STILLBIRTH

COUNSELING
Approach using the six
step protocol while
managing similar to
post traumatic stress
disorder
 Introduce self and explain
the reason for the
interaction to follow. E.g.
My name is ___ and Ive
been asked to have a
discussion with you about
your delivery.
 Ensure availability of
support in form of a
relative preferably the
partner or nurse
 Find out how much the patient knows:

1. Can you tell me tell me about the events

of today?
2. Can you tell me about your management
during the pregnancy and any medical
conditions prior to and during the
pregnancy?
3. Were you ever warned about any
complications or abnormalities during the
pregnancy?
4. Enquire about her diabetic status.
 Breaking the bad news
Give a warning shot. E.g.
This is difficult to say but I
am afraid that the news
about your baby is not what
you want to hear. I am sorry
to inform you that despite
our best management and
through no fault of yours the
pregnancy has resulted in a
Explain the term still birth to the patient
and explain the possible causes while
ensuring that the patient is made aware
that the exact etiology is uncertain and
the still birth was by no means her fault.
Empathize with the patient, comforting
her with the appropriate use of personal
space and sympathetic gestures while
allowing time fort the internalization of
the news presented.
Address any concerns the patient or
partner may have. Advise on counseling,
support groups and address the
psychological requirement of the
patients.
Advise the patient on the need for
Glycaemic control or for post partum
testing in the case of GBM. The patient
should also be counseled on
management of subsequent pregnancies
in light of her diabetic state.
Advise on contraceptives and
pap smears following delivery.
Patients may also be advised
to delay subsequent
conception until grieving has
subsided and both partners
are emotionally and mentally
fit.
If necessary offer puerperal lactation
suppression( carbezoline) if the patient so
wishes.
Patients and families are at increased risk
of depression as such regular visits
should be planned, aimed at addressing
any new emotional developments and
concerns of the patient.
Summarize while comforting and
reassuring the patient with the aid of an
agreed upon plan for further visits