Perinatal Loss: Impact on Parents, Extended Family, and Nurses (Nursing)

00:01 Grief and loss has an impact on both parents.

00:05 Often, we center our counseling or therapy or support on the birthing person.

00:11 But remember, there are two parents that are involved in this situation.

00:15 So we need to really observe both of them for signs of depression or health problems.

00:21 Maybe marital disruption or even partner disruption for couples that are not married.

00:26 We can also have decreased overall wellbeing.

00:29 Just because we get into a situation of complicated grief or we're not able to practice activities of daily living, and that can absolutely happen.

00:37 And the nurses need to really be on the forefront of helping to anticipate that and support the family through that.

00:43 We also want to think about recovery for the family and maybe give them some ideas when they're ready for how they want to move forward.

00:50 Some families might create a memorial or a fund, or they may find a new sense of purpose in their life as they begin to really deal with the loss.

01:00 They may decide to have additional children.

01:03 Maybe you've heard the term rainbow baby, and a rainbow baby is a baby that comes after you've had a loss.

01:09 Some parents do that. It's not something that we recommend or really give advice about when that occurs, but definitely know that that's one of the ways that parents tend to really address some of the grief that they're experiencing.

01:23 Now it's important that we know that it doesn't matter how long the person was pregnant or how long it's been since the death occurred that there is going to be an impact of loss for that family, and we need to ask often and support those parents.

01:38 Beyond the parents, there are other members of the family.

01:41 Think about the children that were expecting that brand new baby brother or sister to come home, and they're not.

01:48 And depending on their developmental age, there may be some things that we can do to support the siblings as they go through this loss as well.

01:55 And what about the grandparents? Those of you that have been in families, sometimes, you've had that experience where the grandparents are almost as excited about the pregnancy as the parents are.

02:06 And so imagine what that loss feels like and those same feelings of grief and regret, and they're also concerned about their own children, so it's almost a double effect for the grandparents.

02:15 And the support might be there for the parents, but it tends not to extend out to the rest of the family, so let's do a better job about that.

02:24 So let's talk about how the nurse should respond.

02:28 First, it is very important that we acknowledge the family's grief.

02:32 Let them know that it is normal to have a range of really responses to what's happened.

02:38 It could be sadness or anxiety or stress, distress, anything, but let them know that it's okay to feel all the feelings they're having.

02:48 Help them to really begin to create support systems, both in the hospital or the clinic.

02:54 But thinking about what they're going to need when they go home.

02:57 Do they need help with other children? Do they need help making decisions about going back to work? But help them to identify that. That can go a long way in the road to recovery.

03:07 We also want to help the parents to realize that this is an experience that happens in the moment, but it has reverberations for a lifetime.

03:15 So it's not something that you just get over. You just go on.

03:19 We want to guide parents in coping and encourage them to spend time with their baby, and we'll talk about that a little bit more in just a minute.

03:27 We also in the labor suite can create rituals.

03:30 We might want to encourage the family to have a photographer come and take pictures of the baby, dress the baby, take footprints and handprints because these are momentos that mean so much to the family, even if they're not really able to really take it all in at that particular moment.

03:46 So things that we say have a huge impact on families.

03:50 We want to say baby versus fetus.

03:52 We might say fetus when we're talking to our healthcare colleagues, but that's not the way we want to talk about the baby regardless of what the baby looks like, what condition it's in when it comes out, it's a baby, and that's how we need to refer to it when it comes out.

04:06 We want to listen empathetically to whatever the family's feeling, and again, it may not always be clear to us.

04:12 It may not be something that we expect, but we need to be there to listen and we want to avoid any statements that minimize the loss.

04:19 You know, this is God's way or you can always do this again or any of those other things that really minimize the client's experience.

04:28 Now, there's value in words but there's also value in not saying anything at all.

04:34 Your presence is a wonderful source of support.

04:37 Sitting quietly with the family, just holding a hand, or not touching the client if that's what they would prefer.

04:44 They may not be ready to talk about what's happened right now, and that's an okay response as well.