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What are your next steps?
Postnatal check-up
Consultant hospital appointment
Investigations after a stillbirth
Support after stillbirth
Many parents describe the walk out of hospital without their baby, after having a stillbirth, as one of the most difficult and devastating moments of their lives. Some people find that knowing what to expect once you get home can make things a little smoother.
You should be offered appointments for postnatal care and to discuss the results of any tests. Local areas and hospitals have slightly different ways of doing things, so please use this as a basic guide. The team looking after you will explain what happens in your area.
What are your next steps?
With your consent, the hospital will get in touch with your GP, community midwife and health visitor to let them know what has happened. They will offer you care and support after you leave hospital.
Sometimes a midwife might visit you at home; other people prefer a phone call. If you have a strong preference, it is important to let your maternity team know so they can try to best meet your needs. You may have questions about recovery or have stitches checked, for example.
The timing of these visits or calls are usually decided with you and based on your needs. They may continue for a few days to a few weeks.
Postnatal visits and appointments are usually arranged by the hospital before you go home. If you don’t hear from a community midwife or bereavement midwife within a few days of arriving home, let your bereavement midwife or hospital know so they can ensure you get the care you need.
The team caring for you should also let you know about local support groups and other organisations which may be able to support you.
You should be offered an appointment to talk to a doctor about the birth and to discuss the post-mortem and test results (if you chose to have these done). You can also talk about how you are recovering physically. Some people also want talk about plans for a future pregnancy .
Following a stillbirth, many people find they feel overwhelmed by all the new information and difficult decisions they need to make. Lots of people find it helpful to attend appointments with a support person, for example a partner, a relative and/or a friend. They can be there to support you, and to write down or remember any information that you might not have taken in. They may also think of questions to ask that you hadn’t thought of yourself.
Postnatal check up
Your six-week postnatal check-up is usually at your GP surgery.
This routine appointment is mainly focused on physical recovery after giving birth. If you have a partner, you might want them to be there so you can both talk about how you are coping.
You might want to ask questions about trying for another baby 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. This usually takes place around 6 – 12 weeks after the birth of your baby. It can take longer if detailed tests (for example a post- mortem examination) have been done.
Here are some tips which may help you prepare:
- When you make the appointment, say if you do not want to wait with other parents and newborn babies before you go in.
- Write down your questions before the appointment. You might feel emotional, so it helps to take some notes with you.
- You might want to take someone with you who can take notes. It can be difficult to take in and remember information in these circumstances.
- You might want to speak to your GP or hospital beforehand to find out more about what your appointment involves.
- Ask for a letter summarising the appointment.
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 part of standard NHS care. This should be done using the National Perinatal Mortality Review Tool.
This review helps parents understand as much as possible about what happened and why their baby died. It also helps the hospital learn from what has happened, to improve care and help prevent stillbirths in the future.
As part of the review process, a clinical team meets and looks over the hospital notes to understand what happened. You should get as much information as possible from all the people involved in your care. Often a healthcare professional who works at a different hospital is there, to give an unbiased opinion on the care that you had.
The hospital should tell you a review is taking place and give you the chance to ask questions, raise any concerns or give information about your care for the review panel. You will not be invited to attend this meeting but you can share your comments in writing.
After the review, you will be offered an appointment to discuss it with your consultant. This can take time, as it can take weeks to 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 Maternity and Newborn Safety Investigations (MNSI) programme (formerly known as the Healthcare Safety Investigation Branch, or (HSIB) will replace some SIIs. This is usually for the cases of babies who were full-term and died during labour.
You should be told about an MNSI investigation before you leave hospital, or within 5 days of going home, and it won’t take place without your agreement. The MNSI investigation is independent and not run by staff from the NHS Trust where the baby was stillborn.
Find out more about MNSI and how it works.
The NHS Review will still take place regardless of other investigations. It may not be completed until the MNSI investigation has been carried out.
Support after stillbirth
Many people find it helpful to talk with other parents who have had a stillborn baby. Your bereavement midwife or maternity team should be able to tell you about local and/or national baby loss support groups and counselling services. We also have a closed Facebook group where you can connect with other people whose babies have died.
You can talk to a Tommy’s midwife free of charge from 9am-5pm, Monday to Friday on 0800 0147 800, or you can email them at [email protected]. Tommy’s midwives also run a specialist Black and Black-Mixed Heritage Helpline through which you can book a call if this feel more appropriate to you.
Although they are not trained counsellors, our specialist midwives can offer a safe supportive space for you to chat through your experiences. It’s a chance to gently process all you have been through with someone who cares and understands.
If you’re worried that you or your partner are struggling to cope after losing a baby, it may help to talk to your GP. They should be able to help you get further support.
Read more about coping with grief after stillbirth.
Some other organisations that can support you after stillbirth:
Sands
Teddy's Wish
The Lily Mae Foundation
Stillbirth stories
