Born to die: healthcare for deaths of unviable babies in the Province of granada (Spain)

Born to die: healthcare for deaths of unviable babies in the Province of granada (Spain)

Encarnación Martinez Garcia (1), Maria Teresa Rivas Castillo (2), Beatriz Arrabal Delgado (3)

(1) Midwife, Hospital de Guadix, Granada, Spain; (2) Midwife, Hospital de Motril, Granada, Spain; (3) Midwife, Hospital Materno-Infantil Virgen de las Nieves, Granada, Spain;

Background
Babies that are born alive and die instants or minutes later, due to their extreme prematurity or unviable malformations with life, and resuscitation maneuvers or maintenance of life are not performed due to their futility, are usually separated from the parents and left to die in solitude. Although in most hospitals in Andalusia and Granada there are protocols for care at Perinatal Death, it seems that the option for these unviable babies to die with their mothers and families has not yet been routinely implemented. The objective of this study is to analyze the existence of recommendations in the care protocols for perinatal death in the hospitals of Granada (Andalusia, Spain), so that these babies die with their mothers and families, and identify the real scope of this practice.

Methods
The protocols on care for perinatal death of the five hospitals in the province of Granada where deliveries are attended were analyzed qualitatively and the relevant managers were interviewed.

Results
In all hospitals analyzed there are protocols for the care of Perinatal Death that include the recommendation that parents see and be with their children as long as they consider necessary when they are born dead or die shortly after. However, in daily practice, with unviable babies, there still seems to be reluctance among some professionals to offer this possibility.

Conclusions
Despite the advances reached in the knowledge of perinatal grief, the implementation of protocols and the continuing education for professionals in hospitals in Granada, there are still certain limitations in practice that can be related to myths or beliefs on the part of health providers, making traditional paternalism prevail. Therefore, greater effort is required to apply good practices, and further research to identify the specific causes of this in some hospitals in Granada.

Ethical considerations
No ethics approval was required. The personal data are confidential and were treated in accordance with the Organic Law of Protection of Personal Data 3/2018. The information obtained was used exclusively for the specific purposes of this study. The authors of this study declare that they have no conflict of interest

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