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Most midwives cannot access bereavement care training during working hours

Leading pregnancy and baby loss charity Sands has published the results of a survey, which found the majority of midwives working in NHS trusts and boards are expected to complete vital bereavement care training in their own spare time.

Good quality bereavement care is vital for parents who have experienced the loss of a pregnancy, or
whose baby has been stillborn or died in hospital during the first weeks of life.

Although just over three quarters (77%) of trusts and boards reported that bereavement care
training was accessible to their midwives, only a third of trusts and boards (33%) said that those
midwives were given time during working hours to attend it.

Sands believes that high quality bereavement care training must be prioritised within all NHS health
trusts and boards. The charity is now calling for all healthcare professionals in contact with bereaved
parents, to have dedicated time for this essential training during working hours.

Sands is urging everyone to raise this important issue with their local health trust or board chief
executive. The charity has launched an e-action as part of its latest campaign, Together, we are
Sands, that asks NHS leaders to ensure that their frontline staff are given time in working hours to
attend this vital training.

Clea Harmer, Chief Executive of Sands, said: “Every parent whose baby has died, equally deserves
excellent bereavement care. It’s the very least we can do for them. So it is simply not good enough
that so many midwives and other healthcare professionals either don’t have access to this training,
or are expected to do this in their own time outside of work hours.

“Bereavement care training is essential to ensure the immediate and long-term wellbeing of families
affected by pregnancy loss or the death of a baby. Sands can offer support and training to midwives,
and other healthcare workers, to ensure they have the skills they need to both care for bereaved
families, and to look after their own wellbeing.

“Nothing will ever be able to take away the grief parents suffer when they lose a baby, but ensuring
the right care and support is in place can help them come to terms with their tragic loss. Poor
bereavement care can exacerbate a parent’s grief and have an immediate and long term effect on
their mental wellbeing , but good care can and does help them on their painful journey.”

More findings from the Sands survey

Overall the survey found wide variation between different professional groups in the provision of
bereavement care training; midwives, obstetricians and gynaecologists having the best access, and
A&E staff or paramedics having the least.

For example, only 39% of trusts and boards said this training was accessible to ultrasound
practitioners, who may be the first person to spot that a baby has died, and only 4% were given time
to attend during working hours.

Across the UK, an average of 49% of trusts and boards said that bereavement care training was
available to staff across the range of healthcare professionals, but only 12% said time was given in
working hours to attend.

Why bereavement care training is so important

Thousands of parents experience pregnancy loss or the death of a baby every year. It is estimated in
the UK that one in four pregnancies end in miscarriage, 5,000 wanted pregnancies are terminated
for medical reasons every year, and 13 babies are stillborn or die shortly after birth every day.

Caring for parents whose baby has died can be challenging for professionals, who may feel
unprepared and daunted. Specialist training is therefore vital to boost their confidence, skills, and
their own wellbeing, which in turn enables them to provide excellent care for families.

Earlier this year, Donna Ockenden noted the devastating effect lack of compassion had on a whole
community in her report into failings in maternity care at Shrewsbury and Telford Hospitals NHS
Trust. The Immediate and Essential Actions in the report highlighted that staff “should have been
trained in dealing with bereavement”.

Parents’ experiences of bereavement care

Amie’s daughter Charlotte was stillborn at 37 weeks in 2015. She found the care she was given at the
time helped her and her partner on their bereavement journey and has gone on to set up a Sands
support group in her home town.

Amie said: “My immediate bereavement care was excellent. I was taken great care of when
delivering my daughter and had lots of memory making opportunities with her following her birth.

“I was supported by lots of photos being taken, hand and footprints and had a 4Louis memory box
where I could keep a lock of her hair. I also had the charity “remember my baby” come and visit me
and they took some beautiful photos of us as a family and of my little girl which I truly treasure.

“My bereavement care once I left the hospital was a few phone calls from the bereavement midwife
but otherwise nothing. Counselling lists were at least six months waiting list. I used Sands forums,
my family and good friends as my support.”

Parents and family members have told Sands about the poor or non-existent bereavement care that
they experienced in the past, which shows the life long impact this lack of care can have on bereaved

Zoe’s daughter Poppy Grace died in 2013. She said: “Things have moved on a long way since we lost
our daughter Poppy Grace, in terms of bereavement care, but even then there were so many things
that were handled badly (or not at all) by the services that should look after you. Being able to spend
time with her and bury her was all a part of our grieving process.”

Sands working to improve bereavement care

Healthcare professionals are an important part of the Sands community, and we work to support
them to deliver good bereavement care.

The National Bereavement Care Pathway (NBCP) which is currently being rolled out in England and
piloted in Scotland, clearly sets out what good bereavement care training for staff should look like.
Bereavement care training is one of the nine NBCP standards central to high quality bereavement

Sands offers evidence based training from experienced trainers to build the confidence knowledge
and skills of staff to support families through pregnancy and baby loss.7 Anyone interested can find
more information at training.sands.org.uk

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