Support in the community
Aim to provide good communication between all health professionals and ensure that women and partners continue to receive the aftercare and emotional support they need in the community setting.
Women and partners tell they found it hard to cope after their loss and often could not find appropriate support.
What do we need to do?
- Offer women and partners a telephone call and/or home visit when they are back in the community. GPs should consider writing a letter expressing sorrow and offer an appointment.
- The loss should be coded in the GP notes and references to an ongoing pregnancy cancelled.
- Ensure good follow up care is provided for the partner as well as woman.
- Allow enough time to offer emotional support as well as check the mother’s physical health.
- Discuss with the woman or partner the difficult emotions they may experience to reassure them that feelings of grief and loss are common.
- Offer to discuss with women and partners how to talk about the baby who died with existing siblings.
- Ensure ongoing care is available where it is needed.
- Give women and partners the contact details of a healthcare professional they can contact for information and support - a template contact card is available.
- If not already fully aware of this, explain about the emotional support available to women and partners via support organisations. Never refer to ‘post-abortion’ counselling services unless you are confident they are completely non-judgemental and without anti-abortion bias.
- Make sure you know who can offer psychological support to bereaved women and partners and their wider family and if professional referral is required, offer to do so.
- Offer referral for specialist psychological support if there are signs that might indicate PTSD or clinical depression, and, if appropriate, for mental health assessment.
- Consider NICE guidance QS115 on antenatal/ postnatal mental health and SIGN guidance 127 on perinatal mood disorders.
Follow up meeting
- Remember to keep within the scope of your practice when providing information, explaining procedures or answering questions.
- Help the woman and her partner to consider questions they want to ask before this meeting.
- Allow enough time for women and partners to understand information and ask their questions.
- Pay attention to the woman and her partner’s emotional wellbeing as well as physical needs.
- Discuss care for potential future pregnancies and what, if anything, can be done to reduce risk.
- If the baby had a condition which gives an increased risk for future pregnancies, and if genetic counselling is required, offer a referral. If appropriate, discuss what women and partners can do to reduce risk e.g. folic acid supplementation. Give information on any screening/testing that may be available in future pregnancies and ensure women and partners are aware of how to access this.
- Provide women and partners with a letter summarising their follow up meeting and send a copy to their GP.
My husband is finding it hard to cope still. It’s not just about support for women themselves, there needs to be support for partners themselves.
I was told in the hospital that I would receive a date for a follow up appointment with the consultant in about six weeks after birth. Six weeks came and went and there was nothing - it only adds to the stress of the situation. If there is some issue that appointments cannot be carried out in said time frame, then communication is the key.
How will we know we have achieved our aim?
Women and partners will tell us their emotional needs were recognised and they were given appropriate advice on getting the care and support they wanted.
Staff will say they feel able to recognise the loss and they are confident and competent when identifying contacts for further care and signposting support organisations.