Out of hours - the on call staff can be contacted through hospital switchboard.
The loss of a baby can result in many mixed emotions. This information is here to assist and guide you. Whilst it is impossible to cover every detail, we have tried to provide help and advice in this booklet.
Please do not hesitate to ask any questions, even if you may think that it is an odd question, it will be answered respectfully. The staff will do their best to provide support and space for you at this emotional time.
First few hours and days after your baby’s death:
At first you may feel in a state of shock, events which are happening may seem unreal and difficult to understand. Decisions you are asked to make may feel uncomfortable or difficult, but please take your time and discuss everything with the midwife or health professional caring for you. It may help to write down any questions you have thought of during this unsettling time.
We understand that whatever you do at this time is really important for the future and that creating memories of your baby can be really precious. The most important thing is that you feel able to do whatever you feel is right for you during this very emotionally painful time.
We will do our best to care for your needs within a special room on the delivery suite, where you can have privacy but still be close to staff.
Photographs
The Bereavement team/Bereavement Midwives can arrange for photographs to be taken of your baby (with your consent). These would be included in your memory box.
You may also want to take your own photographs with your own camera/phone.
Memory Box
The Bereavement Team will try and help to create as many memories of your baby as possible.
The following can be included in your memory box:
~ Photographs
~ Hand and foot prints
~ Lock of hair (where possible)
~ Umbilical clamp
~ The clothes and blankets your baby was photographed in (baby will be dressed in an identical set)
~ Teddies/toys
A Service of Naming and Blessing
Giving your baby a name may help to establish their identity.
The hospital chaplain can arrange for a bedside blessing or ‘Naming ceremony’ to be held before you leave the hospital.
Book of Remembrance
The pages in this book provide recognition and a lasting memory of your special baby.
You and your family are welcome to come and look at the book by making prior arrangement with the chaplaincy. An entry of your baby’s name and a message can be recorded at no cost to you.
Documentation and Registration
A baby born before 24 weeks which shows no signs of life does not need to be registered.
Following a stillbirth (A baby born from 24 weeks onwards which shows no signs of life and where no heartbeat was detected). Your baby needs to be registered as stillborn and the medical staff caring for you at the time will issue a Medical Certificate of Stillbirth. This will be given to the Mortuary/ Bereavement Staff who will contact you to arrange an appointment to register your baby’s stillbirth. When you register your baby’s stillbirth, the Registrar will give you a form authorising a funeral to take place.
Registration must take place within 42 days of birth at the Registry office within the district of the place of birth.
Following a neonatal death (a baby is born alive and then dies within 28 days of birth) it will be necessary for you to register both the birth and the death. The Bereavement Team can arrange this for you.
Registrar Information
The Registrar will ask you the following information:
~ Baby’s full name
~ Date and place of birth
~ Date and place of death
~ Baby’s age at death
~ Cause of death (on medical certificate)
~ Parents full name(s), occupation and address.
Coroner
By law, some neonatal deaths have to be reported to the Coroner who has the responsibility of investigating certain deaths. If a referral to the Coroner is made, your baby’s doctor will discuss this with you first. The Coroner will review the situation and make one of the following decisions:
~ Give permission for the hospital doctor to issue a medical death certificate, or
~ Decide to investigate your baby’s death further. If this decision is made, further information will be available from the Coroners office on 01603 774773.
Please note a delay in funeral proceedings may occur if a referral to a Coroner is made.
Hospital post mortem examination / investigations
The Bereavement Team will come and see you to discuss a post mortem examination. This needs careful consideration but may be essential in helping you to understand what caused your baby’s death. We will not carry out any investigation without your full signed consent. If the coroner is involved then the coroners offices will inform you that a post mortem is to be performed and will also instruct you as to what will happen next. Baby post mortems are not undertaken at the James Paget hospital so your baby will be transferred to the Norfolk & Norwich hospital for this to take place.
Going Home
Leaving hospital without your baby can be a very emotional experience.
Staff will provide support to you and will continue to provide this care and support once you return home. Please be reassured that your baby will be well cared for and treated with the utmost dignity, respect and compassion by all staff.
Your community midwife and GP will be informed that you have gone home. Follow up visits from your midwife can be arranged. You can contact the mortuary/bereavement team, bereavement midwife, GP or Central Delivery Suite at any time.
You should receive a GP appointment 6-8 weeks after delivery. However, if you don’t hear anything, then contact your GP to arrange an appointment.
Taking your baby home before the funeral
An option you may not have considered is whether to take your baby home for a short time before the funeral. This is best arranged through the Bereavement Team/Bereavement Midwives who can also make an appointment for you to come and see your baby once you have gone home.
A member of the Bereavement Team will come and speak to you about your options regarding a funeral.
You may choose to have your baby either cremated or buried.
If you decide you would like to have a service this can also be arranged for you. It can either take place in the hospital chapel or at the crematorium if you choose to have your baby cremated. You can choose to have the service as a private event for just yourself and your partner, or you may also invite family members/ friends if you so wish to.
If you would like to speak to a chaplain then the Bereavement Team can arrange this for you.
These are the options available to you:
1. You may make your own arrangements with a funeral director of your choice. The majority of funeral directors provide this service free of charge or ask for a minimal fee. You need to be aware if you choose to have your baby buried then there will be a charge for the deeds, burial plot and headstone.
2. The Bereavement Team can make funeral arrangements on your behalf. The team can organise for a service to take place in either the hospital chapel or at the crematorium. On the day of the cremation, hospital transport will transport your baby to the crematorium. The Bereavement Team will contact you a few days after to make an appointment for you to collect your baby’s ashes.
Not everyone will want to hold a funeral for their baby and this is something that the bereavement office can also assist with.
You can choose to have a funeral but not attend or you may choose to have your baby cremated and have the ashes scattered within the crematorium grounds.
Whatever option you decide, be assured that your baby will be treated with the utmost respect and dignity.
There is no charge to parents for a hospital arranged funeral.
Maternity and Paternity Rights
If your baby is to be registered as a stillborn baby or as a birth then a death - you may still be able to claim full maternity pay and paternity rights (depending on your employer).
Following a neonatal death you can also claim child benefit for a period of time (regardless of how long your baby lived for or at what gestation they were born).
If your baby was born with signs of life before 24 weeks gestation you will need to speak to your GP to obtain a medical certificate (known as a statement of fitness for work) for as long as you feel necessary. This can be reviewed as and when needed.
For the Father
Sometimes as the Father you can feel that you are here to support everyone else and that a lot of the support is directed towards your partner. You need time and space to grieve too. Please do ask for support if you feel lost, alone or unsure what to do.
Other children
If you have other children you may feel at a loss as to how to explain what has happened. You are the expert with your children and will know what understanding they have of death and what it means. You may need to dig deep into your resources to answer questions which may seem very direct or uncomfortable.
Our tendency is to protect our children, however, sharing emotions and grief with them can help them to express their feelings, which although feeling uncomfortable at the time may be beneficial in the long term. If possible, use language that is honest and easy to understand (e.g. try not to say that the baby was born asleep as they will want to know why they are not waking up, or say we’ve lost the baby as they may wonder why you don’t go and find the baby).
Gifts for your baby to go into the coffin can be very important. If you have children of any age, it can help them to say goodbye and deal with their feelings of loss at this difficult time.
There is a charity called Winston’s Wish, which offers support to families and especially to children. They can be found at www.winstonswish.org.uk
Family and Friends
Family and friends may find it very hard to know what to say or do. Be honest and say if you need to talk or if you would prefer to be on your own.
Accept offers of help, particularly practical help, as ‘normal’ or ‘mundane’ jobs such as ironing can seem just too difficult to tackle and then the pile of ironing can start to really annoy you.
Sometimes doing those mundane jobs yourself is helpful so you may have to guide people close to you offering help.
Relationship with partner
When you are both grieving - sometimes in different ways - it may become difficult to provide mutual support. This is a normal reaction and you should try and take one day at a time. You may find it helpful to seek additional support from a counsellor, SANDS or other support services.
Emotional and Physical Effects
Here are some of the ways you can feel grief – you may feel some of them now, in the future or not at all:
~ Disbelief
~ Overwhelming sadness
~ Isolation
~ Nothing at all – numbness
~ Anger – at others, yourself, injustice, God
~ Guilt
~ Lost
~ Failure, inadequacy
~ Physical pain in arms, throat, chest
~ Emptiness
~ Madness
~ Confusion, restlessness, a sense of searching
~ Forgetfulness
~ Anxiety, fear
~ Dreams
~ Despair
~ Jealousy
~ Extreme tiredness
~ Can’t sleep or sleeping all the time
~ Can’t eat or eating a lot
~ Obsession about getting pregnant again
~ Fear of pregnancy
There is no right or wrong way to grieve. The important thing is to give yourself time and to share your feelings with someone you can trust and who will listen. Sadly there are no short cuts.
Getting back to doing ‘normal things’ such as going to the supermarket or collecting children from school can feel very strange at first. You may even feel a sense of guilt that you are ‘getting on with things’. You may be worried about becoming upset whilst you are trying to do normal things. This may happen, but do not worry, you are entitled to be sad and upset about your loss. Seek support from those you are close to when you do these things for the first few times.
Going back to work
If you have a job it can be very hard to decide when to go back to work. If your baby was registered then you are entitled to full maternity pay and leave.
Everybody is different. Sometimes it is easier if you can go back to work gradually. Perhaps call in one day with a work colleague just to see everyone for the first time. Then, if possible, work reduced hours to begin with. Colleagues need to be aware that one minute you will be ok, then the next minute you may need some time to yourself if you feel overwhelmed by your emotions. They, and you, need to know that this is normal when bereaved and will gradually become less frequent.
Stopping baby-related post
You may have subscribed to mailing services who will be sending you information related to babies over the coming weeks and months. At this time, this can add to your distress and hurt. Please contact MPS (Mailing Preference Service).
Tel. no: 020 7291 3310
Web: www.mpsonline.org.uk
A mail suppression form is generated from CDS via BOUNTY.
The future
Once all investigation results are available you will be offered an appointment to see your Consultant. Some results can take up to 3 – 4 months to be available. Over the weeks, months and years to come your feelings can be mixed and changeable. This is normal. Please ask for support when you feel you may need it. If you become pregnant again, this can be a time of very mixed emotions. The loss of a child at any age is often described as the most devastating loss a parent will experience. It is ‘the wrong way round’ for your baby to die before you. It is quite usual to be struggling several months later and to feel the need to talk and for reassurance. Even many years down the line, parents still mourn the loss of their baby.
These continuing feelings of loss and sadness are normal. But you also need to know that with support, the rawness of pain and anguish felt in the early days, weeks and months, can change and feel more bearable.
Often talking to parents who have also suffered the loss of a baby can be helpful.
If after 3 months, there are persistent difficulties adjusting to life following your loss, contact your GP who may be able to refer you to someone who may help. Alternatively, contact the Bereavement Midwives.
More detailed information can be found in the SANDS booklet, Saying goodbye to your baby.
Reference: James Paget University Hospital Children’s Bereavement Booklet
