Reviewing Loss to Improve Outcomes: A Conversation with Dr. Frank Manginello

For nearly 30 years, Frank Manginello, MD, has served on the Fetal Infant Mortality Review Committee and recently announced that he is stepping down from the committee. Dr. Manginello is a renowned neonatologist who spent 40 years at The Valley Hospital, where he served as the Director of Neonatology and Children’s Services before retiring in 2020.


Our Fetal Infant Mortality Review Program (FIMR) works with health care providers to support grieving families while also gathering data to better understand the cause of their loss. The committee, comprised of medical professionals and community advocates, recommends perinatal and infant care changes and community education to help prevent future fetal and infant deaths. As the Chair of this vital committee, Dr. Manginello shared his expertise and leadership.


The Partnership is grateful to Dr. Manginello for his outstanding service and commitment to improving health outcomes. 


Liliana Pinete, MD, MPH, Chief Operating Officer of the Partnership, recently interviewed Dr. Manginello. He shared his insights and looked back on his work.


Dr. Pinete: Dr. Manginello, during your amazing career as a neonatologist, you took care of babies in very high-risk situations. What drew you to this career?


Dr. Manginello: I love answering this question. When I was a senior in college, just transitioning from basic science into pre-med, my landlord was the director of the neonatal intensive care unit at Georgetown Hospital. He brought me by to see this very new science in 1968. I was fascinated by acute care, chronic care, developmental work, the family interactions, and the research. So going into medical school, I knew what I wanted to be. I was like light years ahead of all my classmates.


Dr. Pinete: What’s the biggest lesson you have learned in working with families?


Dr. Manginello:  You know, I’ve learned these things gradually over the years, but I first realized that when a mom has delivered [the baby] and I’m going in to see them on the same day or the following morning, a mom is almost always in bed. I hate standing up and looking down at people. I’d always pull up a chair, sit down and be at eye level with the mom. I would introduce myself and say, “What questions do you have?” I learned very early to shut my mouth, open up my ears, and just listen to the stories that people had to tell. Once you’ve heard their concerns, you can figure out how you had to interact.


Dr. Pinete: You’ve generously given your time to chair our Fetal Infant Mortality Review Committee, and as we know, it’s not a job that many people would raise their hand to do. Why were you willing to take on this role?


Dr. Manginello:  Well, number one, Ilise Zimmerman [founding President and CEO of the Partnership] and I were friends for a long time. She asked, and I certainly said yes. I knew working in New Jersey, looking at both fetal and maternal mortalities, there was an awful lot of work. By reviewing infant deaths and looking at the science, looking at the community, looking at education and how we could provide help through the consortium now, the Partnership through physicians, through churches, through local organizations was just going to be meaningful, not for me, but the entire community.


Dr. Pinete:  Can you tell us why the Fetal Infant Mortality Review Committee is important? What impact does it make?


Dr. Manginello:  We try to improve outcomes. Whether that’s by holding program educational programs for physicians, social workers, and medical staff, whether it’s going directly to the families and having them learn what to expect during the course of a pregnancy, or whether it’s reviewing all the death data, we are trying to come up with reasons that we can avoid this in the future. Every aspect of the Fetal Infant Mortality Review Committee is good for our community. Unfortunately, in the United States, we don’t have some of the best fetal outcomes in the world. There’s an awful lot of work to do.


Dr. Pinete: We transitioned to the new Chair for our committee. What advice would you give to the next Chair of the committee?


Dr. Manginello:  Well, as you know, the new co-chairs are old friends of mine. And what I advised them was to read the cases very carefully and listen to all of the consultants that are at the table with you. Because there’s a lot of very smart people out there – people that are involved in every aspect of care – and they all have very good information to give. You don’t have to do everything yourself. There’s an awful lot of good help there.


Dr. Pinete:  In your role as a physician, you’ve witnessed great joy in the birth of a child but also the sorrow of families coping with loss. What advice would you give to parents who have suffered the loss of a fetus or an infant?


Dr. Manginello: Again, I think you just must first listen. You may have to share a tear with somebody, offer your understanding, and help by referring to support groups. I think one of the worst things that you can say is, “I’m sorry, you can try again,” because that’s not what someone wants to hear. But you have to be willing to understand their loss, listen to them, what it means to them, and help them get through this initial phase.


The other important part is I’ve seen too many tragedies one year after a fetal or infant loss. Get in touch with someone 11 months after they’ve had a loss to make sure they’re doing okay because the anniversary of a loss can be more difficult than the loss itself. Making sure that [the family] is okay at that one-year mark is really important.

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