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If a baby may die before birth

Aim to thoughtfully prepare a family as early as possible when a baby may die before birth and support them throughout the period when there is uncertainty about if, when and why their baby may die.

Families often know when staff are concerned that a baby may die. This causes anxiety if staff don’t communicate their thoughts and plans at an early stage and if there is poor continuity of obstetric and midwifery care.

What do we need to do?

  • Remember to keep within the scope of your practice when providing information, explaining procedures or answering questions. Be prepared to consult with or refer to suitably trained colleagues whenever necessary.
  • The reasons why and when a baby may die are variable, therefore it may take days or weeks to give definite answers. Share the known facts as they emerge with parents even though an underlying diagnosis or outcome has not been confirmed.
  • Explain to the woman and family that confirming why and when their baby may die before birth may take days or weeks.
  • During this period, make sure the family knows what will happen next and ensure:
    • continuity of obstetric and midwifery care
    • a key contact is identified who will support and coordinate care, including bereavement care, for the woman and couple right through their journey – this may be the primary midwife
    • the key contact also provides continuity during the Perinatal Mortality Review.
  • Record the care plan on the mother’s maternity record including planned continuity of care and key contact.
  • Explain how support organisations would be able to help and offer their contact details.

How will we know we have achieved our aim?

Families will tell us they felt well supported and prepared and were aware of the facts as they emerged.

Staff will say they feel more confident and competent involving families at an early stage.

Go to When a fetal heartbeat is not heard

When you are in a situation, with a baby that has passed away or is about to, just say - don’t tiptoe. Sit down and have a sensitive conversation and come in and just say it. Don’t try to butter it up into something it’s not. They were dancing around the subject and we never got any straight answers. Be direct.
Staff need to use direct and appropriate language. Don’t dance around the subject. Be direct, compassionate and kind.
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