Perinatal Death: Grief Support for Families

Abstract

Adequate support for parents whose baby dies requires close listening to the parents themselves, and familiarity with other successful programs of helping parents with grief: Interviews with 24 parents who lost their babies revealed what they found to be supportive or damaging behavior on the part of caregivers. Parents wanted doctors and nurses to acknowledge their feelings of shock, guilt, and grieL to recognize the importance of parents' memories of the birth and the baby, and to help parents sharpen the reality of the death. Parents' and hospital staff views of several types of grief support through the postpartum period, during and after hospital discharge, and throughout a subsequent pregnnncy and birth, are discussed. (BIRTH 10: 2, Spring 1983) What do parents who have lost their baby identify as supportive or unhelpful behavior on the part of doctors and nurses and other caregivers? We know that nurses and physicians feel acute pain, and perhaps shock and guilt when a fetus or baby dies during their care. We accepted the premise that caregivers themselves must recognize their own feelings before they can approach bereaved parents in a warm, understanding manner and took the next step, that of finding out from the parents themselves what they found helpful and harmful on the part of caregivers after the death of their baby.Interviews were held with four couples who had lost their babies and were enrolled in preparation for childbirth classes for a subsequent birth. Six teen other parents were interviewed about their perinatal loss in maternity clinic settings and in group meetings. This paper summarizes the interviews with these 24 parents.

Hospital Care for Parents After Perinatal Death

“…Syracuse, NY: Syracuse University, 1995; Cacciatore, in press.). 17,22 Three described parents who were resentful about inadequate pain control during labor, and five reported parents who regretted feeling sedated during delivery. Although sedatives are not a recommended treatment for grief reactions, a surprisingly high 41% of parents interviewed in a 1994 study reported that their physicians had prescribed such medications.…”

Navigating care after a baby dies: a systematic review of parent experiences with health providers

“…Nurses who gave parents permission to cry, who used humor appropriately and who seemed to go out of their way to spend extra time with the family were viewed as particularly supportive. 16,30,44 Many parents felt their nurses had given them special attention; some identified this as extra emotional or spiritual support whereas others saw it as additional time or care beyond the usual tasks. 17,20 Several parents commented that when caregivers were themselves tearful, it felt honest and genuine and the tears seemed appropriate.…”

“…Parents frequently described nurses bending hospital policies to accommodate them, such as expanding visiting hours or allowing children on the wards. 16,20,24,44 Families appreciated nurses who took care to provide special photos or mementoes of the baby or who helped them create memories of their baby. 17,18 Nurses who attended to the physical needs of mothers after delivery, including small tasks such as brushing a mother's hair or holding her hand, were also seen as supportive.…”

“…45 Parents generally wanted to know the cause of death and although they did not always recall the details, they did remember if the physician had sat and talked with them about this topic. 30,44 Parents made note of staff who helped keep the family informed and who provided information about treatment plans or prognosis of critically ill infants. 16,18,38,44 Families also liked providers who they felt gave honest answers and appreciated health teams who provided them with consistent information, though parents often reported wanting even more information and explanations.…”

“…30,44 Parents made note of staff who helped keep the family informed and who provided information about treatment plans or prognosis of critically ill infants. 16,18,38,44 Families also liked providers who they felt gave honest answers and appreciated health teams who provided them with consistent information, though parents often reported wanting even more information and explanations. 16,31,46 Finally, Wing (2002) described a perinatal grief program with multiple components and found, not surprisingly, that there was a correlation between the overall number of bereavement services given to parents and their general level of satisfaction with care.…”