It is also always stressful for any caregiver to accompany parents who are going to lose or have lost a baby. You wonder what to say and what the contact will be like. Unfortunately, there is no script or protocol for it and you have to do it based on your intuition and sensing, which is different for everyone. So: do and say the things that come naturally to you, and “don’t show a rehearsed trick”.
We can give you some tips on communication and baby care and we’ve put together a checklist to make sure you don’t forget anything.
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Checklists
Here you will find KCKZ’s protocol for maternity care in a family where a baby has died.
Do’s & Dont’s
Do’s
Discuss the wishes of the parents before giving birth
Do they want to see baby right away, right on the chest, who cuts the umbilical cord, etc? Make sure there is enough room to decide otherwise after the delivery. Stay in close contact with both mother and father during and after the delivery. Situations may still change, or things may feel different than they had expected. Previously made choices may feel less suitable now. Thus, it is essential to keep checking whether the way things are is OK for the parents.
Do the same things as you would do for a living baby
Measurement/weighing/carrying in your arms/wigging/talking.
Recognising and naming fulfilled needs
- love
- proud
- heat
- becoming a mommy and daddy
- making memories
- birth
- pregnancy
Recognising and naming unfulfilled needs
- sadness
- anxiety
- anger
- frustration
- disappointment
- remorse
Making sure parents make the right choice
Give them all the information they need to make the right choices, but don’t force anything. Every parent has their story and their history and, based on that, they don’t or don’t want to do things.
Parents have completely lost control of their lives. Give them back control where (medically) possible. For example, let them think about the date of the birth. Some want to wait a bit longer to arrange things, others want to give birth as soon as possible.
Share your own story
This can sometimes be very helpful when the parent feels less alone, or allows them to make the right choices based on your experience.
Live / pretend:
When parents are anxious, instead of just talking, it can help to pretend by holding the baby, talking to him or lovingly caring for him. If you are open to parents taking over, you will see that this often happens. Give them space.
Congratulations/Condolences
Some parents like this, otherwise parents want the intended intention but in other words, instead of congratulations, say for example how beautiful the baby is and instead of condolences you can say how sorry you are. Do what works for you.
Make a difference between medical and non-medical information
Many parents want the medical information to be concrete, clear, honest and to the point. Indicate clearly why certain things go the way they go and what the medical reason is. That often provides understanding. If there is a choice, let parents choose. Where possible, give parents back control over their lives.
Deviate from protocols that apply to live babies
For example, if a father wants to take his deceased baby to his wife who is lying in the recovery ward, he does not necessarily have to carry the baby in a crib, you can give father the baby in his arms.
Don’ts
Trying to ‘justify’ things or improve the mood:
- Fortunately, you have other children.
- You’re still young.
- He wouldn’t have had a good life with this condition anyway.
- Luckily, he hasn’t lived.
- Luckily, you haven’t been able to get attached yet.
- I don’t have any children of my own.
‘Fill in’ for the parents
Don’t make decisions for parents. Let them choose for themselves. Don’t just put on a hat because the head isn’t pretty, don’t dress the baby yourself because it looks nicer. Don’t cut the umbilical cord yourself because it is more convenient.
Congratulations/Condolences
This point is at the do’s but also at the don’ts. Some parents don’t like it at all and even find it painful to be congratulated. But almost every parent likes to hear how beautiful the baby is. Instead of condolences, you can say how sorry you are. Do what’s right for you.
Share your own story
This is not useful if you only share the story in order to process or determine something yourself. It is possible, in that case, that the parent feels that your story makes them feel unheard. It is only possible if it is functional.
Care
Physical care of the deceased baby
Vulnerable babies (premature birth or macerated)
Do not place the baby on a fabric surface, e.g. a hydrofield cloth/wrap. This sticks to the fragile skin and you often can’t get the cloth off without damaging the baby (even more). Use the back/plastic side of a fibre mat. This does not stick to the baby and can easily be changed.
Don’t dress the baby and don’t put on a hat. Again, clothes and hats stick to the body, get dirty and start to smell and cannot be changed.
Lubricate the baby completely with (lots of!) baby oil. This ensures that the baby leaks and sticks less. When the baby oil has been soaked in properly, you can use a soft cloth to gently wipe away any excess skin with a soft twisting motion, after which you can often dress/wrap the baby.
If the baby has severe maceration, it helps to dab the maceration spots with a soft cloth (hydrofield cloth) with thin bleach. The spots will be ‘burnt shut’ through the bleach, so that they no longer stick and leak and the baby could be dressed.
The scent of the bleach evaporates after a while but you can also mask them by rubbing the baby with baby oil afterwards.
View the working instruction here.
Apply Vaseline to the baby’s lips as soon as possible after birth. This prevents dehydration and therefore (black) discoloration of the lips. You can also use Flex for this, which is available through Omega Supplies.
Don’t bathe the baby. This damages the fragile skin and causes extra damage and dehydration.
Apply the water method: www.watermethode.nl
Less vulnerable babies (from about 25 weeks and not macerated)
You can bathe the baby.
Massage in/massage with baby oil. Especially mothers who have had an emergency section like this because they had to miss the first contact with their baby.
Comb and cut a few hairs.
Get dressed / put on a hat.
Additional Support
Felice Foundation
Makes the sad farewell a little nicer by offering all parents a name pendulum and a wooden name animal free of charge. The foundation also supports parents who are struggling financially. See www.stichtingfelice.nl for all the possibilities.
Make A Memory Foundation
Makes photos of sick or deceased children from 23 weeks of pregnancy up to the age of 18, free of charge www.makeamemory.nl.
Stichting Still (Still Foundation)
Offers a free photography session to families of a seriously ill child or parent.
In addition, she provides photography of sick, dying or deceased babies from the 2nd trimester of pregnancy.
www.stichtingstill.nl
Stichting Phéron (Phéron Foundation)
Provides information on the website. The Phéron Memory Box helps healthcare professionals in the hospital to provide fine aftercare and allows parents to create tangible memories in a gentle, intuitive way. The Phéron Foundation works together with 25 hospitals.
www.stichtingpheron.nl
Stichting Hanne (Hanne Foundation)
Offers an information booklet, and has developed a memory box which contains beautiful memory products. The Hanne Foundation already works with 7 hospitals that give the box to parents. If you also want to connect, please mail to: marlieke@stichtinghanne.nl
www.stichtinghanne.nl
Stille Levens (Silent Lives)
Resource centre on infant death providing much useful information regarding the loss of a baby.
www.stillelevens.nl
