Appendix C: Interventions for Supporting Mothers and Families After Infant Death, Stillbirth, or Miscarriage
Interventions for Supporting Mothers and Families After Infant Death
- Offer the client to remain in program from 4-8 weeks post event; have an agreement between the HVer and the client as to how long the client will remain in the program.
- NFP programs should consider the use of Visit-To-Visit Guidelines: Stages of Grief, Stillbirth, Loss of My Baby, Remembering My Loss, Loss – How to Cope, My Grief- My Partner's Grief, My Song, Breath those Thoughts Away, etc.
- Understand the do's and don'ts of what to say if an infant dies. (see Table 1)
- Understand there may be different support needs at different times in the grief processs. (see Table 2)
Table 1: What to say, and what not to say, if an infant dies
Below is a table from a qualitative phenomenological study that identified thirteen support needs at different time periods of the grief process for families experiencing a child death. Consider using the information in the table below when writing local agency adverse outcomes guidelines for client visit schedule and support.
Table 2: Support needs during the grieving process for families experiencing a child death
Interventions for supporting clients who have experienced a miscarriage or stillbirth:
Attachment between a mother and baby begins before birth. It is important for mothers and families to experience an empathetic and supporting environment to come to accept the reality of a miscarriage or death of an infant. Normal grief reactions include sadness, depressed mood, irritability, preoccupation, anxiety and changes in eating and sleeping patterns. (10)
- Determine the meaning of loss to the client: if during pregnancy, does the client use the term “baby", or have they given the pregnancy a name? Does the client refer to herself as “mother"? How do they respond to the question, “I wonder how you are doing with all of this?"
- Assess the parent's knowledge base about the situation. Help mother understand what will be involved with pregnancy loss; and
- If it is a late pregnancy loss, determine what hospital practices and supports are available, such as holding the child or on site memorial services. encourage naming of the baby; prepare for magical thinking (that it's a mistake and their baby really isn't dead);
- Prepare woman for changes, such as possible breast milk;
- Ensure woman aware of postpartum danger signs;
- Physical care should be included as you would in any postnatal care.
- See table 2 above.