Recurrent perinatal loss: a case study

From Death Notification Through the Funeral: Bereaved Parents' Experiences and Their Advice to Professionals

Parents who experience the sudden death of a child will interact with many professionals in the period immediately following the death notification through to the funeral. The way these professionals respond to the parents during this critical period may be perceived as helpful, and thus support them in beginning the process of managing the trauma and starting a healthy grieving process. It may also be perceived as unhelpful, though, and contribute to more prolonged and complicated grieving. This article identifies the interventions that a sample of 20 parents who had experienced the sudden death of a child found helpful with different aspects of grieving. Specific advice is given to police, nurses, doctors, coroners, social workers, crisis counselors, funeral directors, and chaplains or clergy.

Experiences of african american parents following perinatal or pediatric death: a literature review

A child's death is one of life's most difficult experiences. Little is known about the unique factors that influence the grief experience for bereaved African American parents. Through an integrative review of 10 publications, the authors describe the grief responses, outcomes, and implications for African American parents who experience the death of a child. Four themes emerged: (a) emotional response to loss; (b) factors that added to the burden of loss; (c) coping strategies; and (d) health consequences of grief. Healthcare providers, administrators, and policymakers should be sensitive to the unique needs of African American parents following a child's death.

Le retour au travail lors d’un deuil périnatal

Cette recherche empirique qualitative de type exploratoire a pour objectif principal de lever le voile sur l’expérience de retour au travail d’employés vivant un deuil périnatal. Plusieurs recherches s’attachent à décrire et à étudier les conséquences d’un deuil périnatal chez les parents. Il est alors établi que le deuil périnatal se distingue des autres types de deuil, bien que l’intensité de la douleur vécue soit aussi importante.

Pour l’heure, la littérature en ressources humaines se fait plutôt discrète sur la problématique du deuil périnatal spécifiquement en contexte de retour au travail. De fait, il devient nécessaire de référer à des études s’intéressant au retour au travail à la suite d’autres types de difficultés personnelles. À ce sujet, les écrits soulèvent trois catégories de facteurs influençant le retour au travail : les facteurs sociaux, organisationnels et individuels.

L’importance de la perte que le deuil périnatal représente pour les parents endeuillés est souvent sous-estimée au sein des organisations. Lorsque les parents reviennent au travail après la perte de l’enfant à naître ou de leur nourrisson, ils sont fréquemment encore bien ancrés dans leur « processus de deuil » et d’adaptation à celui-ci. Or, le retour au travail dans le cadre d’un tel type de deuil est généralement peu encadré par les organisations. Cette étude fait donc état du vécu des employés en deuil au moment de leur réinvestissement en emploi. Afin d’explorer leur expérience, trois groupes de discussion ont été menés au Québec, avec des femmes ayant vécu la perte de leur enfant à naître ou de leur nourrisson.

L’analyse de contenu a permis de conclure que la prise d’un congé à la suite du décès de l’enfant à naître ou du nourrisson, bien qu’importante, est insuffisante à elle seule, puisque lors de la reprise du travail, l’adaptation au deuil n’est pas terminée. Le facteur qui semble le plus déterminant au regard d’une réinsertion réussie s’avère le soutien que procurent les organisations par le biais de diverses pratiques, les plus importantes étant l’accès à un programme d’aide aux employés et l’aménagement du travail.

Fathers’ Perspectives During Pregnancy, Postperinatal Loss

OBJECTIVE

To present information about the father's perspective during the experience of a pregnancy following perinatal loss.

DESIGN

Descriptive phenomenology.

SETTING

Interviews were done in a venue chosen by fathers (home, clinic).

PARTICIPANTS

Ten fathers who had experienced a loss within the prior year and were currently with that partner in a subsequent pregnancy. FOUR THEMES EMERGED: Recognition, preoccupation, stoicism, and support.

CONCLUSIONS

Participants describe the need to be recognized by others. The orderly conduct of their daily lives is disrupted by preoccupation with the pregnancy. They feel unable to share their own anxiety and fear because they want to protect the mothers. Societal pressure to "be strong" and the belief that "men don't share" appear to inhibit fathers from getting support. Strategies to assess and support fathers emotionally at the time of loss and in the subsequent pregnancy need to be explored.

Life support decisions for extremely premature infants: report of a pilot study

The purpose of this pilot study was to describe decision making and the decision support needs of parents, physicians, and nurses regarding life support decisions made over time prenatally and postnatally for extremely premature infants. Using the collective case study method, one prenatal, one postnatal, and one postdeath, if the infant had died, tape-recorded interviews were conducted with each parent. With parents' permission, prenatal interviews were done with the physicians and nurses who talked to them about life support decisions for their infants. Twenty-five tape-recorded interviews were conducted with six cases (six mothers, two fathers, six physicians, and two nurses). Hospital records were reviewed for documentation of life support decisions. Results of this pilot study demonstrated that most parents wanted a model of shared decision making and perceived that they were informed and involved in making decisions. Parents felt that to be involved in decision making they needed information and recommendations from physicians. Parents also stressed the importance of encouragement and hope. In contrast, physicians informed parents but most physicians felt that parents were the decision makers. Physicians used parameters to offer options or involve parents in decisions and became very directive at certain gestational ages. Nurses reported that they believed that parents needed information from the physician first, then they would reinforce information. The results of this study offer an initial understanding of the decision support needs of parents.

Follow-up of Parents who Experience a Perinatal Loss: Facilitating Grief and Assessing for Grief Complicated by Depression

The importance of providing follow-up support to parents who have experienced a perinatal loss has been described in the literature. Anecdotal reports demonstrate that many health care professionals provide some type of telephone follow-up contact to bereaved parents in the weeks following the loss. Yet, limited information exists to guide the way that follow-up telephone calls are made, especially for assessing complicated grief. Health care professionals are often challenged as they attempt to identify parents at risk, especially when contacts are provided over the telephone. While it is never easy to talk to a parent during the very painful adjustment at home, guidelines for follow-up telephone calls can assist professionals in providing sensitive, individualized follow-up care.