Communication of mourning
Tags: Baby, child, Communication of mourning, Physiological, physiological processes, suitable space
The loss of the child after the 25th week or birth:
what methods of communication with the mother and the copy in the early stages of mourning
Mourning is an emotional response and physiological processes related to change if the latter suffered a loss.
Mourning is a path that is divided into several phases, in which the variables of the emotions are directly proportional to the value that each of us gives what he has lost. It can happen, for example, that the spontaneous fetal death of a child unwanted lead in parents more pain relief .. The same is true of a malformed child or disabled person. This occurs even if the parents were aware and had agreed to keep it.
Before getting into specific, which will be the theme of loss of communication, I think it is appropriate to obtain an overview of possible biopsychic and emotional context of the women with whom we deal and to which we will communicate that have lost their baby during pregnancy or shortly after birth.
It should be borne in mind that pregnancy is a very special woman. There is naturally a consideration that even remotely resembles the!
E ‘in place in all his being a change, a profound transformation that makes it unique. It is not a weak woman or weakened due to pregnancy, and should not be considered and treated as such. This is a woman who has undergone great changes in fast times, and is definitely sensitive and emotional.
Women who are taking the path-birth pregnancy – childbirth – childbirth, breastfeeding, are a category apart from all other women, a sort of unidentifiable ethnicity at any point on earth and yet everywhere present.
So I think that if you lose your child is primarily through the knowledge and awareness of their psycho-biological context, together with an attitude of true appreciation, which we hope to be able to propose a suitable space in which the quality of communication, dialogue and, above all, of listening, they can also offer support and containment
While pregnancy can be a privileged moment for the woman in his personal growth, the other involves a crisis of identity, linked to ongoing change, which is expressed at all levels of his being: physical, psychological, emotional, behavioral.
His transformation is reflected in all areas of his life relationship: the relationship with your body is changed, the couple, tied into the family of origin, in its relations with friends and colleagues from work: practice, with the image he has of itself.
The anxiety-related components to this process, in which the flux-loss-factors change constantly alternate, sometimes overlapping, may be particularly intense in the first child because you must embark on an entirely new path, never lived before. The labor, delivery, meeting the child, nurturing, breastfeeding, postpartum depression, … are all situations where he heard much of which, perhaps, also read, but not has never had an experience which, however, have however created constraints, expectations and spurred his imagination.
Among other things, it often feels in the middle of a process which inevitably pushes the unknown, where, while going through the transition from daughter to the door to become a mother and parental-pair to pair.
There are many questions that it poses during pregnancy, which may be anxiety and who is unable to answer certain among them emerges then essentially one question: what will become of me and my child, everything will be right?
It is not a rule that those who have already had one or more children is much better. There are no points of reference on which the woman can safely lean: every pregnancy and every birth is a unique and unrepeatable, unique and unrepeatable as the child is born.
Moreover, if past experience was problematic, even traumatic, it is clear that the emotional components, could rise still further, in fact, exist in her fear that history will repeat itself.
In addition, state anxiety can become very problematic if the pregnancy was not desired.
As we can see, the mother who stands before us, who lost a child and is about to begin the mourning, we know very little of his history, his anxieties, his fears. But it is still important to consider that a woman who has already tried and dealt with different path loss in pregnancy, especially those related to change.
This, and much more, is the one which is being announced that it has lost or will lose her child.
It should be borne in mind that there is a mother deep in every pregnant woman. This mother unconscious psychobiological, we must take into account as we prepare to release the real mother that her child died, or will not survive. And we must take account not only when the loss occurs after the 25th week, but even if it occurs in the preceding months.
Secret of this mother must be considered in the case of voluntary interruption of pregnancy.
When a child dies for small, for whatever reason, there is always a wound that opens in the deepest parts of the woman and that bleeds for a long time. Sometimes for life.
Since the beginning of pregnancy, changes in hormone production show in her existence, at a deep level, a state of awareness of the child.
There are objective physical and psychological changes caused by the very presence in her son since the first interactive processes, particularly visible from the hormonal changes that occur from conception dall’annidamento and then continued throughout pregnancy until after the birth.
When he can not even be pregnant, kicks off a moving dialogue between the biochemical pregnant and the child in her womb, an extraordinary process of reception and protection
(EPF, PAF, cortisol), nurturing (estrogen) and adaptation (progesterone) that continue throughout pregnancy to support (adrenaline), protect (endorphins), feed
(PRL) and accompany (oxytocin) new life outside.
A good mother, sensitive, containment, caring, nourishing and foresight, is gradually activated at an unconscious level in every woman, deep in the creases of his being.
This happens even when it comes to a woman who has planned his son, or even has the slightest desire, at least on a conscious level, to become a mother.
But remember that, while the increase in hormone production helps women by encouraging and promoting the adaptation processes related to the new situation, as well as those of openness, reception and ‘attachment to the child, the other makes particularly sensitive, emotional, and therefore much more fragile and particularly disarmed before the communication loss of what for her is not ‘a fetus but a child.
If the loss occurs when the pregnancy is advanced, it may be necessary to induce the birth.
How can a woman feel so sensitive and so mom already deeper in the folds of his being, as it enters the delivery room knowing that bear a son who died?
What support will be given at that difficult moment of his life, a moment that will never forget the most? It ‘obvious that it is important the people are near and dear to her in which he trusts. You can ask her directly who want to have next.
In the complex process of gestation, in itself already so full of changes, losses and readjustments to the new realities which have gradually, which primarily supports the mother of a child, especially if you have much desired and expected, it is the thought of meeting him, that child which receives the movement, which is known whether male or female, whom he calls by name, who speaks with affection and, perhaps, has learned to cradle a bit ‘every night and singing a lullaby.
This woman, so already the mother of his son, will meet and pass a test that you know will not bring fruit as nothing but pain.
So when a woman loses a child to the end of a pregnancy, and especially if it has invested with him much of his affection and his emotions, is even less, the scene of childbirth, the premium, the point that light up then the ‘had sustained.
Subsequently, the pain of loss will be added to see that your body continues to record the presence of the child: there was a hardship, there were contractions, there was the birth … then her breasts swollen, produce milk … but the baby is gone. For a long time after giving birth your body will remember that painful reality.
To help a mother facing the early stages of mourning I think is fair and important to have an intimate space for conversation and quiet, where there is security will not be disturbed.
I’ve heard sad stories of traumatic interviews occurred in the ward, in the chaos of the corridors, or in the studio, constantly interrupted by phone or by nurses who knocked and entered directly. One mother even told me that the statement of the loss of the child was taken to the presence of some medical trainees.
Should have at least one person who was dear to her, in which both confidence and putting faith in which, possibly her boyfriend, his best friend, or midwife who has followed.
I think it is equally important to consider offering them all the time may be reasonably necessary, at least an hour before it can begin to process your grief.
To avoid leaving the time required by the needs of the department, you could, for example, to announce that the discourse that is now expected in the ward and agree with a colleague to intervene to set hour. And ‘far preferable to peek more or less frequently to keep talking clock or heading for the door and continue standing in the doorway.
It ‘important to be clear, honest, simple and accurate communication: use scientific terms can only be a source of misunderstanding for those who are not insiders.
Refer to the child, calling him “fetus” is unfortunate and brutal.
Using metaphors as “her baby is gone” is just as inappropriate as to say it will soon have another. Do not forget that she is taking place in the triple loss of a child: the mother’s psychobiological, the imagined and real. All this is not minimized, nor the child is replaceable. Anyway, there’s a pain that needs to be experienced at all levels before you can think of another child.
Advising, consoling, tell her not to cry, be strong, solutions … everything that does not help the evolution process of mourning.
It ‘important to clarify to ourselves that our role in this specific circumstance is particularly to encourage those in front of us and not to repress his feelings and emotions but rather, to express them, even with the tears and possibly help find its solutions.
So our task, as well as to be available to answer truthfully all questions that could be done, is mainly to listen, especially using the technique of active listening, ie summary of feedback on what it says that relate to his emotions in order to encourage her to continue talking.
It ‘also important to the body attitude. If the interview is in the studio, not interpose tables or desks, sit still as possible front, putting a chair at his bedside when the occasion requires it, do not keep your legs crossed or folded arms: messages are closing, look into her eyes without secure, showing little signs of interest with the head or the expression of the face that we are attentive to what he says and we are participating.
Always avoid overwhelm when standing, if you are sitting or lying: this loss of communication, moving from foot to foot when you are both standing is a sign of carelessness or haste
When a child dies in the ward move many emotions in all staff who came into contact with the Mother, if they all dislike, and more, the midwife and doctor that have followed. It would be really helpful if they were organized periodically structured spaces for dialogue and discussion where operators have the opportunity to meet and develop their experiences.
It ’s not always easy to contain their emotions and maintain control. However ‘well avoid sitting on the bed to touch her, to take her hand, to hug her: what can be done only in exceptional cases creating a situation that justifies this behavior truly empathetic confidential.
It ‘may top it refuses to believe what is told: this should not be interpreted as a sign of no confidence against the operator but as an attempt to remove the time of the discovery of the inescapable fact and feel pain .
Sometimes this stage of denial event may occur with a freeze or an emotional state of shock. E’allora should gradually lead to the discovery of the loss but without forcing it and respecting its time. In such circumstances, the companion ol’ostetrica of trust can be of great help.
There may be anger and rage in this path of mourning: “why me?”. Sometimes the anger is directed toward God, or of specific persons or circumstances experienced it accountable for the loss: the gynecologist that the ‘would properly followed, the midwife, too much work that has been loaded, a fight with partners … etc.. Investigate, counter, justify, defend colleagues at this delicate stage of mourning is counterproductive for everyone.
And ‘better not. You may even talk about that later.
Sometimes it can happen if you take it with itself, assuming you have created situations that could have killed the child. And ‘then very important to grasp this particular signal and intervene immediately with appropriate explanations adequately reassuring because, then, this behavior could evolve in a very disadvantageous guilt in his life as a woman and mother of the children he has or may still have.
After the first manifestations of sadness and pain, is in any case always important to accompany the substantive conclusion that the loss in time to accept and integrate into his life.
Propose and help, as long as it so desires, to have memories of the dead child will help avoid that, then you create in her dissociating situations where, for example, might be that it continues to relate to his son as if he were still alive.
The thought of being mother, albeit briefly, of that child which has retained at least one photo or a lock of hair, ol’impronta a leg, which probably washed, dressed, who gave a grave with a small ceremony, the support in the process of acceptance of loss and resolution of mourning.
There are women who own specific demands, on the other when they do not think or believe is not possible to make similar demands. It is therefore appropriate to make suggestions.
Sometimes they refuse, except to have a rethink even months after the loss. It would therefore be appropriate that a picture was ever made to the child, taking care of quality and with adequate precautions hiding any deformity. Parents should be made aware of the existence of the photos, the archive of the hospital, and that will take up later at any time.
The process of mourning for the loss of a child is a complex path, never painless, sometimes painful, which is involved in first person the little boy that we all have: it is alive and vital in the deepest parts of our being, is part of us and is also the land on which to express our emotional life.
I think this is one of the main reasons for the loss of a child is regarded as the greatest grief for ‘human being.
But we must not forget that grief is a process related to change and then, in a sense, is an ‘initiatory experience, that is basically designed to produce change and growth.
It ‘obvious that it is appropriate to communicate this concept to those who are suffering, as it would be absurd to try to intellectualize this experience.
Instead of self-help groups, always very useful and important for the ‘accompanying parents who are experiencing grief, towards the end of a path and following the’ acceptance and to ‘integrate the loss, often emerges this concept connected to transformation taking place and feel the wealth of ‘experience, although painful.
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