QUESTIONS PROVIDERS CAN ASK TO ASSIST THE BEREAVED
I am so sorry for your loss. How can I help you?
What are your traditions when an infant dies?
Is there someone I can call for you?
Has your family ever had this experience before? How did they handle it?
Did you have a funeral service? Was it helpful?
and languages. Members of more narrowly defined groups such as the Hmong still differ in important ways such as level of assimilation into the majority culture, religious conventions, and national heritage. Service providers are challenged to assimilate both the cultural and personal aspects of each family to understand their unique experience. There is no ‘magic formula’ or ‘cookbook’ for working successfully with families of different cultures. The best approach is perhaps the simplest—ask family members, “How can I help you?” and then listen carefully to their answers. Each bereaved mother, father, and family member may have different needs. Learning how these needs may be shaped by cultural traditions and values can help providers avoid being judgmental and determine how to provide the most effective, respectful support in each case.
Working with the members of a family in which an infant has died can be one of the most difficult challenges health care providers face. It is often hard to listen to a family member describe their pain as they relate the birth and death of their child. Encounters generate a variety of feelings in the provider. Providers need to be aware of their own feelings before reaching out to bereaved families. Effective support of families who have suffered a fetal or infant loss begins with a self-assessment of one’s own cultural back- ground as well as one’s knowledge of and attitudes toward other cultures. It is important to note that every person views different cultures through their own cultural lenses, and this view may affects their ability to provide competent care for families whose back- grounds differ. The National Center for Cultural Competence, Georgetown University Center for Child Health and Human Development provides tools for self-assessment at (
http://gucchd.georgetown.edu/nccc/selfassessment.html). A self-assessment checklist specific for SIDS and infant death is available on the website.
Most importantly, providers must be comfortable asking the bereaved family member how they can help. Families frequently are willing to discuss cultural traditions that may help them cope with the loss. Families will answer gentle, non-invasive questions about their needs. The health care provider can use active listening skills to learn about the culture and provide appropriate support. Our challenge is to be open and accepting, listen to and hear their pain. This ‘simple’ act will help these families as they journey through their grief experience.
RESOURCES The National Fetal and Infant Mortality Review Program (NFIMR) is a collab- orative effort between the American College of Obstetricians and Gynecologists (The College) and the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration. The NFIMR provides technical assistance to develop and implement a FIMR program. NFIMR works with states to explore methods to manage multiple reviews and to identify models that integrate local FIMR recommendations into regional or statewide assessments.
http://www.nfimr.org/home
The federal Maternal and Child Health Bureau funds four Centers to address the issues of Sudden Unexplained Infant Death (SUID) and other infant death:
The National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Project IMPACT with ASIP supports state and local infant death programs through sharing infor- mation, promoting policy and legislative changes, building upon resources, and fostering partnerships and communication.
http://www.suid-im-projectimpact.org/
66 VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT
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