Butterflies and Ribbons: Supporting Families Experiencing Perinatal Loss in Multiple Gestation

• Main Authors: Béatrice Boutillier (Author), Nicholas D. Embleton (Author), Sophie Bélanger (Author), Alexie Bigras-Mercier (Author), Audrey Larone Juneau (Author), Keith J. Barrington (Author), Annie Janvier (Author)
• Format: Book
• Published: MDPI AG, 2023-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/children10081407; 2227-9067
• Keywords: multiple pregnancy; twins; triplets; neonatology; palliative care; prematurity; Pediatrics; RJ1-570
• Source: Children, Vol 10, Iss 8, p 1407 (2023)

<b>Introduction:</b> In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal. <b>Methods:</b> Two educational programs were evaluated with pre- and post-course surveys, questionnaires administered to participants, and audits. <b>Results:</b> In the online Butterfly project (UK; n = 734 participants), all participants reported that the training exceeded or met their expectations, 97% reported they learned new skills, and 48% had already applied them. Participants expressed gratitude in their open-ended answers: "<i>I feel a lot more confident in supporting parents in this situation</i>". In the Ribbon project (workshop for neonatal clinicians, Quebec; n = 242), 97% were satisfied with the training and reported feeling more comfortable caring for bereaved parents. Knowledge improved pre-post training. Audits revealed that 100% of cases were identified on the incubator and the baby's/babies' admission card, all changed rooms after the death of their co-twin/triplet, and all had the name of their co-twin/triplet on the discharge summary. All clinicians (55) knew what the ribbon symbol meant when asked during surprise audits at the bedside. <b>Conclusion:</b> Different educational strategies to optimize communication with families after the perinatal loss of a co-twin are appreciated and have a positive impact.