These ten principles detail what Sands consider to be the key elements of high quality bereavement care.

Parents’ perspectives and collaborative working with healthcare professionals have informed these principles.

  1. Care should be individualised so that it is parent led and caters for their personal, cultural or religious needs. Parents should always be treated with respect and dignity. Sensitive, empathetic care is crucial and may involve spending time with parents. This should be recognised by managers and staff.
  2. Clear communication with parents is key and it should be sensitive, honest and tailored to meet the individual needs of parents. Childbearing losses can involve periods of uncertainty and staff should avoid giving assurances that may turn out to be false. Trained interpreters and signers should be available for parents who need them.
  3. In any situation where there is a choice to be made, parents should be listened to and given the information and support they need to make their own decisions about what happens to them and their baby.
  4. No assumptions should be made about the intensity and duration of grief that a parent will experience. It is important that staff accept and acknowledge the feelings that individual parents may experience.
  5. Women and their partners should always be looked after by staff who are specifically trained in bereavement care and in an environment that the parent feels is appropriate to their circumstances. In addition to good emotional support, women should receive excellent physical care during and after a loss.
  6. A partner’s grief can be as profound as that of the mother; their need for support should be recognised and met.
  7. All staff who care for bereaved parents before, during or after the death of a baby should have opportunities to develop and update their knowledge and skills. In addition, they should have access to good support for themselves.
  8. All parents whose babies die should be offered opportunities to create memories. Their individual wishes and needs should be respected.
  9. The bodies of babies and fetal remains should be treated with respect at all times. Options around sensitive disposal should be discussed and respectful funerals should be offered.
  10. Good communication between staff and healthcare teams is crucial in ensuring that staff are aware of parents’ preferences and decisions; therefore, parents do not need to repeatedly explain their situation. This includes the handover of care from hospital to primary care staff, which should ensure that support and care for parents is seamless. Ongoing support is an essential part of care and should be available to all those who want it and should continue to be made available to all women and their partners during a subsequent pregnancy and after the birth of another baby.