Occupational health and safety legislation reinforces employers’ responsibility to provide a work environment that is free of risk to employees’ psychological health. In settings where traumatic stress is acknowledged as occupational stress, employers have a duty of care to develop strategies to reduce cumulative traumatic exposures that may affect the workforce. (Leinweber, Creedy, Rowe, & Gamble, 2017, p. 44)
In order to provide best practice bereavement care in Maternity and NICU settings, clear, evidence-based pathways of care need to be in place so that:
1. Families receive optimal support at this traumatic time.
2. Staff feel empowered and confident in caring for families at the time of fetal or neonatal death.
3. Staff feel supported in dealing with their own emotional responses.
4. For subsequent pregnancies, families consider returning to the hospital in which they experienced supportive bereavement care.
Bereavement midwife, Eliza Strauss provides consultation to maternity hospitals seeking to establish or improve their bereavement care processes.
From training midwives who are at the 'front line' of caring for bereaved parents, through to the development and implementation of policies and procedures, Eliza consults to maternity hospitals to ensure that clear practice guidelines inform staff to support bereaved parents in the best possible ways.
Eliza was awarded the national "Excellence in Bereavement Care Award" by the Australian College of Midwives for her work in the area of perinatal loss in a maternity hospital setting.
Eliza holds an additional postgraduate certification in Bereavement Counselling and Intervention, which has informed her work in establishing best practice bereavement care.
Strauss, E (2020) My journey to becoming a bereavement midwife, Australian Midwifery News, Vol 20 No 1 pp 34-35
Strauss, E (2019) Perinatal Loss and the Midwifery Student, Australian Midwifery News, Vol 19 No 2 pp 18-19
In my previous role as CEO of Bereavement Care at Sands Australia, I have spoken to hundreds of bereaved parents and to midwives who work with parents at the acute stages of their grief. Although midwives reported feeling clinically prepared for perinatal death, they commonly acknowledged their lack of confidence and training in supporting the emotional and mental health needs of bereaved parents.
We know that bereaved parents are at increased risk of poor mental health outcomes, and the care they receive at the time of their loss impacts their mental health trajectory.
Following training in perinatal loss, midwives reported feeling better equipped in both their practical and emotional capacities to support bereaved parents. When midwives are trained in perinatal loss, and maternity settings have clear, evidence-based guidelines, the more likely that good quality bereavement care will be offered, and both the bereaved family and staff caring for them, will feel supported.
In my work as a perinatal psychologist, I have heard many bereaved parents recount their experiences of loss. They remember the smallest of details about the ways in which they were told there was a fetal abnormality, the moment they found out their baby had died in utero, the agonising decision-making about ending a pregnancy, and the care they received in delivering their babies who died. These memories stay with them, and impact their experiences of subsequent pregnancies, and their decisions about where to deliver.
When bereavement care is done well, and parents feel respected and nurtured, they are more likely to choose to return to the hospital in which they experienced the loss, believing that the staff will understand their backgrounds and be compassionate to the additional anxiety and vulnerability they bring.
Dr Renée Miller