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Follow up care of bereaved parents after treatment withdrawal from newborns

Abstract

OBJECTIVE To explore parents' experiences of bereavement care after withdrawal of newborn intensive care.

DESIGN Face to face interviews with 108 parents of 62 babies born over two calendar years in the East of Scotland.

RESULTS Only 22% were seen by six weeks after the death, 10% were not recalled before 6–11 months, and 8% were not seen at all in the first year. All except one couple saw the neonatologist who had cared for their baby. Only 33% remembered a neonatal nurse being present. Most (88%) were seen in the study hospital. Parents highlighted a number of specific needs. Appointments should be: (a) scheduled soon after the death of the baby and certainly within two months of the death irrespective of whether or not autopsy results are available; (b) with the named neonatologist; (c) in a setting away from the hospital if possible. Parents value: (a) efforts to find out how they are coping; (b) full frank information given sensitively to enable them to build up a cohesive picture of what happened and assess their future risks; (c) reassurance where possible, but half truths, false reassurances, and broken promises are unacceptable.

CONCLUSIONS Follow up care is a crucial part of the management of families from whose babies treatment has been withdrawn. Resources devoted to it should be re-examined to provide a service more in tune with parental need. In choosing the place, timing, and conduct of the meeting, staff should be sensitive to the expressed wishes of the parents themselves.

  • follow up
  • treatment withdrawal
  • bereaved parents
  • neonatal

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