How to care for a baby who dies in utero, prior to birth

1. Have two care givers for delivery, preferably one is RTS Counselor. One care giver concentrates on baby, and one on the mother.
   
   
2. Discuss with the delivering physician what to expect in the condition/appearance of the baby. Review the chart, ultrasound and prepare the parents! Be honest, but also explain that fears are almost always worse than reality. Reassure them that you are there to help them.
   
   
3. Have a warm basin of water to receive the baby. Prearrange for the doctor to hand the baby to you and gently place the baby in water.
   • This bathes the baby, and bodily fluids will rinse away.
   • This also preserves integrity of skin and minimizes slippage.
   • Do not rub to wash or dry the baby.
   • Do not use soaps-this will hasten a skin breakdown.
   
   
4. Offer baby unclothed, wrapped in a blanket to parents for bonding. If lotion or powder is desired, place on the blanket, not the baby.
   
   
5. Start taking pictures with Polaroid and a 35-mm camera. Get both parents and the baby into pictures and encourage other family members. Don't forget to take pictures of hands and feet.
   
   
6. Allow parents private time with baby and leave the camera with them. Get OUT of the room and take other family and friends with you. Explain to parents that you will be back in 15 minutes, sooner if needed. Also explain to other family and friends that parents need time alone with their baby. BE BACK IN 15 MINUTES! Control visitors by parents' wishes, not the request of visitors.
   
   
7. Encourage parents to dress their baby, even tiny ones. This is a great time to do measurements. If parents participate, be their photographer. Capture every moment you can. If they choose not to participate, stop and take pictures as you go.
   • Consider props, i.e., wedding rings, toys, teddy bears, special blankets, religious items.
   • Allow parents to choose the outfit they prefer, if applicable.
   • Sensitively drape imperfections for photos.
   
   
8. Once pictures are taken, take hand and footprints. Take several sets for parents and offer a set to grandparents.
   
   
9. Personalize ID bands. Write the baby's name on them, not male/female. The same for the crib cards.
   
   
10. Now is the time to bring in younger children and siblings. Stay with the family until a comfort level has been reached. Remember they are in shock and hurting and children will have a myriad of questions, needing reassurance and support.

    ***Note
    Very rarely does baby's condition require that you limit the amount of time parents can keep their baby with them. It is okay in most cases to keep the baby over night if born late in the day. Allow the parents that option to decide when it is time. Remember that you are dealing with all different people and you are in a trusted role to guide them through the first hours. This will impact them forever.

11. Prior to release, make sure parents have received information on support groups where they are able to get help. Even if they feel they will not need it, many parents desperately seek help once the numbness wears off.