summary
The UFRJ Maternity School has become a reference in welcoming pregnancy grief, implementing for 15 years actions such as the creation of a Finitude dispensary and a farewell space, as well as providing psychological support, promoting a greater humanization of care in cases of child loss.
At 39 weeks pregnant with her first daughter, Ligia Aquino went into labor while at home and did what every mother does: she packed her bags and, accompanied by her husband, went to the maternity ward for Laura’s long-awaited birth.
However, upon entering the birth preparation room, he received news he did not expect at all: the baby had no heartbeat. The pregnancy loss was mentioned by the nursing technician directly and without any care.
“I was in shock and it took a while to realize that my baby had died. Two days ago, I had an ultrasound and she was fine. It was a risk-free pregnancy and suddenly I received this news. Without any care or follow-up from a psychiatrist,” she recalls.
Ligia received natural labor induction, but it was unsuccessful and she had to undergo a caesarean section to give birth to Laura. “I was admitted to the maternity ward and listened to other mothers giving birth to their babies. A nurse came into the room and asked me how breastfeeding was going. It was a huge shock and it all made me sadder,” says the woman, who because of her hospitalization was unable to attend the baby’s funeral.
Reports like Ligia’s are not rare, but to ensure rights and better care for families, in August this year, the Humanization of Maternal and Parenting Grief Policy came into force, which defines respectful care, which helps in the recovery of people who have gone through this trauma.
Law No. 15139 introduces a series of decisions for public and private maternity hospitals, including the possibility for families to spend a final moment with the baby, take photos or receive records such as fingerprints and say goodbye. It was also determined that the child’s name could be registered on the death certificate, and if that was in the family’s interest, he could be buried or cremated.
In addition, women who have had 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 necessary to welcome this family and respect the moment of mourning. It is necessary to check the pain of these people,” adds Ligia, who after the death of her child founded the Do Loto Institute for Parents, an NGO to welcome families facing the pain of pregnancy, perinatal, newborns and infants.
The maternity hospital has been providing care for years
Long before the law came into force, the maternity ward of the Maternity Faculty of the Federal University of Rio de Janeiro (UFRJ) implemented procedures to welcome mothers and families bereaved by the loss of a child during pregnancy, childbirth or in the first days of life.
About 15 years ago, he established the maternity ward of Finitude Hospital, where these mothers go after their loss. The place is far from the ward where births take place and mothers and children are admitted to the hospital.
The specialists noted that the coexistence of these women who were suffering from grief with other mothers of children who were born alive or were breastfeeding increased their suffering.
“The maternity ward contains high-risk pregnancies, and over the years, the same professionals have felt the need for more welcoming care for mothers and families who lose their babies. Little by little procedures have been created and implemented,” explains Penelope Marinho, physician and healthcare director at the Maternity School of the UFRJ/Ebserh Hospital Complex.
Another measure was to create an environment in the maternity ward where families could say goodbye to the baby in privacy. In the space called morge, parents who want can spend time with their children and thus create memories.
The room is small, but parents and family members, such as grandparents or siblings, can stay in it as long as they need. The place has drawings of colorful angels and clouds on the walls that add lightness to the environment.
“Despite all the pain, it is a moment of meeting between parent and child. So it is important for them to see the characteristics of the child, they can take the imprint of the little foot, pick it up and dress it,” adds Camila Haddad, psychologist and head of the interdisciplinary sector of the Maternity School at CH-UFRJ/Ebserh.
Staff also provide clothing, if the family doesn’t have any, and also distribute two small cloth hearts, made by volunteers, as a keepsake of the deceased child. One is buried with the child and the other remains with the family.
“One of the biggest complaints from parents is that they don’t have many items to remember their children, so every little detail to build a memory is worth a lot,” Haddad said. “It’s a way to make mourning real.”
Psychological support
In addition to this space, mothers, who have their babies in the ICU (Intensive Care Unit) with a short life expectancy, can spend more time with their newborns, holding them, as well as receiving visits from their closest family members. In some cases, the team sets up what looks like a screen, to ensure the privacy of the moment.
“The whole team took great care of me. They embraced me in a difficult time, and I had support from the ICU doctors and a psychiatrist who accompanied me at all times,” recalls 28-year-old craftsman Pamela dos Santos Lisboa.
After a risky pregnancy, Pamela lost her daughter, Maria Vittoria, who was born 23 weeks premature and spent a few days in the maternity intensive care unit.
Psychological support, like the one Pamela received, is provided to mothers in person or over the phone. It can occur throughout prenatal care, at birth and in the following months, and is provided for as long as the mother needs it.
Other provisions of the Humanization of Grief Policy at the UFRJ Maternity School include, for example, music therapy sessions for patients and healthcare teams, which aim to provide moments of relaxation for mothers.