There are no uniform and adopted guidelines in all hospital and clinic settings that inform perinatal grief practices. Few settings have formalized guidelines to manage this population, and more frequently the policies might be haphazard or are not consistent. Certainly policies are important and reviewing them more so.
For pregnancy after a loss (PAL), there seem to be fewer policies in place. Some settings allow for a support person to be in the ultrasound room with the PAL mom, while others might only allow for a spouse or blood relation to accompany her. In other settings, only the patient is allowed into the ultrasound room. When thinking about this scenario, it might be important to consider not only the practical considerations (such as, is there space to perform the ultrasound with additional people in the room) but also the emotional considerations (who is there to support the mother if bad news is shared?). Every scan inches a PAL mom closer to a healthy baby, and she comes into the room anxious and hopefully leaves calmer…for the moment.
Labor and delivery is another place where considerations and potential exceptions might need to be made for a PAL mom. Consistently, there are policies around how many people can be in the delivery room, and most hospitals state up to three additional people. The policy makes sense: it allows for relatives and partners to be included while keeping a tab on traffic flow and ensuring that the nurses and physicians have ample space to do their jobs. However, it might be important to consider the value of adding a potential fourth person, such as a doula, who can keep delivery running smoothly as she works to manage a PAL mom’s emotional state.
Balancing the needs of the hospital to have policies and the needs of certain patient populations who might need exceptions to those policies isn’t easy. As a healthcare professional, you are in the position to advocate for your patients and assist them in making potential changes in their experience that can provide a sharp contrast to the sad outcome they had previously.