Communication

Stress and grief can impact how people absorb, retain, and respond to information. Given the amount and significance of the conversations that happen around perinatal loss, strong communication skills are essential for all health professionals who work with these families. Unfortunately, many families report negative experiences with health professionals, and most health professionals receive little to no training in having these discussions.

When giving bad news, it is important to provide privacy, support, and clear information. Sensitive language throughout the situation helps to support patient-centered care. This can include simple acts such as using the baby’s name, explaining medical terms, and avoiding medical jargon such as ‘products of conception’, ‘spontaneous abortion’, ‘fetus’, or ‘not compatible with life’. It is important to be honest about what is known and not known. Non-verbal communication is equally important during these conversations. This is especially true when there are language barriers.

It may be necessary to share important information multiple times. This allows the family time to process the details, or they may not hear and understand it well if it is only presented once. Providing information in both verbal and written materials can also help meet different learning styles. Communication between health professionals can minimize confusion and prevent the family from needing to repeat their story or being given contradictory information.

Families have shared many comments that are often helpful, and also those that are not helpful. It is appropriate to ask to hear their story, express your sympathy, validate their emotions, or reassure them that they didn’t cause their baby’s death. Platitudes and cliches are usually not helpful, as are any comments that minimize their emotions or try to find a positive in the situation.

Recommendations

• All staff with the potential to care for perinatal loss families should receive education and compassionate communication.
• Be open and honest with families about all the information that is known or not known.
• Avoid medical jargon or insensitive terms
• Allow for silence.
• Avoid assumptions or impulsive reactions.
• Validate the family’s emotions and feelings.
  Be prepared to repeat information.
• Identifiers should be used in charts and physical spaces to improve communication among health professionals.
• Utilize resources to minimize the impact of language barriers.
• Maintain respectful non-verbal communication.
• Allow a support person to be present for important conversations if desired.
• All providers should receive education in delivering bad news or conducting difficult conversations.