The death and the pregnancy and infant grief constitute a disturbing reality for parents who go through this ordeal. This issue is still known very little and misunderstood by the health and social services. Different resources such as CLSC, the attending physician, the nurses and private professional services can provide the necessary assistance to parents during this difficult time.
The values and attitude of the health care professionals towards death may influence their ability to intervene with the parents who face the death of their baby. How they respond to the parents or how they accompany them during this period can thus facilitate how the parents will go through the grieving process and how they will remember their experience.
According to the National Public Health Institute of Québec, there is, in the province, no established intervention protocols on pregnancy and infant bereavement. Across all the regions, the range of services is uneven and practices are diverse. The types of intervention include those designed to recognize the existence of the deceased baby (for ex. encouraging physical contact with the deceased, collecting memories, organizing a funeral ritual, etc.) and counseling interventions (i.e. phone follow-up, home visits, individual follow-up, support groups).
At present, the scientific evidence is insufficient to determine the effectiveness of different types of interventions in pregnancy and infant grief. Therefore, given the current state of knowledge, the rigid application of a protocol is not being encouraged.
It is essential to many families to be offered a choice and to decide for themselves the services that suits them best because it gives them the possibility to regain some control over the events. Thus, it is suggested that professionals offer enlightened choices, support their decisions and avoid putting pressure on parents towards a particular intervention.
How to interact with the parents
- Recognize the loss. Parents consider that one of the most important aspects is to have their loss recognized by professionals, regardless of the age or the gestational age of the deceased baby.
- Use language that recognizes the existence of the baby. Many professionals consider a miscarriage as a non-threatening medical condition to health and use terms such as “product of conception” or “embryo”, which can dehumanize the baby in the eyes of the parents. Therefore, professionals must pay attention to the parents’ words when they mention their baby and use these same words when exchanging with them.
- Respect cultural and spiritual practices of families. It is important that professionals be sensitive to cultural or spiritual practices of the families to avoid misinterpreting a reaction that would be considered normal in a particular cultural context.
- Lend an ear, make time and be attentive. Parents like that professionals take the time to listen or to simply be present with them. They also appreciate that one allows them to cry and one accepts what they have to say without judgment and with compassion.
- Support parents in informing their relatives on the death.The professional can help them decide how they are going to announce the baby’s death to relatives and support them to face the reactions of those around.
- Provide information. The parents want the health professionals and social services take the time to sit with them to communicate various information (causes of death, physical effects of postnatal period, pregnancy and infant bereavement resources, parental leave, etc.). These professionals may be asked to repeat the same information over and over, because parents may have difficulty understanding and retaining details because of their emotional state.
- Coordinate postnatal care.,They have to be consistent with the situation of the family (i.e. avoid that the parents receive a telephone call for the baby’s health monitoring, while one is deceased).
Further training in pregnancy and infant grief
Training on pregnancy and infant grief for professionals