In Today’s Issue:

🔗 The best resources I found this week
📖 Deep dive: Part 1: What to Say to Families After Miscarriage, Stillbirth, or Infant Death
🩷 Self-care moment

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Want to learn how to get Forget Me Not Boxes in your hospital? Reply “Bereavement boxes”

🔗 The Best Resources I Found This Week

📚 What Bereaved Parents Actually Want from Healthcare Teams
A 2024 study reveals six key communication themes parents need most during stillbirth. Read the study

🎯 SPIKES Protocol Training Reduces Provider Anxiety
New research shows structured breaking-bad-news training significantly improves healthcare confidence. View the research

🏥 U.S. Hospital Survey Reveals Major Stillbirth Communication Gaps
National survey of 289 staff found significant variations in training and support practices. Access findings

📖 Deep Dive

Part 1: The Moments That Matter Most - Getting the Basics Right

Here's something I've learned after years of studying grief and talking with hundreds of nurses: the moment you deliver or acknowledge the news that a baby has died becomes etched into parents' minds forever. Every word you choose, your tone, even where you're standing - it all matters in ways that will surprise you.

I know many of you feel the weight of this responsibility. In our recent survey, 31 out of 216 respondents said their biggest challenge is "knowing what to say" or "finding the right words" when caring for families after stillbirth. You're not alone in feeling unprepared for these conversations, and that's exactly why we need to talk about this.

Today, we're diving deep into those first crucial moments - when parents learn their baby has died, or when they arrive at the hospital already carrying this devastating knowledge. These initial interactions set the tone for everything that follows.

The Reality Check: When Do Parents Actually Find Out?

Before we get into the "how," let's talk about the "when." This might surprise you: 84-90% of parents already know their baby has died before they arrive at your unit. Only 10-16% discover this during labor and delivery.

What does this mean for you? Most families walking through your doors are already living in their nightmare. They're not coming to you for the initial devastating news - they're coming to you to navigate what happens next. But here's what's critical: how you acknowledge their baby's death and support them moving forward still shapes their entire experience.

Even when parents already know, your words and actions become part of their story. They're looking to you for validation that their baby mattered, that their grief is real, and that they're not alone in this.

The Words That Heal (And the Ones That Hurt)

Research consistently shows that parents remember every detail of how healthcare providers speak about their baby's death. Let me be crystal clear about something: this is not the time for euphemisms or medical jargon.

What Actually Helps

Be Direct and Compassionate:
Instead of dancing around it, use clear language:

• "I am so sorry. Your baby has died"

• "There is no heartbeat. I know this is devastating"

One mother shared her experience:

Use Their Baby's Name:
When you know it, always use the baby's name. Parents desperately want their baby acknowledged as a real person. I’ve written more about this here.

What Actually Hurts

Research across multiple studies shows these phrases cause additional pain:

• "Everything happens for a reason"

• "At least you know you can get pregnant"

• "You can try again"

• "Time heals all wounds"

• "I know how you feel" (unless you've experienced the same)

• "It was meant to be"

• Religious references when not appropriate to the patient

Here's the truth: these clichés, no matter how well-intentioned, feel dismissive to parents who've just had their world shattered.

Your Body Language Speaks Volumes

Here's something that might not be in your textbooks: how you deliver news matters just as much as what you say. Parents are hyper-aware of everything - your posture, your eye contact, your tone.

What Communicates Care:

• Sit at their eye level

• Make genuine eye contact

• Use open, warm body language

• Speak in a gentle, lowered tone

• Offer appropriate touch if welcomed

• Give them your full attention without rushing

One study participant shared: "They (health workers) were calm... She (the nurse) was talking like she was concerned and was really calm when they were talking to us".

Parents notice when you show genuine emotion. Don't hide behind a "professional" mask - your humanity in these moments is what they'll remember.

The SPIKES Framework: Your Roadmap for Difficult Conversations

When you need structure for breaking devastating news, the SPIKES protocol gives you a framework:

S - Setting: Find privacy, sit down, minimize interruptions
P - Perception: Listen to what they already understand
I - Invitation: Ask if they want details, respect their boundaries
K - Knowledge: Use clear language, give information in small pieces
E - Emotion: Prepare for their reactions, give them space to feel
S - Strategy: Summarize next steps, offer follow-up

This isn't a script - it's a guide to help you stay grounded when these conversations feel overwhelming.

Creating the Right Environment

The physical space matters more than you might think:

• Privacy is non-negotiable: Away from sounds of crying babies

• Support matters: Have their person present or help them contact someone

• Time isn't the enemy: Don't rush - silence is okay

• Comfort counts: Think about lighting, seating, interruptions

Two Different Scenarios, Same Compassionate Approach

When Parents Already Know (84-90% of cases)

Your role shifts to:

• Acknowledging their baby's death with genuine compassion

• Validating their identity as parents

• Providing clear information about what to expect during delivery

• Offering meaningful choices about their care experience

When Discovery Happens on Your Unit (10-16% of cases)

• Use the SPIKES structure to guide your approach

• Ensure immediate access to support

• Prepare for intense emotional reactions

• Provide clear, gentle information about next steps

Why This Matters So Much

Here's what keeps me up at night: research shows that the quality of communication during stillbirth diagnosis has lasting effects on families' mental health outcomes. Parents who receive compassionate, clear communication recover better than those who experience poor communication.

Self-Care for Healthcare Providers

Delivering devastating news takes an emotional toll on healthcare providers. Research shows that nurses caring for families during stillbirth experience their own grieving process. Read more about this here: The Realities of Caring for IUFD When You've Experienced Your Own Loss.

Immediate Self-Care Strategies:

• Allow yourself to feel emotions - it's normal and healthy

• Seek debriefing with trusted colleagues

• Access employee assistance programs

• Remember that showing appropriate emotion demonstrates humanity, not weakness

👋 That’s a Wrap!

Before you go: Here are ways we can help your hospital

We offer bereavement boxes to give as gifts to those who leave the hospital after a miscarriage, stillborn, or infant death. Reply to this email “Sample” to get a free sample sent to your hospital.

What we prioritize:

1. Tools for hospitals to create a bereavement experience for families to begin their grief journey

2. Educating nurses with modern bereavement standards and continuing education.

3. Helping hospitals build a foundation of trust and support, so bereaved families feel seen and cared for—now and in the years to come.

These boxes were born out of our own personal losses, including Jay’s (CEO) 15 years of experience working in labor and delivery as a CRNA and witnessing time and again how the hospital experience can profoundly shape a family’s grief journey, for better or for worse.

Until next week,

Trina and Jay
Co-founders of Forget Me Not