Nitzotzot Tikva: Glimmers of hope with a warm hug

In Hebrew, one of the most traditional blessings given to all pregnant women is: “May you leave with your arms full” - in other words, with a healthy baby. This is a happy wish that is extremely meaningful. For a midwife who is with a couple during a stillbirth, this statement becomes much more pointed and painful. It is a delivery where the grief is unfathomable.

What is stillbirth and how can you come to terms with it?

There are 2.6 million stillbirths globally every year. This is a defining event in the life of the woman and her partner, and it has a long-term negative psycho-social impact. Providing professional psycho-social therapy when managing stillbirth is critical, particularly when the difficulty does not end with the actual delivery, and has long-term effects. This is why ongoing continuous contact between the midwife and the couple, from the moment they get the bad news, the contractions, delivery and even afterwards is so important.

This reality led a team of six highly experienced midwives - Tanya Levy, Yarden Shalom, Yael Cohen Goldman, Natalie Becker, Adi Dahan and Osnat Levy - to develop a special program implemented in the delivery rooms at Hillel Yaffe Medical Center. The program is called Nitzotzot Tikva Be’hibuk Otem (Glimmers of Hope with a Warm Hug) and it has two primary objectives: one, providing professional tools to midwives so that they can administer the best possible care to couples experiencing stillbirth, and also to process it themselves. The second objective is to know how to equip the woman/couple with a professional “toolbox” that is appropriate for them so that they can better cope with the difficult experience they went through.

The project was selected from dozens and dozens of projects and awarded a financial grant and guidance from the Briah Foundation, which supports innovative initiatives to promote women's health. They were also awarded the Ministry's of Health's Outstanding Team Prize.

“The midwives receive professional training to become more knowledgeable, gain support, engage in open discussion with a social worker and participate in enrichment workshops. A midwife undergoes professional and targeted training and receives professional tools to provide guidance and support so that in cases such as these, she will be able to provide better professional care,” explained Tanya Levy, the Delivery Room Charge Nurse at Hillel Yaffe Medical Center. “The couples experiencing stillbirth receive comprehensive and professional care from us, which includes extensive knowledge, a memory box, ongoing contact with the attending staff over time and the option of receiving CBT - cognitive behavioral therapy for the women, a special service in Israel that we over here in the Maternity Division.”

Hillel Yaffe’s team of midwives who jointly developed the Nitzotzot Tikva project

Creating a sense of perspective and capability - Yahav Clinic

As part of the Nitzotzot Tikva project and jointly with the medical and social service staff, Hillel Yaffe established the Yahav Clinic, which has a multidisciplinary staff, including a physician, midwife and social worker who guide the couples who experienced stillbirth throughout their hospital stay, starting as soon as they receive the bad news and up until they are discharged. They are also referred to relevant organizations in the community such as the National Insurance Institute and helpful associations.

Working together with Nitzotzot Inbar, a couple that experienced stillbirth receives a memory box that includes a photograph, footprint and handprint of the baby, candle, keychain and book of stories that will help parents cope with the loss. If the couple has other children at home, they also receive a book written for children and a notebook in which the hospital staff write encouraging and supportive messages. “Supportive care for grief and being prepared to cope on the day after minimizes negative health and social impacts on the parents. We make sure to stay in contact, even after discharge, so that we can continue to support them, even remotely,” adds Levy.