Thoughts on working with a laboring patient with a deceased baby?

sbic56, BSN, RN · May 4, 2004

sbic56...that would be my big concern as well.....since we are talking about this, does your hospital have grief counselors readily available or do you just rely on the chaplain or how does that work?

One of our staff RN's is a trained grief counselor and follows all of these patients for the first year after their loss. Unfortunately the lady that had the C/S refused any support or counseling post-partum. As I said previously, in respect for her, I leave out the details of the case, but her inability to cope with the loss was very sad. I wish she could have allowed those who knew how to help her through it.

lgowan · May 11, 2004

It is not an easy situation, and yes I think to start with I shied away from it. However, as I often say,"I work in the happiest or the saddest place in the hospital on any given day." Both situations can be equally rewarding for the nurse. I do encourage the parents to see and hold the baby, however, I respect their feelings. We do provide bereavement packages for the parents including pictures and momentos. That way, they can go through the memories when they are ready.

Lisa

kar212 · May 22, 2004

Hello. I'm the one that started this post. I just wanted to say that I didn't have a c-section and I'm very glad about that. The emotional pain was bad enough. I can't imagine actually wanting a c-section when you're not even going to go home with a live baby. I was 27 weeks along. I was on an antepartum unit and thankfully heard no babies crying. The nurses were wonderful. I was prepared for the stillbirth since we learned at 18 weeks that our baby had a fatal condition.

Kyriaka · May 22, 2004

We have a standard bereavement package made up of pictures and such. Some families don't want it and I just make sure they know that we will save it if they should change their minds.

_______________

This is a very good thing. My mother has the photos of my children in her attic. I havent looked at them. But they are there if I ever want to. And a lock of their hair also.

So perhaps the packet could be given to a family member to keep. It would be a shame if the hospital ever lost the photos and the parent(s) wanted them later.

Kyriaka · May 22, 2004

It still seems like in these scenarios that the patient should be able to decide how they want to deliver. I am not an advocate of c-sections for convenience, but this is one case where I would think there should be a choice.

____________________

I agree. The woman may not want to be awake.

Kyriaka · May 22, 2004

Her baby died and they made her carry her for four days before inducing and delivering.

________________

I had a great aunt who in the 1930's was about 4 months pregnant and they made her carry the full 9 months because they said if they induced it would be a violation of abortion laws!??

Energizer Bunny · May 22, 2004

Her baby died and they made her carry her for four days before inducing and delivering.
________________
I had a great aunt who in the 1930's was about 4 months pregnant and they made her carry the full 9 months because they said if they induced it would be a violation of abortion laws!??

These scenerios are just amazing to me! I still cannot believe that they made my Aunt carry her baby for days.....I would be seriously suing someone over that one. It was so hard on us...I cannot imagine how hard it was on her.

Kyriaka · May 22, 2004

These scenerios are just amazing to me! I still cannot believe that they made my Aunt carry her baby for days.....I would be seriously suing someone over that one. It was so hard on us...I cannot imagine how hard it was on her.

_________________

What is really weird is that the Dr.'s told her that she might die from toxic poisoning, but well, they couldnt violate abortion laws.

From what I was told, for the rest of the pregn. she knitted a little outfit for the funeral! Can you imagine putting someone thru that.

TammyWilson808 · May 23, 2004

I have been an L&D RN for nearly three years and for the first time I cared for a woman whose baby died in utero at 24 weeks gestation. There was a large part of me to be busy with the paperwork and the necessary function of the process. That is the "nurse" part of me. My heart was another story...

I initially walked into the room, introduced myself to my patient and the family and established a rapoir (sp?) with them. As my night progressed, in relating to this grieving woman, I understood my role clearly. I am there to provide emotional support, present both woman and father of the child with labor options and give them what they need---space to feel their loss. I felt my role is and always will be to these aching souls is to focus on this: their angel's presence, though brief with us, had a definite purpose. We not always aware of their purpose, but they are gifts to us just the same. And these precious babies are perfection, their physical bodies might not be, but their essence of who they are is perfection.

I did share this with my patient that night---and I did share my tears of sorrow with both parents. I told her that the whole night I had a knot in my stomach and a lump in my throat and I felt her pain. But what I was feeling paled in comparison to what she was feeling and how her heart ached.

I felt I needed to be professional in dealing with my patients and I know I am a good RN. But I also was dealing with another human being whose heart was full of pain. My gut told me that spilling tears with my patient was a good and empathetic thing to do. Not losing control kind of crying, but tearing is ok! And as an L&D RN, we are taught to trust our gut, our intuition---because it is usually the right thing to do.

I did encourage my patient to have an epidural to diminish the labor pain after she decided to deliver baby lady partslly. Also I did encourage the family to hold baby after being cleaned up and placed in a soft cotton flannel baby blanket. We have a friend of an RN I work with make baskets that baby's nameband, lock of hair, and clothing, etc. go into and the family can take home. We do footprint and provide the family with our unique baby birth certificate. The baby's cribcard with its footprints will in the basket as well.

I have the best job in the world---and for the most part it's happy. And for the other, it's still very satisfying and rewarding. I wouldn't do anything else.

Aloha,

Tammy

Kyriaka · May 23, 2004

Tammy,

May I ask where on the floor was this woman put. When my mother had me (almost 40 years ago) a woman's baby was born stillborn. She was put in a double room with a women who had a healthy baby. That poor women had to deal with happy visitors coming and going bringing gifts and such to the other women. For a whole week no less.

Please tell me that that is not done anymore.

TammyWilson808 · May 23, 2004

Tammy,
May I ask where on the floor was this woman put. When my mother had me (almost 40 years ago) a woman's baby was born stillborn. She was put in a double room with a women who had a healthy baby. That poor women had to deal with happy visitors coming and going bringing gifts and such to the other women. For a whole week no less.
Please tell me that that is not done anymore.

Aloha Kyriaka,

We have a beautiful five labor/delivery/recovery/postpartum rooms. My patient was put in one of the five rooms most separate from the two postpartum couplets we had that night. I have not seen a more protective bunch of nurses (I call sisters) of their patients than whom I work with now. They are my mentors and teachers. They have taught me how to cherish and hold sacred the women we care for. Really! Visitors are screened and only allowed by whom the patient chooses. She was craving chocolate and I was able to find some chocolate ice cream with chocolate syrup for her. Just spoil her rotten. And encouraged her to spoil herself when she got home and cradle herself with her very attentive family's love. I think the best came from that very sad situation.

Aloha! Tammy

Energizer Bunny · May 23, 2004

Tammy, you sound like a fabulous nurse and your unit sounds like just the place I would want to be if ever in that situation. I think you are great!