Before discharge
Aim to support families as they leave hospital and adjust to going home without their baby.
Families tell us leaving the baby in the hospital is difficult. They feel unsure about who is caring for their baby, where care will take place, and who will be providing contact and support for the family after they leave.
What do we need to do?
- Give the family time to ask questions about who is caring for baby, place of care of baby and who to contact when they leave the hospital.
- If appropriate psychological support is available, immediately and longer term, offer the opportunity to take the baby home or out of the hospital environment - a template form is available. Refer to local guidelines on taking a baby home e.g. informing Police Scotland.
- Recognise the added complexity when discussing the woman’s postnatal care and physical changes to her body.
- Sensitively discuss the options for donating or suppressing milk.
- Discuss the emotions parents may experience and let them know these are common.
- Offer to cancel the Baby Box delivery if it has already been requested, and the woman, partner or a family member wishes. The box can be cancelled by calling 0800 030 8003. The call can be made either by the parent, a family member or a nominated health professional. However there is no need to cancel if they prefer to have the box.
- Ensure the family understand and have written information on their key contact, ongoing plan of care, and follow up appointment.
- Communicate these arrangements to the primary midwife.
- Update the primary health care team so they are aware when the woman is returning home. The GP, midwife and local obstetric consultant should be informed within 24 hours.
- Offer parents contact with the spiritual care/ chaplaincy team if this had not already happened.
- Provide parents with details of the emotional support available from your Board and primary care team. Explain how support organisations can help and give contact details.
- Consider NICE guidance QS115 on antenatal/ postnatal mental health and SIGN guidance 127 on perinatal mood disorders.
Feedback
- Discuss with parents the channels available for giving feedback about the bereavement care they receive.
- Ensure any verbal feedback is recorded.
- Let them know that they will be asked for feedback on the care they have received at their follow up appointments and by their key contact.
- Consider using Sands' Maternity Bereavement Experience Measure (MBEM) to capture parent feedback.
- Be clear with parents that feedback they give for this purpose is not part of a review of the baby’s death nor a complaints process.
The minute it happens, at the hospital, they need to inform the GP etc. You shouldn’t have to explain yourself when it’s already a stressful and traumatic situation. Shouldn’t turn up at the 6 week check up and be asked “How old is your baby?” It should be in notes and communications.
They need more knowledge and trauma informed practice. Just approach it – what can I do? How can I help you? Refer to baby by their name.
How will we know we have achieved our aim?
Families will tell us they were sure who would be contacting and supporting them after they left the hospital, and knew how their baby would be cared for.
Staff will say they feel confident and competent telling families, before they leave the hospital, who would be responsible for contact and support and explaining how their baby will be cared for.