Before discharge

What do we need to do?

• Recognise the complexity when discussing the woman’s continuing care and physical changes to her body.
• Depending on gestation, discuss lactation and milk suppression.
• Discuss physical changes to the woman’s body and who to contact if she has any concerns.
• Promptly inform primary care staff including midwife, GP and health visitor that the woman has experienced the loss of her baby, and where she will be staying when she leaves hospital.
• Discuss with the woman or partner the difficult emotions they may experience to reassure them that feelings of grief and loss are common.
• Sensitively explain that physical postnatal checks are not routinely offered but the woman can ask to see the GP.
• Ensure all women and partners are given a follow-up appointment. Ensure women
  and partners know what to expect from this appointment, the location and who can attend.
• Ensure that timing of appointment is realistic e.g. if awaiting post-mortem results.
• 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 woman, partner, a family member or a nominated health professional.  However there is no need to cancel if they prefer to have the box.
• Be aware of what is available locally to mark the woman’s notes to alert staff to her previous
  loss. If the woman wishes, a previous pregnancy loss form can added to her notes - a template form is available.
• Explain about the emotional support available to them via your Board, primary care colleagues and via support organisations and provide contact details. Never refer to ‘post-abortion’ counselling services unless you are confident they are completely non- judgemental and without anti-abortion bias.
• Consider NICE guidance QS115 on antenatal/ postnatal mental health and SIGN guidance 127 on perinatal mood disorders.

Feedback

• Discuss with the woman and her partner the channels available for giving feedback about the bereavement care they receive. Ensure any verbal feedback is recorded.
• Ensure women and partners are asked for feedback on the care they have received at their follow up appointments and by their key contact.

How will we know we have achieved our aim?

Women and partners will tell us they felt informed and knew what they might happen next and who and how to contact for any further care and support they needed.

Staff will say they feel confident and competent to provide clear information, and when identifying contacts for further care and signposting support organisations.

Go to Support in the community