Care provided after death
Midwives play an important role in all circumstances of pregnancy and baby loss including miscarriage, stillbirth and neonatal death. They provide and coordinate holistic care and support for parents and their families. This continuum of care may begin with the support of parents on diagnosis of pregnancy loss or baby death; continue during decision making and the physical management of the mother and include ongoing support and care of the bereaved parents afterwards. Key responsibilities include:
- Facilitating dignified care of the baby, mindful of any health and safety and legal requirements which apply. This should acknowledge the importance of the extended family and the personal, cultural, religious and spiritual preferences of the parents.
- Helping parents be involved in their baby’s care, recognising the importance of creating memories for them
- Ensuring the safe transfer of the baby from the place of birth/death.
- Having an understanding of the requirements and professionals’ responsibilities in relation to:
- Histopathological examination and disposal of miscarriage tissue.
- Hospital post-mortem examination.
- Stillbirth certification.
- Notification of birth and certification of death and subsequent registration.
- Documentation to be completed when cremation is preferred option.
- Circumstances and related processes for referral of deaths to the Coroner.
- Obstetricians, Paediatricians
- Neonatal Nursing staff, Health Visitors and Social Workers
- Mortuary Services, Porters
- Funeral Directors
- Laboratory Services
- Paediatric Pathology services
- Police Service, Coroners Service
- Voluntary Support Groups. (TBC possible addition)
The Standard of Bereavement Care is enhanced when:
- There is a partnership approach between medical and midwifery staff when communicating with relatives and supporting the decisions they need to make.
- There is accurate and timely completion of the relevant consent and certification documentation, where possible, which allows arangements to be made.
- There is good communication from pathology and laboratory services with regard to timescales for return of the baby / miscarried tissue to families.
- There is flexibility to facilitate the parents’ wishes regarding time spent with their baby, and maintenance of dignity when time for removal comes.
Standards and Guidelines:
- Midwives rules and standards 2004. Nursing and Midwifery Council (NMC).
- The Code: Standards of conduct, performance and ethics for nurses and midwives. 2008. Nursing and Midwifery Council (NMC) www.nmc-uk.org
- Record Keeping: Guidance for nurses and midwives. 2009. Nursing and Midwifery Council (NMC).
- HTA Codes of Practice – 1: Consent; 3: Post Mortem Examination; 5: Disposal Human Tissue Authority 2009
- Care plan for women who experience a miscarriage, stillbirth or neonatal death. DHSSPS.
- ‘Guidance on Death, Stillbirth & Cremation Certification’ Ref 20/2008, August 2008 DHSSPS.
- HSC Trust/Employers policies and procedures in relation to pregnancy loss, death and bereavement care.
- ‘Pregnancy loss and the death of a baby: Guidelines for professionals’ 2007. SANDS.