Before I get cracking with this post I want to commend my friend Chantal Lockey, CEO of the Infant Loss Foundation. Chantal is a powerhouse of a woman who brings her own experience of her daughter's death into passionate education for students and midwives. I did a training day with her a few weeks ago and if you ever get the chance to go, do (taking your biggest emotional capacity and a box of tissues).
I remember my Uni giving me a comprehensive study day on supporting bereaved parents.
It was tough, we cried, but we had an idea of the kind of care we’d be giving when that situation came up in practice.
But my inbox suggests this training isn’t given to every student midwife.
This is an issue, because right from the beginning of your training if you’re involved in this care, you have responsibility on your shoulders.
In this post, I’ll go through some of the things you can do to help. Or if you’re a mentor or more experienced midwife, reviewing the basics can be helpful, especially if you have a new student learning with you.
Back when I was a student, here were the questions I had around bereavement care:
• I’m not religious, what if a family is and I fail them in their needs?
• What if I use all the wrong words?
• What if I somehow make it even worse for them?
I bet you’ve spotted my problem already - look at all the ‘I’ statements!
I was making bereavement care all about me.
The one thing I needed to start doing was sending my attention outwards to the parents going through the experience, like shining a torch out instead of in.
There was plenty I could have been doing to make the experience even a tiny bit better as like most student midwives, I had empathy and compassion in spades.
Start by actively listening.
Active listening isn’t just about understanding the meaning – it’s about hearing the choice of words, taking in body language, maintaining supportive eye contact if appropriate, and trying to work out what’s there but is not being said.
Midwives should do this in every type of care but if a baby has died it’s even more important.
If you actively listen you’ll be able to match your language choice to the family's, and pick up on any specific needs, like cultural traditions, or whether they just want a safe haven to make memories with their baby.
Active verbalising can be helpful too.
This is about validating thoughts and experiences – if they say ‘I feel like this is all my fault’ instead of saying ‘it’s not’ straight off, you can echo ‘ok, you feel like this is all your fault…’ to show them they’re being listened to and this isn’t a silly thing to be feeling.
Then you can go on to say ‘but what’s happened to your baby is tragic and is absolutely not your fault.’
However, stay away from ‘at least’ statements.
Even the most experienced of staff can sometimes slip into saying ‘at least you got to meet them’, ‘at least you can get pregnant’, most horrific, ‘at least you didn’t get to know them before you lost them’.
Any attempt to frame things more positively is likely to cause more pain.
Remember however much your mentor prides themselves on being a ‘tough old bird’, the death of a baby is always a tragedy, so ask them if they’re ok.
There’s plenty you can do in terms of basics, like making sure linen is clean, there are enough pads, drinks and snacks keep topped up and buzzers are answered promptly.
Volunteer to get your mentor a brew or do the clearing up so they can have a few minutes. They might chuckle at you as you’re less experienced but caring for all members of your team is always the right thing to do!
Remember the partner, especially if they’re a guy.
Men often report feeling lost and powerless in the best of labour ward situations, and I’ve heard Dads call the death of their baby ‘hell on earth’.
As a student, you’ll often have a bit more time and may be able to make all the difference for them. While care always must have the woman at the centre, caring for Dads is a huge part of holistic midwifery.
Listen to what they have to say. Get them involved in the care of the baby if they want to be, things like dressing them, changing their nappy, taking photos or taking a lock of hair. Treat them as all important, because they are.
Do your own preparation at home.
Early in your training, or while you’re an aspiring midwife, spend some time on YouTube looking at the many videos on the topic of infant loss. We're in a privileged time, bereaved parents have made us many resources to learn from, for free.
It will be especially useful to see what babies look like at different gestations or who are in poor condition. This experience will help you as it’s a shock the first time you see a deceased baby, and when you’re caring for parents you want your emotional energy to be spent on them rather than your own reaction.
This dramatisation is an amazing teaching tool, there are some good elements of care and some terrible to identify.
Find something beautiful to comment on. I once looked after a woman who had a traumatic and complicated stillbirth and the baby was in poor condition, but he had beautiful eyebrows and eyelashes. She lit up when I commented on this.
Finally, it’s ok to cry. You don’t have to be an automaton. Crying with parents is sometimes the best care you can offer as it validates that what they’re going through. Of course you can’t make it all about you – parents should never be comforting you! But showing your emotions is part of building that mutual respect which all midwifery care should be based on.
To quote my friend Chantal: 'I think if you do not care or feel anything at times such as these, then really you're in the wrong profession.'
And on that wise note, I challenge you to leave me a comment.
What's the most important thing you've learnt to do for bereaved parents from this post?
Or, if you have personal or professional experience of infant loss, what's the most important lesson you wish all staff knew?
As always, thanks for reading and caring about these midwifery topics and getting involved with such enthusiasm here and in The Secret Community For Midwives In The Making on Facebook.
Your insight could be exactly what a student needs to hear to give outstanding infant loss care.
Until next week, Ellie x