Neonatal Death: Reflections for Physicians

[摘要] When an infant dies, a bereaved family is left to face the same mourning processes as any grieving family. However, recent reports indicate that these families often experience the process with more intensity and for a longer duration. Cullberg states that one third of the mothers in his study developed pathological mourning after one to two years. American fathers, as Kennell and Klaus2 point out, often react with overactivity and never completely resolve their grief. Blank3 explains that siblings with extended grief reactions are among the reasons for the development of her Early Crises Consultation Service. Clearly, the physician in contact with such a family has a role to play in their continuing recovery.The purpose of this article is to focus on the physician's role as counselor to a family following neonatal loss. Our personal experience and a review of the literature form the basis for specific recommendations regarding the physician's role. (B.A.E. recently experienced the loss of twin newborn sons at 7 and 8 days of life. A coxsackievirus B2 septicemia was suspected as the cause of death in each case. H.A.H. is the neonatologist who counseled the family after the twins' death.) The various phases of mourning are described and recommendations for counseling are given at appropriate intervals.The article is presented from the viewpoint of an intact, extended family that is interacting in the grieving process. We recognize that single parents and parents separated from relatives and friends may go through a more extended process. The skill of a caring physician is especially essential under these circumstances when support is minimal, and more frequent visits than recommended here may be required.

[学科分类] 儿科学