The COVID-19 epidemic and possible assistance in perinatal bereavement.
For a few weeks, the COVID-19 epidemic has also been overwhelming our nation , putting a strain on our hospitals and healthcare professionals. All efforts are currently concentrated on managing the epidemic and the patients in need of intensive care; these efforts add up to all that is “normal administration” in the daily work of doctors and health professionals.
In our hospitals, operators currently carry out a double job: they take care of their patients and deal with the Coronavirus emergency, putting in place all the strategies to minimize the infection and taking care of promptly identifying and treating the affected subjects in the most appropriate way. .
This work is possible only thanks to a very widespread and very rigid organization of spaces, times and ways of accessing the structures.
In particular, in hospitals, to reduce the risk of contagion, access is allowed only to patients and not to accompanying persons .
If this perfectly logical and acceptable rule is understandable when it comes to a routine visit, a few more problems arise when we have to face bad news, a complicated situation or a bereavement.
While the Coronavirus rages and catalyses everyone’s attention, in fact, everything that happened before continues to happen : in these hours, as I write, there are women who are hospitalized in obstetric pathology for a complication that arose during pregnancy, premature babies are born who need intensive care, fetal pathologies are diagnosed and there are babies dying in utero.
All of this is happening, hidden by the Coronavirus. All this happens in a surreal atmosphere, made up of distances, silences, masks, fears and prohibitions.
Women who face these adversities today are called to face them more or less alone.
Even the health workers who work alongside them are substantially alone, more alone than ever, because the Coronavirus has put many colleagues in isolation, has moved various operators to high-intensity wards and increased the workload of individuals.
Healthcare workers who assist women with high-risk pregnancies or adverse obstetric and neonatal events, in these complex days, are called upon to provide their normal routine care, to show human closeness in any case, and in a certain way also ” become a family “for those same mothers, because they are alone with them, in that crucial moment.
In addition to this, operators must also be able to be bridges and offer a minimum of remote support to fathers and other family members who are forced to wait outside and yet need to receive correct information and appropriate communications.
In this very particular situation, all the subjects (carers and carers) are simultaneously affected by more than one trauma.
It should be borne in mind that when there are multiple traumas simultaneously or in close sequence, it is more difficult to maintain a strong and effective helping relationship, it is more difficult to make decisions, it is more difficult to trust and trust. We often touch the threshold of panic, and we know that panic is a situation in which people lose control and are at the mercy of events.
It is really very important for families facing the pathology or loss of their child these days and for the operators who provide assistance to be able to proceed in this troubled situation one step at a time, making the best possible decisions, considering the particular historical moment. which adds to an already shocking situation such as that of anticipatory mourning in the case of obstetric pathology or premature birth or full-blown mourning in the case of perinatal death.
The death of an expected child, the pain of women and partners is never a neutral event for operators. Inserted in this trench context, these griefs can represent the straw that breaks the camel’s back, and give a hard time to the operator who wants to do his job well.
Here is an agile list of the areas considered most important for good assistance in perinatal bereavement and adverse perinatal events, accompanied by small explanatory explanations (one for each macro-area, there are many others that you can deepen in our available text for free on Amazon from tomorrow morning):
- Respect for the couple and the child : it is true, there is the Coronavirus emergency, but for that specific woman we are witnessing the loss of her 15-week-old baby is something far greater and more traumatic. Respect is needed for the experience of others. All time.
- Communication and information: it is true, there are very strict rules due to the epidemic, and it is necessary to respect them but it is also necessary to keep in mind that during a perinatal trauma it is essential to communicate with the couple. Nothing prevents us from activating video calls in order to involve the partner or family member waiting outside in communications and information.
- Management of the most appropriate delivery methods and accompaniment to delivery: one-to-one assistance can make the difference in this dystopian moment. The higher the level of distress and pain, the more comforting is the continuous stay of a specific trusted person. In all this chaos, having a non-traumatic memory of your birth promotes not only grief processing but resilience.
- Hospitalization – Hospital stay: a Long hospitalization means more loneliness and more prohibitions to enforce: it is difficult, it is alienating, but maintaining a little human contact and cultivating a minimal helping relationship with patients offers them the opportunity to feel part of a group of people united to face an emergency, together, and not a trivial occupied bed.
- Creating memories: funerals and all gatherings of people are prohibited at this time. The cemeteries are closed. This means that families affected by perinatal bereavement, for which the funeral rite is often the only and last moment of closeness and greeting of the child, will be deprived of this opportunity for some time. Deprived of the last farewell. It is obvious that in the absence of this opportunity, the collection of memories after childbirth assumes a role of primary importance, and it must be done in the best possible way.
- Assistance after discharge: at this time it is not possible to schedule check-ups and meetings unless strictly necessary. It therefore becomes essential to be discharged from the hospital with all the written information on the puerperium and its physiological course and on the psychological aspects of perinatal bereavement; it becomes essential to have a telephone number of the ward where you have been hospitalized to call in case of requests and clarifications. It can be very important, as already happens in some hospitals that collaborate with us, to have a well-identified path so that the woman is never left alone but knows that she is included in a clear and organized program.
We at CiaoLapo also do our part, making our books available for parents free of charge here on our website in the documents area and our book for operators on Amazon.
#togetherwe have a lot
