To ask the Minister of Health to detail any support that is provided to mothers and families who have experienced a stillbirth, broken down by Health and Social Care Trust.

Belfast HSC Trust

Within Belfast Trust, all midwives, doctors, neonatal nurses as well as clinical support staff provide bereavement care. The service employs two full-time specialist Childbirth and Loss midwives who will meet with bereaved women and their partners upon request to provide help and support in the initial bereavement period and following discharge home. In Royal Jubilee Maternity Hospital the Trust endeavour to care for families who have experienced pregnancy loss from 12 weeks gestation in the Snowdrop Room. This is a dedicated bereavement room on a separate corridor within delivery suite with an ensuite bathroom, tea and coffee making facilities and has also been co-designed with members of the Snowdrop Group. The Snowdrop Group works in partnership with the bereaved parents to enhance and improve bereavement care.

Families are supported to spend time with their babies, make memories and share this precious time with extended family members including siblings as appropriate. They are guided in making decisions in relation to further investigations including hospital post-mortem examination. Staff discuss and assist families in making funeral arrangements for their baby. In addition staff recognise the impact for families experiencing stillbirth where English is not their first language. They engage with the appropriate interpreting services and are respectful of the cultural needs of individual families. Families can also avail of the chaplaincy service. Bereaved families receive one to one care from a dedicated midwife within delivery suite, supported by the Childbirth and Loss Midwives. Families are supported to spend time with their babies, creating memories and introducing their baby to siblings and or extended families

On discharge to the community, GP services provide ongoing support. Bereaved families are also given information about a range of charities including Sands, Child Bereavement UK, Anam Cara, Tiny Life, the Twins Trust, Cradle and Aching Arms.

It is recognised that families who experience a stillbirth are vulnerable to mental health difficulties and trauma symptoms alongside their grief. If required those families can be referred to the Maternity Psychological Service, embedded within the Royal Maternity Jubilee Hospital. Referrals for women, and birth partners/fathers are accepted and they are offered individual or couples-based sessions, depending on the clinical need. There is a longstanding high demand for psychological input into Maternity services, coupled with limited resources within the Maternity Psychological Service, and the service is actively exploring opportunities to improve access for psychological interventions and reduce waiting times for bereaved families.

South Eastern HSC Trust

South Eastern Trust provide a bereavement suite for women who sadly experience a stillbirth. The maternity service has two bereavement midwives who provide listening support with guidance to families who have experienced miscarriage, stillbirth or neonatal death. They receive referrals from early pregnancy services, neonatal services as well as from the maternity unit. They also provide face to face support to bereaved families while they are inpatients.

Northern HSC Trust

The Northern Trust is committed to delivering high quality, compassionate care to women and their families following loss at any stage during pregnancy. Women and families experiencing miscarriage or a stillbirth have the support of the multidisciplinary team, the Trust Bereavement coordinator, the Bereavement Support Midwife, specialist midwives and specialist nurses who work collaboratively.

The service provides support and guidance to all parents who experience pregnancy loss at any stage of pregnancy, miscarriage, stillbirth, early neonatal death, termination for medical reasons, and pregnancy after loss.

In the clinical setting bereaved parents are cared for in our recently opened bereavement room. ‘The Willow Suite’ is a dedicated space for parents and families following the loss of a baby after 20 weeks providing an appropriately safe and sensitive environment, which upholds privacy and dignity whilst giving the opportunity to grieve and spend time with their precious baby whilst in hospital. On occasions there may be more than one bereaved family, therefore staff will use judgement as to their placement. Prior to 20 weeks, those experiencing loss are cared for in a private room on the gynaecology ward. In both clinical settings and supported by the multidisciplinary team parents receive:

Compassionate and empathetic care

Clear and sensitive communication

Guidance to make informed choices and decisions,

Emotional support

Opportunities for memory making with provision of memory boxes, additional resources & bereavement photography,

Provision of cuddle cot whilst in hospital or for use at home – a specialised cooling cot giving parents the opportunity to spend as much time as needed with their baby both in hospital or at home in the time before burial or cremation

Individualised care planning

Assessment of mental health and onward referral if necessary

Opportunities for Remembrance and reflection

Support of specialist bereavement support midwife and signposting to other specialist services as required -outlined below

The Bereavement Support Midwife works alongside multidisciplinary professionals providing training, support, guidance for staff in the clinical setting and supporting women and their families following miscarriage or stillbirth in the weeks and months after discharge as needed. The Bereavement Support Midwife also offers a listening service following loss at any stage of pregnancy, miscarriage, stillbirth, neonatal death, termination for medical reasons, or in a new pregnancy after loss.

The Listening service is a 1:1 session (or sessions as required) with the Bereavement Support Midwife. This is a supportive session, which is individualised, led by the individual and offers signposting or referral to other services as required. The location, length of time and frequency of appointments are tailored to the parent’s needs. The parent also has access to the Bereavement Support Midwife via text, phone or email outside of these appointments. In addition to the listening service, if other specialist service are required for example therapeutic counselling or psychological support, the individual may be referred via a number of pathways;

Referral to Mental Health Practitioner at GP practice

Referral to GP

Referral to community mental health team or psychological therapies

Referral to Trust Perinatal Mental Health Midwife

Referral for support at the Extra support/Birth Trauma Clinic or debrief clinic.

Referral to Social Complexities midwife

Signposting to local and national charitable organisations for further support, befriending services, counselling services is also an option for families when psychological therapy is not required. Following Recurrent Pregnancy Loss, the Northern Trust offers referral to a specialist clinic. The clinic provides strong continuity of care for women and their partner. A small multidisciplinary team specialising in early pregnancy and recurrent miscarriage lead this clinic. The purpose of each appointment is to provide specialist support, undertake investigations, and provide treatments with an overall aim of reducing anxiety and improving mental and physical well-being prior to any future pregnancy. The Bereavement Support Midwife provides a supportive role alongside this clinic by providing a listening service, extra time, emotional support and guidance when needed.

Recognising the importance of remembrance for all bereaved families, the Trust organise remembrance events for all those who have experienced the loss of a baby or child. These events are in the form of a snowdrop walk event for all the family once a year, interdenominational remembrance services in both areas of the trust, and the opportunity for parents to have their babies name entered into the books of remembrance. Events are also held throughout baby loss awareness week to raise awareness and give staff and service user’s opportunities to remember and reflect.

The Trust have recently established and opened our own dedicated Garden of Remembrance where families can come to remember and reflect. This space also hosts bereavement remembrance events throughout the year. Many parents have expressed their sincere appreciation for these services and events and have found comfort in remembering their baby or child in this way. A service user group, ‘The Butterfly Group’, is available for bereaved parents, NHSCT staff and members of public. The group meet quarterly with the aim of improving services and bereavement care.

Southern HSC Trust

Southern Trust have purpose-built bereavement suites situated in the delivery suite where mothers are admitted for labour and birth. Both these suites are geographically located to avoid additional trauma for parents/visitors by meeting other birthing parents. The area has been sound proofed to avoid any noise disturbance. These rooms are suitable for any gestation usually used for 17-42 weeks gestation. Both suites have soft colours and furnishing to ensure the room appears less clinical and more conducive to the needs of bereaved families. Families remain in these room for labour and delivery and then discharged home.

Families are discharged home with resources to provide comfort and support and offered a listening visit in Dromore Listening Rooms or telephone support from the Bereavement Midwife. Staff are caring, compassionate, emphatic and supportive to all bereaved parents. The Bereavement Midwife also signposts bereaved parents/families to other charitable organisations/support groups such as Little forget me nots, Cradle, SANDS NI, 4 Louis, Tommy charity.

Parents/ siblings are offered additional visits to Dromore listening rooms as required. Support visits are offered following coroner reports.

The Bereavement midwife contacts parents on the baby’s due date to offer emotional support and this support is continued throughout the year with the Trust’s annual Service of Remembrance.

With subsequent pregnancies emotional support is offered by bereavement midwife throughout the pregnancy journey.

Some parents become involved with organising fundraising events throughout the year for all those who have been affected by baby loss.

Western HSC Trust

In Western trust all women who have experienced a stillbirth are offered support by Midwifery/Obstetric staff who will manage and support them throughout their care. Women are also offered additional support by the Pregnancy and Loss Midwife for the Trust. She offers to meet with families face to face or via telephone and provides a direct contact number should they require her assistance. Women are also provided with details of support organisations that they wish to avail of at this time or at a later date. The Trust also invite our mothers back for a consultation with their named consultant.