BLOG: Learning from midwives leading the way in bereavement care

Donna Ockenden, Senior Midwifery Adviser reflects on the support given to families who have experienced bereavement

Professional development is at the very heart of revalidation and as part of my recent visit to the maternity and neonatal services at the Simpson Centre for Reproductive Health at the Royal Infirmary of Edinburgh I was delighted to see just how much value the team place on this. The midwifery practice development team there have created a ‘Professional Development and Clinical Skills Passport’ for hospital and community midwives. It’s a fantastic tool which allows midwives to record all of the skills they have gained in one helpful document. Midwives can easily see what training they’ve done, and it provides them with a handy reminder of what they need to do.

This was one of many examples of good practice I saw on my visit to Edinburgh where midwives took the time to talk me through their process for learning when there are adverse or unexpected outcomes. As we are all aware supporting women and families during pregnancy, birth and the postnatal time is not always without complexity and occasionally things can go wrong. Where this does happen, the service encourages their staff to be open so the whole team can learn from any incident that occurs. Every morning the maternity team hold a multi -professional ‘rapid review’ meeting and discuss untoward or unexpected events and ensure rapid feedback of any learning to staff. If there are examples of good practice, even within an untoward incident then this is also shared.

During my visit I also learnt about the ‘Being Open’ process. There are often a lot of questions from families after an untoward or unexpected event, and many will want involvement in any investigation or enquiry process that follows. The maternity services in Edinburgh make sure that mothers and families are given one dedicated named contact within maternity throughout the duration of any investigations that follow.

One of the main things I took away from my visit was the care and support the maternity and NICU teams give to mothers and families who had tragically experienced a stillbirth or baby death. The service has adopted a collaborative approach to support mothers and families through their loss. Health professionals working across many disciplines including pathology and mortuary staff are part of the ‘team’ – they also involve those working alongside the hospital such as local charities and funeral directors. It’s clear that midwives are a key part of that multi- disciplinary team in Edinburgh and are absolutely focused on providing the best possible support at a tragic time.

The service has also worked with Sands Lothians, a charity that supports the provision of compassionate care to families following the death of their baby, to produce an animation called ‘Parent to Parent’. This sensitive resource offers support to bereaved parents when they’re making a decision on whether or not to have a post mortem. In making the animation the team spoke to parents who had experienced a bereavement and asked what questions went through their minds when reaching their decision. The animation is a really good example of how the maternity team is reaching out to, and involving parents and learning from their experiences to help others.

When a family experiences a bereavement it can often be the small details that are appreciated by families. The maternity team in Edinburgh can arrange for a trained and experienced photographer at the hospital to take photos of the family and their baby to provide a lasting memory. Photographs are then provided to the family on a memory stick or similar. This small but really important gesture shows the huge amount of thought that the team put into caring with kindness and compassion for mothers and families.

To further support the fabulous work of Sands Lothian a wide range of multi professional ‘Simpson’ staff as well as their families and friends, recently took part in the Edinburgh Marathon Festival, undertaking 5k, 10k, half marathons and marathons. The team did amazingly well on behalf of Sands Lothian raising over £23,000. Throughout my visit this ‘team spirit’ was really evident throughout care provision in maternity and NICU with staff commenting positively on how much they enjoyed working for the service.

As part of my role with the NMC I visit maternity services across the UK. Please do let me know if you would like me to visit your service or contact me at any time. I’m always keen to make sure that information that is shared with me reaches the very heart of the NMC, meaning the decisions made by the NMC about midwifery are grounded in up to date insight directly from today’s midwives and maternity services.

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