Perinatal Loss Alert Program

You may not realize it, but

there is a

GAPING HOLE

in your practice.


1 in 60 pregnancies end in stillbirth
(26,000 per year)

1 in 4 pregnancies end in miscarriage; some think it's closer to 1 in 3
(500,00 per year)

23,000+ babies die within their 1st year

These stats don't include losses during/after IVF or other assisted reproductive techniques

How many of these deaths occurred in your practice?

Are you providing the best care you can for your patients?


PLAP is the "next step" in providing evidence-based continuity of care for families following a perinatal loss. With 1 hour and 2 SIMPLE STEPS, staff awareness, knowledge, and empathy increase, along with patient satisfaction, retention, referrals, and healing.

Why Was the Perinatal LOSS ALERT Program Created?
While many hospitals now have policies and procedures in place to assist families during a perinatal loss, once patients are discharged they often discover that the same level of understanding, education, and care are lacking from other members of their medical care team.

Background
The statistics you read on the home page are astounding, and yet baby loss is often called a "silent loss" because no one seems to want to talk about it. The one place many women WANT to talk about their loss is with their OB physician. But when clinics are unaware of a loss, or how to sensitively interact with bereaved patients, women feel more isolated, angry, and hurt.

You see, after a loss at ANY gestational age, it is very difficult for parents to return to their physician's office because it is laden with potential emotional triggers.

Most postpartum visits occur just a couple of weeks after delivery, a time when parents are emotionally fragile and their baby's death is still raw. For many, your office is the place where parents discovered they were pregnant and began and dreaming about their new family. For others, it may be the place where they discovered their baby had no heartbeat, or where they learned devastating news of a lethal anomaly. Having to return to the office, let alone be in the presence of pregnant women, so soon after a loss is a heart-wrenching experience.

In a busy office environment, it can be difficult to take a few moments to review patients' charts, and often you're not notified of a loss before the patient returns for her postpartum checkup. I've heard many experiences of grieving parents who were required to complete a Postpartum Depression Inventory or were asked how their baby was doing, because staff was unaware that their baby had died. And I've heard far worse experiences. These are just a few quotes I've collected for a research article I'm creating on this program:

• At one visit, the nurse asked me how far along I was. When I said my baby died! She acted like it was nothing.
• At my postpartum checkup the nurse opened the window and asked, in front of the entire waiting room, the date that my baby died. I was completely devastated and embarrassed. Why couldn’t she have asked me privately??
• The first thing my physician asked me was, 'How's the baby?'.  And she was present during delivery.
• Doctors didn’t care. They told me just flush the baby when I went to the bathroom.
• I thought it was cold for an OB to tell me to not have any more children right after I lost a child.
• My doctor was not on call during his birth but was aware I had lost him. She sent her nurse practitioner in for both of my follow up appointments. I have not seen her since a month before my miscarriage.
• My physician said "I knew this was going to happen, I've had 2 losses within the last 2 weeks, it always happens in threes" This is extremely insensitive and not something I should be hearing.
• The nurse came in and asked where my baby was and how he was doing. She was fairly new to the practice and didn't even bother to read my chart before walking into my room.
• My doctor didn't warn me that getting an ultrasound might be a trigger when I see my empty womb. I needed one to make sure there was nothing left behind, but when I saw the screen it was a huge trigger.
• They never called me after discharge. That was a huge part of my PTSD.
• The doctor refused to tell me the baby died so I had to read it on a paper she gave me to take to radiology. Everyone else was amazingly supportive. The next day at my d&c, everyone was supportive, except the MA who asked if I was there for an abortion. No, the baby I really wanted died!
• The ultrasound to determine the loss was very difficult. It was treated matter-of-factly and instructions were given rather than a discussion taking place.
• I think sitting in the waiting room was very difficult to be surrounded by pregnant happy moms and dads. But even more horrifying was sitting in a small room full of families/dads/moms waiting to get their ultrasounds or sharing their ultrasound photos just days after I had lost my baby.
• At the hospital the physician who checked me out first said: well at least you were not that far along. I started crying and he did not even notice. :(

In a systematic review of parent experiences with health providers, Gold (2007)* found that parents reported the lack of communication between staff members about the death of their baby was an egregious error. Many expressed resentment when staff members seemed to have forgotten a baby’s death or made thoughtless comments. The most frequent criticism of staff was lack of emotional support or frank insensitivity. Gold noted that “when a baby’s death is viewed as a traumatic event, a random comment from a doctor or nurse at a time of high parental arousal may have far more impact than it otherwise might. In these settings, a provider’s insensitivity could contribute to long-term difficulties in coping for distressed parents and might increase the chance of a complicated grief reaction. One thoughtless comment after a death may become engraved in a parent’s memory even though the same comment in a routine setting might be distressing but have no permanent sequelae.” (Gold, K.J. (2007). Navigating care after a baby dies: A systematic review of parent experiences with health providers. Journal of Perinatology, 27, 230-237)