Information for parents following the death of their baby before birth
Patient Information Leaflet
We wish to extend our sympathy to you and your family and offer you our support at this difficult time.
The following days may be difficult; however, it is also a time during which several matters must also be considered.
All this can prove very confusing, so try to avoid making any hurried decisions. Take time to talk to us and your family before deciding what is best for you.
We hope the information in this booklet will offer you help and guidance in your time of need. It does not cover everything related to the long-term emotional support you may need. There are organisations that can help and support you during this time, the contact details are listed on page 8 of this booklet.
If you need any help, please do not hesitate to ask any member of staff involved in your care.
Fetal Medicine midwife: .............................................................
Telephone number: ....................................................................
Bereavement Support midwife: .................................................
Telephone number: ....................................................................
Your Consultant is: ....................................................................
Consultant’s secretary: ..............................................................
You will be admitted to Sandringham Ward or the Central Delivery Suite
On: . ............................................................................................
At: ..............................................................................................
Feelings
Losing a baby is an experience that many will share, but we all react differently. For some, expressions of grief will be overwhelming and public. For others they may be very private, but no less deeply felt. Partners, family, and friends may all find it difficult to show their emotions. Many of us need to share our emotions to be able to cope with them. These feelings are real and painful, but they are also acceptable and understandable.
Grief throws our lives out of balance and there are bound to be good days and bad days. Try not to let this overcome you; this is normal. Take time to think through any decisions, as major changes at this time could be unsettling.
Induction for Delivery
You’ll be offered 2 types of induction, medical and surgical. The doctors will discuss the benefits and risks for both. Medical induction can be done at any stage of pregnancy, but we only offer surgical procedure at Queen Elizabeth Hospital during the first 12 weeks. If the surgical procedure is something you wish to consider we can book you into another hospital in the region or you can access British Pregnancy Advisory Service (BPAS).
We know it is a very difficult time and throughout the procedure your husband, partner or friend can be with you on the ward. You will receive support from the nurses/midwives and doctors and pain relief will be prescribed when required.
Two days prior to the induction, you will be given a tablet called Mifepristone which is an anti-progesterone tablet. This allows the uterus to become more sensitive to the later medications we use. After being given the tablet, you will go home but will be asked to return if you become unwell. You will be admitted for the induction process two days later. If you need any advice during this time, please contact the delivery suite on 01553 613720. 2
Occasionally the tablet may cause some bleeding or even contraction pains (these can feel like strong period pains) and if this occurs you should ring Delivery Suite on 01553 613720 and we may admit you sooner. More commonly you may experience some milder pain, and, in this case, you could stay at home and take Paracetamol for pain relief. You are advised not to use Aspirin or the Ibuprofen-type of tablets as they may interfere with the medication.
When you return to the ward/delivery suite two days later, you will need to have Prostaglandin tablets which will be inserted into your vagina by the doctor. These tablets are given to start the uterus contracting. After that you will be given regular medication by mouth until delivery. The time interval until delivery can be very variable – usually later in the evening but very occasionally it may take longer. You should plan to stay overnight in case this is necessary. You will be given plenty of pain relief, usually by injection, although some women may require an epidural anaesthetic (an injection of local anaesthetic which is given into the lower back).
At the time of delivery, the placenta (afterbirth) may come away on its own but occasionally it may be necessary to take you to theatre to have this removed under a general anaesthetic. The amount of blood loss at the time of delivery is variable and on very rare occasions may be quite heavy requiring the offer of a blood transfusion.
If your blood group is Rhesus negative, an injection of Anti-D will be given to you. You may go home once you are feeling well and the timing of this will depend on whether you needed to have a general anaesthetic and your physical condition. The nursing/midwifery staff will keep you informed.
Aftercare
The hospital staff will answer any immediate questions you may have, but it is difficult to think of everything at this time. An appointment will be made for you to see your consultant around 12 weeks after the birth of your baby. It is important that you ask any questions that you like – it may help to make a note of them beforehand so that you do not forget anything. At this appointment you will be able to discuss the results of any investigations that have been carried out and any implications these may have for future pregnancies. This appointment may or may not include a physical examination.
You are advised to see your GP after discharge. Bleeding may continue for 2-4 weeks and sometimes may be quite heavy, although some women continue with a light loss until their next period. You are advised to wear sanitary towels, not tampons, to assess blood loss and prevent infection. You are advised not to resume sexual intercourse until the bleeding has stopped.
It is important that you contact your GP if you experience any of the following:
• Prolonged heavy bleeding with clots
• Vaginal discharge that looks or smells offensive
• Rise in temperature
• Pain when passing urine.
You may start to produce milk about 3 days after delivery and this can obviously be very distressing for you. Medication is available to stop this process occurring if you wish, the hospital midwives will be able to give you this. You may also want to take a mild painkiller such as Paracetamol. You will be more comfortable if you wear a well-fitting bra until the process is finished. You can also buy breast pads to soak up any leaking milk.
Further Investigations
You may be offered a post-mortem examination. This will be performed at Addenbrookes Hospital in Cambridge; this may provide you with information about why your baby died. This may also be able to tell you whether the same problem is likely to affect any baby you may have in the future. You will also be offered blood tests and other investigations to try and establish the cause of your baby’s death.
Your doctor, nurse or midwife will be able to give you more information to help you to make your decision.
Remembering Your Baby
Seeing your Baby
You will have the opportunity to see and hold your baby if you would like to do so. If you or your partner wishes to do so after the delivery, please discuss with the Nurse/Midwife caring for you.
Naming your Baby
In some cases, it may not always be possible to identify the sex of your baby at the time of the birth. Therefore, it may be advisable to choose a name that is suitable for either a boy or a girl.
Blessing your Baby
Your baby can be blessed by the Hospital Chaplain, or a Minister known to you. This blessing can occur either with or without you being present. A blessing card will then be given to you.
Dressing your Baby
Depending on your stage of pregnancy, you may not have any clothes for your baby. The hospital has small items of clothing/ blankets that you may wish to use. Please discuss options with your midwife/nurse
Photographs and Mementos
We can take photographs of your baby. These photographs are taken with a digital camera and will be available for you. If at this time you do not wish to have the photographs, they can be given to you on a memory card just in case you change your mind. It may be possible to provide hand and footprints if you would like them, if your baby is big enough it may be possible to have these as imprints in clay as well. If your baby has hair, it may be possible to take a lock of hair. You are of course welcome to take your own photographs. You can also use the charity Theresa’s Tiny Treasures for memory work, information and contact details are provided.
Book of Remembrance and Remembrance Service
You may like to enter you baby’s name in the SANDS (Stillbirth and Neonatal Death Charity) Baby Book of Remembrance which is situated in the Sacred Space within the hospital. You may wish to write your own thoughts or a special poem in this book, this can be arranged through the local SANDS representative, see page 8. There is no time limit for this entry.
An annual Baby Remembrance Service is held around Baby Loss Awareness week which takes place in mid-October.
Arrangements for your Baby’s Funeral
There are several options available to you for your baby’s funeral. The chaplains, midwives or nurses will be happy to discuss with you. The Chaplaincy office can also help you to find a Funeral Director in your area.
Frequently asked questions
What if I have had a caesarean section before?
Your consultant should discuss your choices with you. If you have had a previous caesarean section, your consultant will consider this when planning your care with you.
Will I need to register my baby’s birth?
If your baby dies after 24 weeks of pregnancy you will need to register the birth.
How long will I have to stay in hospital?
Usually, an overnight stay is required but occasionally this may be longer. It would be advisable to bring enough belongings for a two day stay as opposed to an overnight stay (just in case).
What if I don’t want to see or hold my baby?
This is fine, and we will support you in which ever choices you make.
Do we have to pay for car parking?
Unfortunately, car parking charge is mandatory when in the hospital grounds, although the midwife who is looking after you can provide you with a parking permit. Please ask if you haven’t been given one and we’ll give you one.
Can I have visitors?
We do not restrict the number of visitors that you may wish to have. If you would like family members to visit or would like a family blessing, you are welcome to do so.
Can I take my baby home?
If you feel you may wish to take your baby home following their birth, please discuss this with the midwife/nurse looking after you. There is a process that needs to be followed but you can take your baby home if you wish to do so.
SANDS
National Helpline: 0808 164 3332
Email: helpline@sands.org.uk
www.sands.org.uk
SANDS Local Co-ordinator: Danielle Kendle: 07917 579104
The Norfolk Sands group aims to offer support for bereaved parents and families. If your baby was stillborn, or died during or soon after birth, SANDS offers support, however long ago that might have been.
Miscarriage Association
Helpline: 01924 200799
Email: norfolkmiscarriages@gmail.com www.miscarriageassociation.org.uk
If you have been affected by miscarriage or ectopic pregnancy, the Miscarriage Association offers information and support, and meets at the Norfolk & Norwich Hospital on the 1st Wednesday of every month.
Time Norfolk
Tel: 01603 482732
Helpline: 01603 927487 www.timenorfolk.org.uk
Time Norfolk provides free confidential help and support to anyone who may have an unplanned pregnancy, or who has experienced pregnancy loss through miscarriage, termination or stillbirth. They provide support across Norfolk to women and their partners of all ages.
Theresa’s Tiny Treasures baby
bereavement photography and keepsakes
Tel: 07443 870043
Email: theresa@theresatinytreasures.co.uk www.theresastinytreasures.co.uk
Charity No: 1169080
To request this document in a different language or format, please contact 01553 613391 or email communicationsqeh@qehkl.nhs.uk
