When a baby dies

Taking care of a postpartum patient who just lost her baby is probably one of the most heartbreaking assignments you can have as a nurse.

I am in no way claiming to be an expert at taking care of patients in this situation, but I have learned a few important things to keep in mind.

  1. Although her chart will say “fetal demise,” never use those words in front of her. Her BABY died. Period.
  2. Your hospital should have some sort of subtle identifier on the door. Ours was a falling leaf symbol. If you’re in any hospital role that interacts with patients, make sure you know what your symbol is.  I’ll never forget the look on my patient’s face when the phlebotomist saw the nursery bassinet next to her bed and congratulated her.
  3. Don’t use any of those sayings you’ve probably heard, such as “God needed another angel” or “It was all in God’s plan.” I’ve heard family members say these things, and trust me when I say it doesn’t help.
  4. Many parents will want to hold their baby, even hours after they’ve passed. If the baby has been in the morgue, please wrap him in swaddling blankets from the blanket warmer before bringing him to their room. Always keep several of these blankets in the warmer, even if it’s on a different unit, just in case.
  5. Remember that both parents are grieving. Sometimes the dad doesn’t know what to say to his wife. Please let him know that this is okay, and that just being there with her is enough.
  6. Visitors- some women will want to be surrounded by them, others will want to be left alone. No matter how pushy the mother-in-law (or sister/best friend/aunt) is, don’t let her enter the room until your patient says it’s okay.
  7. Some women will want to talk about whose nose he has, or point out to you that his toes are long, just like his dad’s. This is perfectly normal and if she starts the conversation, look at her baby and comment about his cute little ears, or whatever feels right at the time.
  8. Before saying anything meant to comfort the mom, put it through one simple test: Would you say it to her if it was her six-year-old who had died instead? If the answer is “no,” don’t say it.  For example, “You can always have another baby.”  Or, “When will you start trying again?”
  9. Please don’t try to find anything positive out of the situation, because there are no positives to be found. One family member said to my patient, “Well, at least you’ll get to sleep while you’re recovering from your C-section.” Of all of my patients, these women are probably the ones who sleep the least. So if there’s a family member saying things like this and upsetting your patient, get them out. Announce that you need to clear the room for an exam, then ask your patient if she wants the visitors allowed back in.
  10. Remember that everyone handles traumatic situations differently. Some patients will barely say a word to you, while others will need someone to talk to. Adjust your treatment of the patient to her needs, not your expectations of her needs. I remember how stiff and uncomfortable I was around my first patient who’d lost her daughter. As I was leaving her room, I said I’d be right back with her “Victoria’s Secret panties”- what I always call those horrible mesh postpartum panties. I gasped, horrified that I’d made even a tiny joke in her time of mourning. And you know what? She laughed. Hard. She then made a joke about something she’d done during the delivery, which made her laugh even more. About a minute later she started crying, and I sat on the bed, crying with her. It’s hard to explain, but it’s almost as if my little “mistake” broke the awkward ice between us, allowing us to be ourselves– which is exactly what she needed right then.
  11. Be prepared to cry. I’ve taken care of ten women who’ve lost their child– thirteen babies total. And I cried for or with every single one of them. I never let my patient see the full extent of my tears, because I didn’t want her to feel like she needed to comfort me- but I felt her loss on a deeper level than I’d ever expected.

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