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Analysis

Who cares when you lose a baby?

20 May, 2010

Who cares when you lose a baby?

NMSF founder and chairman Andrew Canter describes survey findings into bereavement care provision across NHS Trusts.

NMSF founder and chairman Andrew Canter describes survey findings into bereavement care provision across NHS Trusts.


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Midwives magazine: June/July 2010



When you lose a baby illustration


The National Maternity Support Foundation (NMSF) report Who cares when you lose a baby? (NMSF, 2009) is based on a survey carried out among NHS Trusts, using the Freedom of Information Act. The survey looked into the Trusts’ provision of specialist bereavement midwife care for couples and their families who have suffered a stillbirth or the death of a baby shortly after birth.

The survey – conducted between June and August 2009 – was undertaken to highlight the shortcomings in bereavement care available. Around four out of five NHS Trusts responded to the survey with the disclosure of the required information. This is the first wide-ranging report into the state of bereavement midwife care across the NHS and brings important issues surrounding the service to the forefront.

The fact remains that 6500 babies are stillborn or die shortly after birth (Sands, 2009) per year, so the need remains for specialist bereavement counselling to be available within every NHS Trust where maternity care is provided.

When you lose a baby table

The survey showed that 74 NHS Trusts (40%) had no specialist bereavement midwife. It is somewhat alarming that several Trusts had never offered bereavement midwife counselling and others simply paid ‘lip service’ by offering the services of their chaplain. Others outsourced their bereavement care to either local authorities or charities, such as Sands (stillbirth and neonatal death charity).

In other Trusts, the responsibility was shared among the midwives, with no formal qualifications in counselling. In the Healthcare Commission report Towards better births (Healthcare Commission, 2008), it is clearly stated that Trusts should ensure that all staff are appropriately trained, up to date and confident in practising the essential skills needed for a safe and high-quality maternity service, which must include bereavement care.

The death of a baby is a devastating experience and the effects of grief can be overwhelming. This tragic event affects the whole family, not just the prospective parents, but the extended family and friends.

The ‘knock on’ effect of losing a baby is often overlooked by the health authorities in terms of bereavement care. Often the grieving parents are told that they can get support from charities and are handed several leaflets to guide them through the difficulties surrounding the loss of a baby.

Invariably the parents and other family members are in shock for some considerable period. The mother is especially vulnerable, as she must cope with both the emotional turmoil of losing her baby and the physical trauma of going through the labour process and all this entails, with nothing but a dead baby to show for this tremendous effort.

Although midwives do receive bereavement care training, it remains a tiny part of their overall training and does not include any counselling skills, which are so critical.

There are some guidelines (Foundation for the Study of Infant Deaths, 2005) on bereavement care following the loss of a baby, but they were produced in November 2003 and last revised in March 2005.

Given the tremendous stresses this puts upon those who have suffered this type of tragedy, it was interesting and somewhat concerning that there was such an apparent lack of resource in this area of maternity care. This is clearly demonstrated from the direct quotes from several hospital Trusts (see box).

This NMSF report was inspired by my personal experience. Both my partner and myself received incredible ongoing counselling from a specialist bereavement midwife following the stillbirth of our first child, Jake in October 2005.

The support was the key to helping us through the darkest periods and getting our lives back on track. Our local NHS Trust provided the bereavement care, even though the stillbirth occurred at another hospital outside of our locality.

Having attended local support groups organised through Sands, we were shocked at the lack of bereavement counselling available through the NHS. Although Sands offer a befriending service, we felt that this did not go far enough in dealing with the emotional turmoil and post-traumatic stress we were suffering.

During this time, we met many other parents who had suffered the loss of a baby. The picture of bereavement care and counselling was extremely mixed. Many were still suffering from the shock of losing their babies and were unable to get the counselling they desperately needed. 


References

Foundation for the Study of Infant Deaths. (2005) Guidelines for health visitors and midwives when a baby dies suddenly and unexpectedly. See: http://fsid.org.uk/Document.Doc?id=89 (accessed 19 April 2010).

Healthcare Commission. (2008) Towards better births: a review of maternity services in England. See: www.cqc.org.uk/_db/_documents/Towards_better_births_200807221338.pdf (accessed 19 April 2010).

National Maternity Support Foundation. (2009) Who cares when you lose a baby?

Sands. (2009) Why17? See: www.why17.org/Why-17-Home.html (accessed 19 April 2010).


Further information

For further information about Jake’s charity, please email: info@jakescharity.org or visit: www.jakescharity.org



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