This study has ended and the results have been submitted for publication.

BACKGROUND

What kind of care do bereaved parents want? And how can we improve both training and support for health professionals who deliver care?

Around 6,500 parents are bereaved every year when their baby dies either before or shortly after they are born. We at Sands know how devastating this experience is. We have written Guidelines for Professionals, now in their third edition, aimed at guiding health professionals in how to care for families when a pregnancy ends or when a baby is either stillborn or dies soon after birth.

While Sands has a wealth of anecdotal information about what bereaved parents found helpful and unhelpful in their bereavement care, there is very little evidence to guide and ensure more standardised practice. Surveys Sands have undertaken suggest that like many aspects of the NHS, bereavement care is a post-code lottery: some units are centres of good practice and others are not. We need evidence to understand the main issues in counselling and bereavement care experienced by women and their partners. What is already done well? How can current care be improved from the parents' perspective? And what are the main challenges in training for staff who care for bereaved parents. How might problems be addressed?

WHAT did THE PROJECT TRY TO ACHIEVE?

The project aimed to recruit recently bereaved parents for a study to understand how they felt about the kind of care they received. In-depth interviews with parents consenting to be involved focused on what was done well and not so well, from 'breaking bad news' to issues regarding discussions about delivering the baby, post mortem consent and follow-up consultations several weeks' after their baby's death with their consultants.

Researchers also asked for the opinions of maternity doctors and midwives, to find which bereavement care practices are helpful and associated with better experiences for parents, and which ones are not, and how to improve care with training.

WHO CONDUCTed THE RESEARCH?

The Principal Investigator on the project was Dr Dimitrios Siassakos University of Bristol NIHR Academic Clinical Lecturer in Obstetrics. His team comprised:

  • Professor Tim Draycott, Clinical Lecturer in Obstetrics, Bristol University
  • Dr Robert Fox, consultant obstetrician, Musgrove Park Hospital, Taunton
  • Dr Kathryn Gleeson, Senior Research Midwife, University of Surrey
  • Dr Alex Heazell, Clinical Lecturer in Obstetrics, Manchester University
  • Mrs Claire Storey, Bristol Sands
  • Dr Sue Jackson, Psychologist, University of the West of England
  • Mrs Catherine Winter, Psychologist, NIHR Western Comprehensive Local Research Network

The research took place in three different units (Southmead in Bristol, Gloucester and Taunton), and the evidence was analysed and interpreted by several researchers as well as bereaved parents.

TIMINGS

The project started in August 2012 and has now finished

Grant awarded

£92,000

References

1. Bristowe K, Siassakos D, Hambly H, Angouri J, Yelland A, Draycott T, Fox R. Teamwork for Clinical Emergencies: Interprofessional Focus Group Analysis and Triangulation with Simulation. Qualitative Health Research. 2012; In Press. Best overall obstetric presentation, RCOG International Conference 2011

2. Siassakos, D, Fox R, Draycott T, Winter C for the Royal College of Obstetricians and Gynaecologists. Late Intrauterine Fetal Death and Stillbirth. Green-Top Guideline No.55. 2010 London, RCOG Press.

3. Siassakos D et al. Retrospective cohort study of diagnosis-delivery interval with umbilical cord prolapse; the effect of team training. BJOG 2009; 116(8): 1089-96 Best Overall Research 2009, SSIH * Top 10 Cited 2009 BJOG Article

4. Siassakos D et al. The active ingredients of effective training in obstetric emergencies. BJOG 2009; 116(8): 1028-32 Best of 2009 BJOG Article * Top 10 Cit