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Stillbirths and miscarriages are terms that have historically made people feel uncomfortable.
They evoke feelings of sadness for the loss of the baby.
But, in recent years, there have been many strides made to improve and promote healing. The ways to do that may not have seemed that obvious years ago, but they are starting to emerge now, according to medical experts.
“We have five labor and deliveries,” Geisinger Registered Nurse Elissa Concini said. “That is typically where these women are, which is hard because we need the resources for the labor and delivery, but we also need to be sensitive to the emotional needs of the patient. So, usually, what they’ll do is put them in a room that’s further away from where all of the obvious live births are happening so that they can kind of be in a more peaceful and quieter place. We always find a private room.”
A private room or a flex room has become a topic of interest, Concini said. Throughout her 12 years as a nurse, she said she’s noticed that more and more of what formerly may have not seemed normal has been normalized.
Both miscarriage and stillbirth are a form of pregnancy loss, according to the U.S. Centers for Disease Control and Prevention. The United States defines a miscarriage as the loss of a baby before the 20th week of pregnancy and a stillbirth is the loss of a baby at or after 20 weeks of pregnancy.
“There has been a shift in understanding that the gift of time is valuable for these families,” Concini said. “There is no limit to how long they want to hold their baby, whether it’s breathing or not. There’s no reason why they can’t take this baby home and bring it to the funeral home themselves. We don’t have to force the baby out of their arms. When I first started as a nurse, what was normal, if they didn’t want to see their baby, we wouldn’t encourage them otherwise. The staff has changed that, our providers as well. We counsel patients. We give them the gift of time. What we know now is that through the normal bonding process, it is better for the families. When they leave, they have some closure.”
Several evidence-based articles report that taking photos, making mementos, and taking time helps.
“Some people may think that acting like the baby is alive is a terrible thing to do,” she said. “But we’ve found that doing all the things that you wished you would do with your baby, that really is normal now…I think the intention, though, does not come across this way. Sometimes, someone with a lot of experience might think this may be more harmful for the patient, but lived experiences tells us that that is not true. We’ve learned that it’s helpful.”
Geisinger records a baby’s heartbeat while it’s alive for parents who know they could lose their child. Some nurses take photos of the stillbirth babies and provide weighted bears the weight of the baby to have something to hold that was the baby’s size, she said.
Throughout the bereavement process, Concini recommends finding additional resources like Stillbirthday.com or finding groups like Harpers Warriors Foundation.
As more and more medical professionals are buying in to seeing labor and delivery structured more broadly, bereavement rooms or flex rooms are starting to become the norm.
“I would love to see a day where we have some way to flex a room or have a room available that is normally a quiet room,” she said. “But, now we have a bereavement room for families. I would never want to use it frequently. It would already be a reconfigured area. Many of our sites have talked about it with the understanding that it wouldn’t be an overnight solution, but now they’ve restructured a quiet area for families to go and sit and visit and to be separate from labor and delivery.”
Here is how Penn State Health Children’s Hospital in Hershey manages bereavement:
“At Penn State Health Children’s Hospital, the Complex Fetal Care Center team gets involved early with parents-to-be whose babies have a known diagnosis that maybe incompatible with life. The Center provides counseling and other services to help parents prepare for adverse outcomes and work through the grieving process.
Our bereavement team works with all parents as needed to create the best experience possible and to preserve memories of their child. This includes partnering with outside organizations to provide parents with a basket of keepsakes, including a heartbeat bear, hand and foot molds and photographs. The team caters its approach with each family depending on their preferences. Parents may choose to hold, bathe and dress their baby. We also have a book cart for parents who wish to read to their baby – and take the book home. The bereavement team also involves siblings – again, based on the family’s preference.
At Penn State Health, we believe that these families deserve the same opportunity to parent as any other family would.”
Penn State Health Lancaster Medical Center (in East Hempfield Township)
“The Family Birthing Suite at Penn State Health Lancaster Medical Center has a flex room that is specially equipped for all care that could be needed for obstetrics patients, including those potentially experiencing a loss. The room’s location allows us to maximize privacy for the family. The Medical Center also connects people who experience a perinatal loss with community support groups.”