Don’t worry, sign here.

by Claudia Ravaldi

“I was crying, desperate, I was afraid and I didn’t want to believe that my baby was being born dead, and she told me, you have to sign here, don’t worry, we’ll take care of everything”.

I have been dealing with perinatal bereavement since my son Lapo died in 2006. Almost 11 years ago.

A reasonably long time to analyze the topic, in all its forms, highlight any shortcomings and try to promote a reasonable and civil change.

I mistakenly thought that a bereaved parent, in Italy, should only take care of his bereavement, of the psychological aspects, of the medical ones possibly related to the event.

I was wrong.

In Italy, a grieving parent must (more often than not) also be an obstetrician, gynecologist, psychologist, lawyer, civil registry official, cemetery services officer, expert in mortuary police laws, autopsies, histological examinations and away talking.

I would say that these are too many skills for a parent struggling with the death of a child.

I would say that each of the professional figures who interface with a bereaved parent, throughout the health / administrative process, should have full knowledge of the subject they are dealing with, to protect their professionalism, and to be able to do their job in the best possible way. daily.

The approximation in health is not an indicator of functioning , in any case. It is certainly not a good investment for the citizen who pays taxes to invest in approximation.

It is not permissible for operators not to know or randomly answer banal and simple organizational / bureaucratic / legislative questions concerning the profession they practice.

In Italy there are approximately 180,000 spontaneous / late abortions (below the 25 week of gestational age) per year.

A large number of people every day lose their child (we can call him in other ways, the substance for the parents does not change) and receive a sheet that should inform about the “disposal” / burial of the body.

In half of the cases, people sign without even reading, letting themselves be guided by what the person in charge says at the moment.

In the other half of the cases, people sign on the wave of emotion and shock, without even being able to think that the pregnancy has stopped and the baby is dead.

Then there are some rare exceptions: men and women lucid in their pain who already have clear ideas and choose appropriately for them, how to approach the subject of the child’s body.

Whatever the decision between the two possible (disposal in hospital or burial), only in these rare cases can we be sure that that decision will have been responsible and aware, and therefore will NOT be an occasion for regret or remorse.

All the other cases remain to be faced: those in which the operator cannot explain, and those in which the parent cannot understand / nor decide what he wants to do, because everything is absurdly reversed.

It would be tempting to blame the “single operator” who cannot explain himself or does not know the rules.

Or the temptation would be to put all the responsibility on the parent in shock, who gives three different answers to the same question asked half an hour later and doesn’t know what he wants.

Instead, the responsibility for this serious administrative breach lies primarily with the hospitals , which faced with a large number of prenatal losses, they are not able to structure and implement an internal protocol that examines this event and examines it carefully, step by step , so as not to leave room for ignorance, and its consequences on the health of users.

A hospital should in fact have a clear diagnostic / therapeutic / legal and administrative process of a product of conception / embryo / fetus that dies and is born in one of its wards:

it should be able to reconstruct the path of this body, from the mother’s belly to the cremation / burial.

He should be able to explain, in due course (not during abortive labor! Or immediately after expulsion), what the law provides for in-depth diagnostics, when necessary, and in matters of burial.

He should know that an untimely and incomprehensible informed consent risks becoming “extorted consent” with what follows in civil and criminal terms.

He should know that it is uncivilized (but also deontologically abominable) that the staff in charge of explaining the procedures and obtaining consent and signatures do NOT know the process and do not know what they are signing.

He should know that a citizen, when he uses a service, has duties and rights. The right to correct assistance, which includes correct information, is inalienable.

For all these reasons, we ask that all Italian hospitals in which birth points and gynecology departments are present create and then promote the application of updated and comprehensive company protocols on prenatal and perinatal death and on assistance to families .

In the meantime, we will continue to send your reports and requests to the urp and the health departments, we will continue, as we have always done, to explain the rationale of a complete and exhaustive company protocol, and we will continue to distribute our information material so that no one else should be told by a healthcare professional:

“ok maybe they haven’t been able to explain to you but lady because she doesn’t calm down she goes home and cries to her son in the house or in the church because she wants to know to suffer, I want to know hindsight I won’t be calmer I don’t sleep I tell you she must understand me and she tells me her son is in a mass grave and how can the municipality look for him nn and he was sent with other abortive products they all go to a grave she cannot look for him in there. “.

This, and it is well known in the scientific literature, constitutes a secondary traumatization that contributes to the pathologization of bereavement. Which in turn is associated with postpartum depression in subsequent pregnancies.

Do we want to promote health, or do we want to be iatrogenic ?

We at CiaoLapo have chosen to be on the side of health.

To better explain, attached our documents on the burial, starting from 2008, which you can find here .

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