39 weeks pregnant with her first daughter, Lígia Aquino gave birth while at home and did what all mothers do: she collected her bags and went, accompanied by her husband, to the maternity ward for the long-awaited moment of Laura’s birth.
However, upon entering the birth preparation room, he received the news he least expected: the baby no longer had a heartbeat. The miscarriage was mentioned by a nursing technician directly and without any attention.
“I was in shock and it took me a while to understand that my baby was dead. Two days before, I did an ultrasound and she was fine. It was a safe pregnancy and suddenly I received this news. Without any care or follow-up from a psychologist,” she remembers.
Lígia was given a natural induction of labor, but it didn’t work and she had to have a cesarean section to give birth to Laura. “I was admitted to the delivery room and listened to other mothers giving birth. A nurse came into the room and asked me how my breastfeeding was going. It was a huge trauma and all this only made my grief worse,” says the woman who, due to her hospitalization, was unable to attend the baby’s funeral.
Reports like that of Lígia are not rare, but to guarantee the rights and better care of families, in August this year the policy of humanization of maternal and parental mourning came into force, which determines respectful care, which helps the recovery of people who have experienced this trauma.
Law 15,139 brings a series of provisions to public and private maternity wards, including the possibility for families to spend a last moment with the baby, take photos or receive records such as fingerprints and say goodbye. The possibility of including the baby’s name on the death certificate was also determined and, if it is in the best interests of the family, to bury or cremate the baby.
In addition, women who have suffered a miscarriage are guaranteed an investigation into the cause of death, as well as specific follow-up in the event of a new pregnancy.
“It is essential that this family is welcomed and that this moment of mourning is respected. It is necessary to validate the pain of these people,” adds Lígia, who, after the death of her baby, founded the Instituto do Luto Parental, an NGO to welcome families facing the pain of gestational, perinatal, neonatal and infant loss.
The maternity ward has been offering care for years
Long before the law came into force, the maternity ward of the Maternity School of the Federal University of Rio de Janeiro (UFRJ) implemented actions to accommodate mothers and families bereaved by the loss of a baby during pregnancy, childbirth or in the first days of life.
About fifteen years ago, the maternity ward created the Finitude Infirmary, where these mothers go after their death. The location is far from the ward where deliveries take place and where mothers and babies are hospitalized.
Professionals observed that the coexistence of these grieving women with other mothers of children born alive or breastfed intensified their suffering.
“Maternity has a profile of high-risk pregnancies and, over the years, the professionals themselves have felt the need for more welcoming care for mothers and families who lose their babies. And little by little, actions have been created and implemented,” explains Penélope Marinho, doctor and care manager at the Maternity School of the UFRJ/Ebserh Hospital Complex.
Another action was to create an environment in the maternity ward where families can say goodbye to the baby in complete privacy. In the space called morge, parents who wish can spend time with their baby and thus create memories.
The room is small, but parents and family members, like grandparents or siblings, can stay as long as they want. The venue features colorful designs of angels and clouds on the walls which add lightness to the environment.
“Despite all the pain, it is a moment of meeting between the parents and the baby. It is therefore important that they see the characteristics of the baby, they can take the imprint of the little foot, pick it up and dress it,” adds Camila Haddad, psychologist and head of the multidisciplinary sector of the CH-UFRJ/Ebserh maternity school.
Employees also offer clothing, if the family does not have any, and also distribute two small fabric hearts, made by volunteers, in memory of the missing baby. One is buried with the baby and the other remains with the family.
“One of the biggest complaints parents have is not having a lot to remember their baby by, so every little detail to build a memory is worth a lot. It’s a way to make grieving a reality,” Haddad said.
Psychological support
In addition to this space, mothers, who have their babies in the ICU (Intensive Care Unit) with a low life expectancy, can spend more time with their newborns, hold them in their arms and also receive visits from their closest family members. In some cases, the team prepares a sort of screen, to guarantee the privacy of the moment.
“The whole team took great care of me. They hugged me in difficult times, I had the support of the doctors in the ICU and a psychologist who accompanied me at all times,” remembers artisan Pâmela dos Santos Lisboa, 28 years old.
After a risky pregnancy, Pâmela lost her daughter Maria Vitória, born 23 weeks prematurely and who spent a few days in the intensive care unit of the maternity ward.
Psychological support, like that received by Pâmela, is offered to mothers in person or by telephone. It can occur throughout prenatal care, at birth and in the following months, and is offered for as long as the mother needs it.
Other provisions of the UFRJ maternity bereavement humanization policy, which are an example, include music therapy sessions for patients and healthcare teams, which aim to offer moments of relaxation to mothers.