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The Midwife and the Bereaved Family

The Midwife and the Bereaved Family by Jane Warland
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A dead baby is a very real happening for some women and midwives. This death may occur in early, middle or late pregnancy, at birth or in the postnatal period. Miscarriage, abortion and stillbirth are the terms used to describe this event in a woman's life. Technology and sophisticated prenatal care have helped to reduce infant morbidity and mortality in Australia. But however good the technology and care may be, when a woman and her family are faced with a dead baby they will ask many questions of both themselves and the caregivers; perhaps not immediately, but they will ask. What midwives need to ask of themselves is 'Do I have the knowledge, the skills and the ability to deal with questions?' This book is based on women s experiences and has been written for midwives, by a midwife. The chapters follow a chronological pattern from early pregnancy loss through to late pregnancy loss. The chapter on subsequent pregnancy is useful as a guide for the midwife who will be caring for that woman and her family. Nothing is overlooked in this book as the appendices give helpful hints and strategies for looking after yourself, men partners, children and grandparents. So often these groups are forgotten in texts and the focus is always on the woman. The cultural section provides an overview of some of the mores and rules of particular cultural and religious groups and will be very helpful to guide care in a sensitive way.
Ausmed Publications; August 2004
167 pages; ISBN 9781597340151
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Title: The Midwife and the Bereaved Family
Author: Jane Warland

'Did I do the right thing?' and 'Is there anything else I should have done?' Most midwives working with bereaved families do a very good job when they are faced with helping a family grieving the loss of a baby. This book sets out to affirm and reassure you, whilst verifying your knowledge and giving you guidelines for 'best practice'. My hope is that you may also acquire a new perspective from information that may either be new to you or that you haven t previously considered.

When a baby dies it is not possible to have a set of procedures for management of a given condition that will lead to an expected outcome, i.e. '3 cuddles of dead baby + photos = good experience'. People are different and what will work well for one couple may not work at all for another. Using actual words from bereaved families as well as from the literature, and drawing from my own experiences, I have attempted to provide you with a range of choices in any given situation in order to foster your own creativity to enable you to individualise care for each bereaved family.

The Midwife and the Bereaved Family is divided into areas of chronological loss and subdivided into smaller sections with subheadings. It is my intention that the reader will thereby be able to quickly find a checklist or a suggestion if needed. Midwives working in labour wards may not feel it necessary to read the early pregnancy loss section; midwives working in a gynaecology setting may not wish to read about later pregnancy loss. However, I do encourage you to read all sections of this book, whether or not they address your particular area of practice, as you may gain an insight into the range of issues that confront your colleagues.

Midwives have a uniquely important role in supporting recently bereaved families and setting them on a 'good grief' path. In-depth counselling, 'stages of bereavement' and 'tasks of mourning' usually occur later than the midwife s care.They belong rightly to practising trained grief counsellors and so are not found in this book.

Midwives are in the unique position of having seen and/or 'known' the dead baby and are therefore very important to the bereaved family. Midwives are in a position of enormous responsibility when providing bereavement care to families.How we act, what we say and what we encourage parents to do or not do,impacts on them for the rest of their lives. If bereaved parents feel they were well cared for then they will often have some positive memories of the experience. If, on the other hand, they received what they consider to be poor care then they will be distressed and angry for a long time afterwards. Helping grieving families consists of the provision of care,support and information both around the time of the death and during any subsequent pregnancy and birth.