds us not to whine about the small stuff.

Best wishes to you and your patient, and to all moms who have babies living only in their hearts.

[life_aknew]

personally speaking, it was nurses like you that changed my path of life forever. you are the reason i set out to become a nurse. your humility and your grace and your care...and yes your grief helped me waaay after i left you.

for me, silence speaks volumes. there are no words or keepsakes that fills that...huge dark space when you lose your child-your flesh and blood that shared your body day to day to day. there isn't anything that stops you from lactacting when there is no baby to feed or the glorious pain you feel as you stare down at a child with perfect features and realize with striking horror that you will never hear them cry or laugh or coo or stare up at you....

the guilt one is riddled with that some how you-your body failed your baby. silence speaks volumes. there are no words-none. whether someone understands or not, the fact that you listened to my incoherrant babbling and sat with me through indescribable grief while i sobbed as i never in life did was the most helpful thing you did for me.

maya angelou said something that i believe is becoming my credo~people may not always remember what you did, they may not always remember what you said - but they will always remember how you made them feel.

i remember. you are a great nurse.:redbeathe