Nursing Care of a Family With a Stillborn

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Table of Contents

Introduction
Literature Review
Aspects of Nursing care of a Family with a still Born
Conclusion
Reference List

Introduction

Discussion

The death of a baby at birth causes a collision that leaves families anguished and disoriented. A stillbirth occurs when a fetus dies between the 20^th week of pregnancy and birth. A stillbirth may be realized while the baby is still in the womb; however, some women endure full-term labor before they realize that their child had died. For a family which has lost a baby, this period is exceptionally stressful, both physically and emotionally especially for the mother (Timby, 2004). For instance, although the woman loses the baby, her body will still produce breast milk and undergoes postpartum transitions, such as hormonal shifts and after-pains.

Nursing care for these women can be a challenging and humbling experience. Nurses must examine their thoughts, feelings, and assumptions about the death of a baby and the bereaved family. This self-examination covers preconceived ideas, judgments, and experiences of loss (Timby, 2004). To provide effective nursing care, nurses must show open and caring attitudes expressed through appreciation and acceptance of validation of the experiences of the mother and her family (Taylor, 1999).

Nurses must be sensitive to the wishes of the mother. The majority of women who experience a stillbirth prefer a room in another unit away from the nursery and postpartum area. It’s important to allow the woman and her family as much time as they need to be with their baby. The desires of the woman and her family should guide the nursing care (Schott, 2007).

Literature Review

Nursing Roles and Functions, and/or Nursing Interventions

Clinicians who have dealt with bereaved families stress the significance of memories and images of the deceased person in assisting the resolution of the mourning process. Many researchers advocate that parents be granted the chance for contact with their dead child, and create mementos of the baby as usual practice. Henley (2008) reveals no evidence that mothers who decide to see and hold their babies are pleased afterward that they have done so; those who decided not to see and touch the baby were divided, with some regretting it, and others feeling that they had done the right thing (Timby, 2004).

Timby (2004) claimed that seeing the baby assists parents make sense of their loss. Schott (2007) discovered that depression was higher in mothers was prevalent in mothers who had not seen or touched their infants. Henley (2008) reported that some families who had not seen the baby were troubled with the fantasy that the baby had not died, but had been stolen or kidnapped.

Schott (2007) explains that occurs after about 1% of all births. Grief after the baby’s death is severe, and for parents, the process of mourning lasts on average 2 to 3 years. Poor marital adjustments, little social support, and poor previous physical or mental health issues are related to more severe symptoms of depression after the loss. In his article, Capitulo (2005) explores the concept of grief due to stillbirth and healing interventions based on evidence for it.

A stillbirth causes profound grief, yet society has ignored this grief for a long time, thus providing the most painful of bereavement experiences. Research on family grief and the requirements of bereaved parents has changed the context of professional intervention from protective to supportive (Schott, 2007). The main concern of these interventions is to assist family healing by aiding them to cope with losses. The necessary interventions can be adapted to promote the healing of the bereaving (Capitulo, 2005).

Nursing roles and functions to families with a stillborn

Nurses play a significant role in families with stillborns. These roles include the provision of competence care; advocating for parents and helping them in grief wall; reinforcing to parents that the event was not their fault; providing sufficient time that the couple requires to say goodbye to their baby; inquiring if a name for the infant was chosen and call the baby by the name (Flenady, 2009).

This gesture will help in making the loss real; acknowledging the families loss by stating “I’m sorry about your losses”: if acceptable with the couple, a member of the clergy may be called for burial and funeral arrangements and for providing religion and spiritual support; initiate hospital protocol for bereaved parents such availing booklets on stillbirths; availing a list of resources, such as support groups upon discharge; make contact follow-ups at intervals of one week, 4 to 6 weeks, 3 months, and at the first anniversary date of death (Timby, 2004)). Nurses can make these contacts by phone, or home visits and are significant for integrating the death of the infant; and schedule grief conferences for parents to meet with the involved medical staff 4-6 weeks after the death of the infant and after a request from the parent (Timby, 2004).

Nursing care interventions

Nurses can play a greater role in assisting the grieving family. With skillful intervention, the grieving family may be prepared to resolve their grief and move forward. To help families in the grieving process, nurses must include the following measures: provide the family with accurate and understandable information; encourage discussions of the loss and venting of feelings of grief and guilt; provide the family with baby mementos and pictures to validate the reality of death; allow the parents unlimited with the stillborn infant after birth to validate the death. Allocate time for the family members to be together and grieve; accord the family the opportunity to see, touch and hold the infant (Henley, 2008); inform the religious leader of the family’s denomination about the death and request his or her presence; assist the family with the funeral arrangements or disposition of the body; provide the parents with brochures advising about how to talk to others siblings about the loss; refer the family to support groups; and make community referrals to promote a continuum of care after discharge (Flenady, 2007).

Aspects of Nursing care of a Family with a still Born

Psychological and Emotional Aspects

A stillbirth usually exposes a family to a traumatic experience. When a stillbirth occurs, parents must come to terms with the grief associated with such loss. In addition, hospital staff members also experience crucial concerns, such as; determining the individual who will inform the parents, choosing the various delivery options, and deciding whether the parents should view the baby after delivery. Once a fetal death has been diagnosed, the health care institutions usually remain with two causes of action. Labor can be induced or the pregnancy can be allowed to continue under observation while awaiting the spontaneous onset of labor.

If the pregnancy is allowed to continue while awaiting the spontaneous onset of labor, hospital staff are faced with having to deal with the often confused and/or angry feelings of the mother and her family (Timby, 2004).

The mother may be confused as to the reasons for such a course of action. At the same time, she attempts to come to grips with the facts of the death of her baby. Timby (2004) noted that once the onset of labor has occurred, the parents experience other feelings of which the hospital staff should be aware. These feelings include: fear, given that there is little to look forward to after delivery, the mother may worry about the child’s appearance, especially if the baby has been carried in the uterus for several days; guilt, where the parents must deal with their sense of responsibility for the baby’s death.

For instance, they may blame their behavior during pregnancy, such as eating and drinking habits; anger, where the parents may be angry at the death of the baby and this anger may be directed at the hospital staff; and loneliness, where the baby’s death may cause the parents to ask themselves such questions as ‘why us?’ or ‘why our baby?’ (Timby, 2004). The parents may experience intense feelings of isolation and abandonment as a result of their shattered dreams (Flenady, 2009).

Social pressures

Parents usually confront problems when they are discharged from health care institutions. One of these problems is the difficulty with which other people deal with their loss. Repeatedly, parents are required to go over the experience in weeks following the loss and may realize that friends are embarrassed or impatient for them to move on. As a result, parents may withdraw from some social contacts, often around the second month. Timby (2004) states that what helps parents is having people who will listen, who will be patient, and allow them to grieve for longer than the listener feels is necessary. Parents appreciate friends and family who recall that the loss was awful for them, and who do not avoid them but who write, call or simply ask how they are coping. Sensitive friends also realize that the parents sometimes need to be alone (Timby, 2004)

Conclusion

In sum, the major issues presented in the articles were: psychological and emotional aspects of nursing care of families with stillborns; the social pressures parents experience after discharge; nursing roles and functions of a family with a stillborn; and nursing care interventions for a family with a stillbirth. The main concern of these nursing interventions is to assist family healing by aiding them to cope with losses through the provision of accurate and understandable information to families; encouraging families to discuss the loss and vet their feelings of grief and guilt; allowing families considerable time with the stillborn (Henley, 2008); providing them with body mementos and pictures to validate the reality of death, and others (Timby, 2004).

Reference List

Capitulo, K. (2005). Perinatal Loss: A Family Perspective. Journal for Perinatal and Neonatal Nursing. Web.

Flenady, V. (2009). Investigations of Still Births. Web.

Flenady, Wilson, T. (2007). Support for Mothers, Fathers, and Families after Perinatal Deaths. Web.

Henley, Schott, J. (2008). Comfort or distress: Should Parents Hold their Stillborn Child?. Royal College of Midwives Journal. Web.

Schott, J., & Henley, A. (2007). Pregnancy Loss and Death of A baby. British Journal of Midwifery. Web.

Timby, B., & Smith, N. (2004). Essentials of Nursing. Sydney: Wolters Kluwer Health.

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