If you would like information about how to help place a Cenotaph Cradle at your local hospital, please get in touch with us here. Cenotaph Cradles extend the amount of time a family can spend with their newborn, and it can make a world of difference in the grieving process.
There are very important actions a nurse can take to help a family dealing with any type of neonatal loss, including:
Answer any questions the family may have. These parents initially may have difficulty trusting the medical community, but nurses and others can play a critical role in regaining this trust by fulfilling promises in a timely fashion.
Although parents may appear to be dealing with their grief quietly, they may actually be in denial and bargaining for the miracle of a live baby.
Assess the parents’ knowledge base about the situation. Ask them if they completely understand the situation and if they have had any previous experience dealing with a death.
Ask them if they would like to have clergy visit them, and ask if anything else can be done to assist them at this time.
Assist with early pregnancy loss. If the pregnancy is ending spontaneously or if the woman will need a surgical procedure, explain as much as possible and appropriate about the procedure and timing of events. Give parents as many choices as possible. If parents come into the Emergency Department, try to reduce as much of the trauma of hospitalization as possible. Provide them with a private room instead of a curtained cubicle, if possible.
Assist with late pregnancy loss. If the pregnancy is at or near term, help the parents revise their birth plan and educate them about options for pain management. Some parents may not have started, or not have finished, prenatal classes yet. It may be necessary to give them an overview of the labor and delivery process.
The most beneficial commodity that any nurse can offer to a grieving family is a nonjudgmental deep sense of caring and personal involvement.
Prepare for “magical thinking.” This can come from almost any parents who are told the diagnosis of fetal death—that this is all a mistake and their baby really isn’t dead. Although parents may appear to be dealing with their grief quietly, they may actually be in denial and bargaining for the miracle of a live baby. They may not truly believe that the baby has died until delivery, when there will be more open displays of grief (Kirkley-Best and Kellner, 1982).
Encourage parents to name their baby. Naming the baby supports the personhood and individuality of the baby, and helps to crystallize the baby’s unique identity and place in parents’ lives.
Encourage parents to see and hold their baby, explaining the benefits of this contact. Refer to the baby by his or her given name whenever possible and describe the baby to the parents before handing him or her to them. If the baby has been in the morgue, let the parents know in advance that their baby will feel cold and will appear to have a blue color.
Help the parents undergo a claiming phase. Give them as many details about the baby as possible, such as the baby’s weight, sex, and physical appearance.
Encourage parents to have photographs taken of their baby. This helps document for them that they are parents. Over time, these photos may become the family’s most significant mementos and memories of this baby.
Make footprints and hand prints of the baby, and, if the baby has enough hair, save a lock of it for the parents. Parents may also want linens and things that came into contact with the baby for their later remembrances.
Label the bereaved parents’ room with a special sign or symbol. This indicates that the patient’s baby has died so that inappropriate comments about the baby aren’t inadvertently made to parents by support service personnel.
Offer parents the choice of being in either the postpartum or gynecologic unit. If the woman has been in the hospital for a period of time before the death of her baby, she may have a strong, supportive relationship with nurses on the antepartum unit; however, most parents prefer to go to the gynecologic unit so that they don’t have to hear babies crying or watch other families with their babies.
Encourage parents to have an autopsy performed. This procedure and its findings can allay much guilt and anxiety for parents by demonstrating the normalcy of the baby.
Prepare parents for the changes ahead. If this was a woman’s first pregnancy, inform her that breast milk may come in and prepare her to deal with this physical and emotional discomfort. Explain that she will have lochia and educate her about the process of uterine involution.
Advise the woman to be aware of postpartum danger signs of endometritis, retained placental fragments, urinary tract infection, and deep vein thrombosis—this is standard information for all new mothers, but sometimes such discharge information gets overlooked because women who suffer pregnancy loss may go home more quickly.
Provide all instructions and information in writing. Parents may be in shock after their loss and may not listen well to instructions.
Grief: What to Expect
Bereaved parents need anticipatory guidance about the grieving process and ways to protect themselves from well-meaning but poorly thought-out advice and comments from family members and friends. Explain to parents that there is no set time frame for resolution or incorporation of grief, even if some people may try to tell them that.
Parents need to know that the grief experience is unique to each person experiencing it. Grief that partners feel will not be identical, nor will their grief be expressed similarly. Their grief will not be the same grief that their own parents feel or that a neighbor who also lost a baby at the same gestational age feels. Try to give parents some strategies to deal with these differences in expression and suggest various methods of communication, such as writing letters or keeping journals about the baby.
Follow-up with these parents after hospitalization is essential to help them maintain the healthy grieving that they started in the hospital. Most programs suggest that the nurse or grief counselor who was the most involved with parents in the hospital monitor the parents posthospitalization. This not only provides parents with a perceived connection with someone who “knew” their baby, but it also provides them with a support person who already knows their situation and circumstances. It also offers nurses feedback about the final outcome for these parents; this reinforcement may energize nurses to provide very special knowledge and care for the next family who suffers a pregnancy loss.
Bereaved parents require sensitive, caring nurses who devote thought and effort to assessing and meeting their special needs.
Bereaved parents require sensitive, caring nurses who devote thought and effort to assessing and meeting their special needs. Such a nurse must provide comprehensive care that takes into consideration parents’ ability to assimilate the necessary shared knowledge. Nursing plays a significant role in initiating a healthy grieving process for parents after they experience a pregnancy loss. The care that nurses provide will have a lifelong impact on the family, as they travel down the long, difficult road to grief integration.
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