Postnatal care after a stillbirth
Different areas and hospitals have slightly different ways of doing things after you give birth to your baby, so please use this as a basic guide.
Your postnatal care is likely to happen like this:
- The hospital will get in touch with your GP, community midwife and health visitor to let them know what has happened.
- They will be able to continue offering you care and support after you leave hospital. For example, you may have questions about what’s normal for recovery, or, if you had stitches, you might like a community midwife to check them if they are painful.
- You should have a six-week post-natal check-up with your family doctor (GP).
- You should have an appointment to talk to a doctor or consultant at the hospital about the birth and to discuss the post-mortem and test results (if you chose to have these done). You can also talk about any post-natal issues at this appointment. Some people would like to also talk about plans for a future pregnancy at that appointment.
If you don’t hear from your GP, a community midwife or bereavement midwife within a few days of arriving home, contact your local GP surgery to find out what has happened. Most GPs will see you at home if you feel you can’t go to the surgery. You can also contact the bereavement midwife and they should arrange a home visit for you.
Your six-week postnatal check-up is usually at your GP surgery.
This routine appointment is mainly focused on physical recovery after giving birth. However, if you’re in a couple you may want to go together, if possible, so you can both talk about how you’re coping.
You might want to ask questions about trying for another baby, the care you might get in future pregnancies, or discuss contraception options to give yourself some more time.
Consultant hospital appointment
You should have an appointment with a consultant at your hospital to discuss your stillbirth and your baby.
Here are some tips which may help you prepare for this appointment:
- When you make the appointment, you might want to explain before you go in that you’d prefer not to wait with other parents and newborn babies.
- Write down your questions in advance. You might feel emotional in this appointment, so it helps to take some notes with you.
- You might want to take someone with you who can take notes. It can sometimes be difficult to absorb and remember information in these circumstances.
- As follow-up appointments happen differently across the UK, you might want to speak to your GP or hospital beforehand to find out more about what your appointment involves.
- Ask for a letter from this visit detailing the conversation that you had.
In some hospitals, the bereavement midwife will also attend this appointment to give you support. You will probably have already met them around the time of your baby’s birth.
Investigations after a stillbirth
NHS Review Process
When a baby dies before, during or after birth, the hospital (or hospitals) should review what happened and the care that the birth mother and baby received. This is known as a ‘perinatal review. Since 2018, this should be undertaken using the National Perinatal Mortality Review Tool.
As part of the review process, a clinical team meets and looks over the hospital notes to understand what happened. This means you should get as much information as possible from all the people involved in your care.
The hospital should tell you that a review is taking place and give you the chance to ask questions, raise any concerns or provide information about your care for the review panel to think about during the review. You will not be invited to attend this meeting. But you can write your questions down for the review process.
After the review, you will be offered an appointment to discuss the review with your consultant. This can take time, as it can take several weeks to gather the information and complete the review. It may be part of the same appointment where you discuss the post-mortem results in more detail, or it may be separate.
Find out more about the review process and the National Perinatal Mortality Review Tool.
NHS Serious Incident Investigation
An urgent investigation called an NHS Serious Incident Investigation (SII in England) or a Significant Adverse Event Review (SAER in Scotland) takes place if there is a major concern that a problem with NHS care contributed to your baby’s death.
In England, an independent investigation by the Healthcare Safety Investigation Branch (HSIB) will replace some SIIs, usually for stillbirths occurring during labour when your baby was born full-term.
You should be told about an HSIB investigation before you leave hospital, or within 5 days of going home, and it won’t take place without your agreement. The HSIB investigation is independent and not run by staff from the NHS Trust where the baby was stillborn. Find out more about HSIB and how it works.
The NHS Review will still take place regardless of other investigations. But bear in mind that this may not be completed until the HSIB investigation has been carried out.
- NHS. Stillbirth – What happens if your unborn baby dies. Available at: www.nhs.uk/conditions/stillbirth/what-happens/ (Page last reviewed: 16 March 2021, Next review due: 16 March 2024)
- Perinatal Mortality Review Tool. Available at: www.npeu.ox.ac.uk/pmrt
- RCOG. Late Intrauterine Fetal Death and Stillbirth. Green-top Guideline No. 55. Last updated February 2017.