Working to reduce baby loss and improve bereavement care
By Heather Bower, RCM Professional Advisor, Midwife on 11 October 2022 Midwives MSWs - Maternity Support Workers Bereavement Care Child Mortality Infant Mortality Miscarriage Neonatal Death Safe Sleep Sands Stillbirth Specialist Midwives
The loss of a baby is devastating for every family experiencing such a loss. It is also traumatic for midwives, MSWs and other healthcare professionals caring for families who are going through this experience. Sadly, stillbirth rates are on the increase again, with rates rising from 3.8/1000 births in 2020 to 4.1/1000 births in 2021 (ONS 2022). This is the first increase in the UK since 2014 and many organisations are working hard to reverse this trend.
The Royal College of Midwives works closely with the Stillbirth and Neonatal Death Society (SANDS). SANDS leads a collaboration of organisations who have developed the National Bereavement Care Pathway (NBCP), which aims to improve the quality and consistency of NHS bereavement care received by every parent during and after pregnancy or baby loss. The NBCP is based around nine standards of care and five pathways to care. The five pathways are:
- termination of pregnancy for fetal anomaly
- neonatal death
- sudden unexpected death of an infant up to 12 months.
NBCP guidance materials supporting these five Care Pathways have recently been updated.
There are now over 100 England hospital trusts who have signed up to the NBCP, which is an amazing achievement. The NBCP is aiming for 100% sign up in England so if your Trust hasn’t yet signed up, you can contact the NBCP here: Registering your NHS Trust's interest | National Bereavement Care Pathway (NBCP) (nbcpathway.org.uk)
THE NBCP is also being piloted in Scotland www.nbcpscotland.org.uk and further information on the progress in Scotland will be published on the NBCP website soon.
An independent evaluation of the pilot NBCP sites demonstrate the benefits of the project. It has improved the bereavement care received by parents, as well as improving the confidence of healthcare professionals to provide good bereavement care. It has also enabled hospital teams and departments to work together to provide consistent care. NBCP Evaluation | National Bereavement Care Pathway (NBCP) (nbcpathway.org.uk)
The second Standard of Care in the NBCP says: “Bereavement care training is offered to staff who come into contact with bereaved parents, and staff are supported to access this training.” Poor staffing levels in maternity are one of the barriers to providing this staff training and development, as highlighted by the RCM in June this year Midwives unable to complete crucial training further highlights need to address midwife shortage (rcm.org.uk) . We know that lack of training is associated with poorer bereavement care and this has a direct impact on the quality of care for bereaved women and their families.
Only by getting the right number of midwives and MSWs who have received the right training can we ensure that we provide the best bereavement care. Every mother and family experiencing baby loss deserve no less.
Office of National Statistics (ONS) (2022) Births in England and Wales: 2021 Births in England and Wales - Office for National Statistics (ons.gov.uk)