Postpartum Care: Mother and Family Delivered Stillborn Child
How do you Care for Parents who gave birth to a stillborn child?
A mother who has delivered a stillborn child could be devastated and a nurse might have to provide an appropriate care during that difficult time. Parents go through increased sense of bonding and attachment during pregnancy, but after a stillborn child they all of a sudden develop grieving process. Nurse should allow the parents to go through grieving phases of denial, anger, bargaining, depression and acceptance. One might spend more time in one phase than another. Some parents take longer than others to get hold of their life afterwards and in such cases it is crucial that the nurse provide support and resource within and outside the healthcare facility for healthy recovery. Mother should be given sufficient time to spend with her baby, and she might prefer to spend that time alone too. Sadness, anxiety, guilt, anger and intense emotional behavior are normal part of grieving, and some family members not realize that. Therefore, nurse needs to educate that it not unusual to develop a sense of guilt or anger towards other family members or healthcare workers. Even though father might not show as much emotions as the mother, he could still be undergoing grievances as severe as the mother due to stillborn child. Nurse can also arrange positive presence of interdisciplinary healthcare team such as grief team, counselors, family and friends, nurses and physicians, and therapists for the family to support them. Nurse need to educate the parents that formal funeral can be arranged if there is one available at the facility. And if the child was stillborn unexpectedly, the parents can request the autopsy to determine the reason for the stillbirth. Educate the parents about the findings, whether it was unexplainable, due to infection, baby’s chromosomal abnormalities, complications with placenta and umbilical cords or anything else (Parents’ Perceptions of Nursing Support Following Neonatal Loss).
A care for a family that has delivered a child with significant birth defects along with anticipation for child death within weeks will be different than the ones discussed above. This is because the death hasn’t occurred yet, even though the grieving process might have already begun since the birth defect exists already. Care will be prioritized in the order of child and then family members. Child will frequently need to be monitored while allowing parents to have a quality time with the baby. Nurse will still need to arrange the presence of interdisciplinary team to provide medical and emotional support. Nurse need to take time to educate family members who don’t understand how the baby developed the congenital defects and why baby could die within few weeks. It is very important that the family knows what to expect during their hospital course, and risks and benefits of surgical procedures of their baby. The parents will need to be explained the process involved in palliative care so that the baby could achieve the best comfort during her last few weeks (Perinatal Loss: A Family Perspective).
Palliative care is an important consideration not only because it makes the patient feel comfortable but also makes the comfort of the patient a higher priority than any other interventions such as treatments of disease and defects. Therefore, the parents might choose their baby to live comfortably and ignore treating the birth defects. Nurse will need to stay on top of pain by administering pain in a timely and efficient manner to allow time for the mother and child to spend time together. Even though it may be important to communicate to the parents about the causes or possibility of birth defect occurrences in their future pregnancy, it is appropriate to postpone that teaching until the end. Other important nursing implications include assisting parents to identify unspoken wishes that may be displayed by their developmentally disabled child, and taking the time to listen, talk, and develop trust and rapport with the family (Providing End-of-Life Palliative Care for the Developmentally Disabled and Their Families).