1. Pregnancy Attachment and the Need to Create Memories Julie Brooks, RN, BSN

2. Why perinatal death can be complicated The suddenness and unexpected nature of the loss The way infant death is socially defined in our society

3. “When a person is born we rejoice, and when they marry we jubilate, but when they die we pretend nothing happened.” (Margaret Mead)

4. Attachment/Bonding Concepts Planning the pregnancy Confirming the pregnancy Accepting the pregnancy Feeling the pregnancy Accepting the fetus as an individual

5. Grief is experienced in relation to the significance of the attached *Each family that experiences perinatal loss will have unique feelings about the pregnancy. *Understanding what the pregnancy means to is the foundation for understanding pregnancy loss.

6. What happens when there is perinatal loss and how can we help? It is critical that the caregiver allow the family to guide their own journey of grief rather than attempt to have a recipe for every situation.

7. Grieving is not a process of forgetting but rather of remembering. Bereaved parents need time to say “hello” before they can say “good-bye” Give information in small doses Parents may not know what memories will be important to them later

8. Memory Making/Offering Choices Assisting with memory-making can be one of the most important things we can to help parents process their grief. Creating Memories – Holding their baby – Photographs – Mementos (Door card, Blessing Card, clothing, Memory Box) – Support for families and follow up

9. Holding their baby, no matter the gestational age. Seeing, holding, and touching may confirm for a parent the reality of the baby’s death and create memories for the future.

10. Photographs provide a lasting memory of what the baby looked like. This is a one-time chance to create the visual memory that must last a lifetime for the parents.

11. Don’t forget the siblings!!! Children are disadvantaged grievers.

12. Follow Up!!! Essential to a bereavement program Contacts are intended to let families know they are still thought about at times we know are difficult to for them (e.g., anniversary date) Keeps communication channels open and allows families to ask questions, seek advice Ideal times…within 1 week, at 3 weeks, between 6-10 months, at the anniversary date