Sands Antigua & Barbuda

  Improving Care When a Baby Dies

No-one can take away the pain parents feel when their baby dies, however sensitive, supportive care in hospital can help to ease the grieving process.

Sands has worked in partnership with health care professionals for over 25 years in the UK to improve understanding of what it means to lose a baby and of what professionals can do to support and care for parents when their baby dies.

We believe that the principles of honesty and respect and the need for clear information and communication should underpin bereavement care. 

Staff Need to Bear in Mind that:

The most reliable source of information about a woman's needs is the women herself

It is never acceptable to assume what parents will want on the basis of their "background", circumstances, way of life, religion or "ethnic group", nor on the basis of the staff member's own culture or the culture of the workplace.

It is always important to ask parents what they would find helpful and to check out any assumptions.

People do not usually mind personal questions - provided that the reasons for asking them are explained, the questions are asked in a respectful and sensitive way, and staff then make a genuine attempt to use the answers to meet the parents' needs.

Parents will not always know what is traditional or customary in their community when a woman experiences a childbearing loss. They may need time to think or to talk to family members and other people.

 Sands Principles of Good Practice

"Bereaved parents never forget the understanding, respect and genuine warmth they received from caregivers, which can become as lasting and important as any other memories of their lost pregnancy or their baby's brief life". (Leon 1992)

 1) Care should be parent-led.

Identifying and meeting the needs of parents should be regarded as an investment in their future health and wellbeing. 

2) Good care involves spending extra time with parents. 

This should be recognised by managers and staff. 

3) Parents should always be treated with respect and dignity and should be supported with genuine sensitivity and empathy. 

4) Each parent's personal preferences and cultural or religious needs should be taken into account.  

5) Communication with parents should be clear, sensitive and honest, and should be tailored to meet individual needs. 

Trained interpreters and signers should be available for parents who need them. 

6) It is not possible to predict the significance that a childbearing loss will have for individual parents.

No assumptions should be made about the intensity or duration of grief that a parent will experience. It is important that staff accept, acknowledge and validate the feelings that individual parents are experiencing. 

7) A father's grief may be as profound as that of the mother: his needs for support should be recognised and met.

The needs of a partner in a same-sex couple should also be recognised and met. 

8) Staff should avoid giving reassurances that may turn out to be false.

Many childbearing losses involve periods of uncertainty. Staff should acknowledge the difficulty of living with uncertainty. 

9) In any situation where there is a choice to be made, parents should be given the information they need, and should be supported and encouraged to make their own decisions about what happens to them and to their baby. 

10) In addition to good emotional support, women should receive excellent physical care during and after a loss.

11) Women should be cared for in a place that is appropriate to their stage of pregnancy and the type of loss that they are experiencing.

12) Women and their partners should always be looked after by staff who are specifically trained to deal not only with their clinical care and physical needs, but also with their emotional needs.

13) Parents whose babies die in the second and third trimester should be offered opportunities to create memories.

Their individual views and wishes should be respected.

14) The bodies of babies and fetal remains should be treated with respect at all times:

Arrangements for sensitive disposal and respectful funerals should be in place. 

15) The hand-over care from hospital to district staff should ensure that support and care for parents are seamless.

16) Ongoing support is an essential part of care and should be available to all those who want it, regardless of the timing or type of loss that they have experienced. 

Support should continue to be available to all women and their partners during a subsequent pregnancy and after the birth of another baby.

17) All staff who care for parents during and after a loss should have opportunities to develop and update their knowledge and skills, and should have access to good support for themselves.