Supporting Families after Baby Loss (What Beyond Bea Taught Me)

*Trigger warning: stillbirth and baby loss*

If you read my review on the Beyond Bea training that I recently attended online, following the coronavirus pandemic, you will see that I had an amazing time and learnt so much. I couldn't fit it all on one blog post and so I decided to split the two areas up into a review and the lessons I learnt. Of course, this is just my take on the most important and stand out moments for me. There was so much more covered so I would thoroughly recommend attending a study day yourself, whether online or in person at some point. It was truly eye-opening and inspiring.

Grief
Bonding is affected in any sort of baby loss and so clinicians need to allow the grief process to be led by mother and to go at their own pace. Grief is individualised and cyclic, but it's never a straight forward process. Language is incredibly important and can have a detrimental effect and impact on women and their families. Medical terms such as medical termination is the same as compassionate induction but kinder, for the families benefit. Similarly, don't use colloquials and ensure parents understand at all times. Whilst staff may think that by being delicate, they are helping, being blunt and using specifics is more genuine and needed. Often families may need repetition to understand due to the grief process, so do re-visit topics.

The “Void”
As a third year student midwife, I still haven't provided full care for a family in this situation and one thing I hadn't considered was a time described as the "Void". This is typically a 24 to 48 hour time frame between the time of diagnosis until induction and often at home. Sadly, there is rarely contact in that time until care resumes again for delivery. There should be a consideration as to whether the bereavement midwife or community midwife can visit to help prepare the family and try to offer comfort where possible. During this time, it may be suggested that parents bring their own muslims as they are thin, but pretty so allow it to cover the cot cooling system.

As baby loss often occurs at an early gestation, birth plans may not have yet been discussed but the conversation should be open to allow the families to still have choice. It's important to give them some information about what is likely to have, especially in regards to labour, as many don’t realise that labour is still likely to be the same. Beyond Bea have just launched their alternative birth bag for families to takeaway and use, which will allow them to still care for their baby and prolong deterioration.

Memory Making
Memory making is a crucial aspect of supporting a family after loss and it's important that you make them WITH the family and not FOR the family. Memory giving is not the same as memory making. It's also useful to recognise and remind the parents that it doesn't start and end with birth because they have already made memories throughout the pregnancy. There are so many great options out there for families to create as keepsakes and momentums.
Memory Making Kit | Beyond Bea Charity
One of the main one includes hand and foot prints. These can be done in different ways, with simple inkless prints, clay moulds or even 3D casts. For all of them, get the parents to hold the baby while it is being done and then follow some simple tips for the best quality results. The clay needs squeezing to remove bubbles and then once fit to the frame, flip over so the completely flat side can be printing upon. For the casts, use oil on the baby's hand for ease. The easiest way to capture moments is through pictures and depending on the baby, black and white photographs can be taken too. Many hospitals have memory boxes donated which can include lots of different things, includes hearts and teddies to be buried with.

I think it's really crucial that we offer as many of them as possible to each family. The more memories the better but they all require consent. We need to normalise memory making and ensure that families don't feel stigmatised by choosing to take photographs. One of the aspects that I hadn't considered was that in an ultrasound scan, as it is a medical necessity, it is one of the only aspects of memory making you can do without consent. Even if the parents don't want a print, you can save a copy and put it in the notes, in case they want it again in years to come.
If families don't want to see their baby - and some may not - there needs to be a conversation around why. It should be a parent-led decision but they need to be informed it is normal to see their baby and also that there is a limited amount of time where this is possible.

Coronavirus
As a final note, Covid-19 has changed society in so many ways and sadly, baby loss has still been ongoing in the midst of it all. Understandably, support has been reduced, but this may make families feel isolated and abandoned. Likewise, funerals have been limited to small groups and therefore parents have worried that family won't have a relationship with the baby and it may be forgotten.

Professionally 
From a professional perspective, regardless of the circumstances, don’t say anything that you aren’t 100% aware of. Instead, say you will find out or confirm with another staff member. Also remember, professionals are still humans, so it is okay not to be okay and require additional support.

In regards to bringing up post-mortems, whilst it is often advised, parents need to be informed that results may be inconclusive and there may not be a reason. However, research is ongoing and additional information may clarify in the future.

Overall
The training session was incredible and this was only a short overview of what I learnt, for my own reflections. It is so important we have conversation and training on the topic so we know how we can best benefit the families that need the support.

If you want to engage in the Beyond Bea training, make sure to head to their website and book for an online session or a Study Day. They also have their annual conference in December this year and I can't wait!

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