Name:

Organisation: Queens Hospital

Award Category: Outstanding Team Care

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My Plea:

We are very thankful to have been nominated for this award and feel very honoured. This was the nomination received by The Butterfly Awards:
“Claire Waters, Celia Burrell and Louise Brodrick were our guiding light throughout the loss of our daughter, Little V, and subsequent rainbow pregnancy, Maddie in 2017 and 2018.
We lost our daughter Vera ‘Little V’ Marston on 20.08.17 at 22+5, we found out due to reduced movements and delivered our baby girl in the Snowdrop Suite – after bringing V into the world we were introduced to Claire, Louise and Celia who helped us with key choices for our daughter. They were compassionate and thorough and so professional, Claire then visited us numerous times at home to make sure we were OK and offered support and guidance.
Queens have a Rainbow clinic and, when we were ready, they were there for us to carry us through our rainbow pregnancy. Of course our pregnancy was an anxious time but Claire was incredible, we were able to go to her day & night, and pop in for a listen in to the heartbeat. Celia as our consultant was amazing, referring us for every scan possible, escalating further when she felt we needed it and ensured we were so well looked after.
Our pregnancy was managed right until the end, when our baby girl Maddie entered the world on 29.07.18. We honestly wouldn’t have gotten through it without them.
Their work is invaluable to people like us, and they are a credit to the bereavement community in their professionalism, dignity and kindness in our darkest hours, it was an honour to share our lightest and happiest times welcoming our rainbow baby girl. We owe them so much.”

We would like to thank Lauren for nominating us and would also like to thank the women and their families and the midwives and student midwives who agreed to us using their stories in our plea and the BHRUT staff members who make our job possible.
The Bereavement Team has gone through some changes this year and now consists of full-timer Louise Brodrick, and part-timers Claire Waters and Donna Archer, supported by Consultant Obstetrician Ms Celia Burrell who runs the Postnatal Bereavement Clinic and is the Consultant for many of our women in subsequent pregnancies.
We support all women and their families who are experiencing a loss after 20 weeks of pregnancy. We are a busy London Trust with an average of 8,300 births a year. Last year (April 2018-March 2019) we supported 82 women and their families through their losses and booked 96 women for our Rainbow Clinics. We provide education and training for Student Midwives, Maternity and Gynaecology staff and run regular study days with SANDS and Child Bereavement UK. We also run an annual Baby Loss Study Day, which is open to anyone wishing to attend, in or outside of the Trust.

What We Do:
At BHRUT, our philosophy is this: We believe that it is a privilege to look after our women and their families, giving them a good experience as they go through what may be the saddest time of their lives. We believe in reaching out and being there at this overwhelming time of sadness and confusion; at a time of loss of a desired child.

All of our women are treated as individuals and we always endeavour to fulfil their needs. We have a bereavement suite on the Labour Ward: The Snowdrop Suite, which has a super-king bed and comfy cushions and throws. It is a home from home area, away from the medicalisation of the ward. All women and their families can spend as long as they like there and this gives them the opportunity to spend time with their babies using cold cots and cuddle cots, all of which have been bought using funds raised by our women, their family and friends. There is a fridge and an area for making tea and coffee in proper mugs. They have a television and a telephone, a freestanding radiator that they can move around the room and comfy chairs for the family to use. There is a memory book that they can read and write in. Many women have commented on the book saying that it helped them to feel less alone after reading what others had written. Lauren (who nominated us) states “…it comforted us reading others experiences, sad as it was; we felt we were lucky almost, as some people who wrote in there had their baby’s alive, but they died after birth and ended up in there; I couldn’t imagine that”.

We feel that memory making is very important and ensure that all midwives and Maternity Care Assistants (MCA’S) are trained to be able to take baby hand and footprints using the inkless printing and the clay kit. Recently we have begun to offer Forever Finley, who are able to create castings of the baby’s hands and feet. Our memory boxes are supplied by 4Louis, and all clients are offered the chance to have photographs taken, which is done by our Medical Photography Department during the week and by Remember My Baby at the weekends. We supply a completed cot card, extra baby labels, a lock of hair; anything we can do to ensure that this baby is not forgotten. Our Trust has a very ethnically diverse population and we are always sensitive to our families’ individual needs. We are aware that not everyone wants to make memories and we respect their wishes, but we do ensure that they are aware that they can change their mind at any time and many have.

We have Aching Arms bears available for all women experiencing loss. We are very aware that not all women want or need a bear but it is nice to be able to offer them. We give them the offer to take or leave the bear when they go home.

We have a good relationship with our Trust Bereavement Office and are able to arrange for women and their families to have their baby’s stillbirth registered at the hospital instead of attending the local registry office. We attend with them to provide support. For those baby’s that are under 24 weeks, and cannot be registered, we can provide a Certificate of Birth Before the 24th Week of Pregnancy, as we are aware that some of our women and their families feel that there is no proof that their baby ever existed. The certificate is in colour and printed on card.

We have our own Postnatal Casenotes, designed by us, which have the Snowdrop emblem on them and are a different colour so that our women can be identified easily. When pregnant again, a Snowdrop sticker is applied to the Antenatal Casenotes so that everyone is aware that the woman has been through a loss previously.

Babies are only transferred to the Mortuary once the woman is ready for us to do so. If she wishes to accompany the baby down to the Mortuary this can be arranged and if requested we will also accompany her when she leaves the building to go home as we know that the hardest thing to do is to leave the baby behind. We have fantastic Mortuary staff who take great care of our babies and we go down and check on the babies in the Mortuary, as we are aware that our women want to know where their babies are and have reassurance that they are being looked after until they go for post mortem or are taken by the undertakers.

We believe that it is important for the women to continue to feel supported, so we offer home visits following their discharge from the hospital. This gives us the opportunity to ensure that they know what will happen next, as we understand that things told to them at the hospital will be forgotten. It also means that we are providing continuity of care at a time when it is most important. We often will not discharge our families until the funeral has taken place, as we know that the impact of the funeral can be positive or negative and that they may need our support afterwards. We only discharge our women when they are ready for us to do so.

Three months after the loss, all our women and their families are offered a debriefing appointment with a Consultant Obstetrician and we attend that with them to provide support and advocacy. Any results received are discussed and plans are made for the next pregnancy.

If and when they are pregnant again they can contact us direct and we book all their appointments for them. We provide their antenatal care, along with a consultant, during their rainbow pregnancy as we know how anxious they are going to be and can provide extra support. The Bereavement Team have been running Rainbow Clinics for over 10 years. We ensure that they are seen every 2-3 weeks throughout, be that by us, having a scan or a consultant appointment, or any other necessary appointments required. Claire provides relaxation sessions and specialist tailor-made group or one-to-one Antenatal Education Classes. In the past, women who had had losses did not feel comfortable attending the Trust classes as they felt that they were designed only for first time mums and felt out of place. It also caused issues with other class members when they asked questions that were out of the ordinary or if they got upset. The classes are well received:

Comments from our couples:
“This class is very helpful for people in our situation. We personally wouldn’t have gone to an antenatal class for first time couples who haven’t experienced a loss. It’s good to see that it is being catered for and not overlooked. Thanks Claire for your help!”

“Claire is a really great midwife and answered every question thrown at her. At no point did I feel we had wasted our time coming. We now feel a lot more ready to have our baby and a lot of the worry is gone”

When the time comes, we endeavour to see our women on Labour Ward whilst in labour or on the postnatal wards afterwards to continue the support and then we often do a courtesy visit at home. Sometimes that is the end of our relationship with them. One woman apologised to us after her second rainbow baby was born. She told us she had not felt the need to be under the care of the Bereavement Team that time; she had felt confident that she could do it without us. That is when we know that we have done our job well! We are also happy to take our women back in subsequent pregnancies if they feel that they need the extra support and we have just seen one of our women through her third pregnancy following her loss!

We use a Rainbow sticker for the Postnatal Casenotes of women who have had a live baby following a loss and we add a page to the notes detailing what they have been through in the past and in the current pregnancy. This prevents too much questioning about the past once the client has been discharged into the community with her baby.

We encourage Student Midwives to spend time with us. Some of the students have chosen to spend some of their elective placement with us, which they have found very beneficial and we have enjoyed having them. As most of our students go on to get jobs at the Trust it is nice to be able to give them an insight into what we do, and what they will have to do in the future in a protected environment before they qualify.

“They knew the ladies that we were seeing in the rainbow clinic from when they had had their losses. They remembered them and their partners and children’s names and their history. The women appeared very relaxed as they did not need to go over their history again. It made a difficult subsequent pregnancy easier for them.” Student Midwife NP, reproduced with permission.

Four years ago we set up Snowdrop Companions. Members of staff are trained to become experts in bereavement. The trainees have a study day with either Child Bereavement UK or SANDS and then attend a follow up half day with us on the legal and Trust paperwork. Our current Snowdrop Companions include Midwives, Community Midwives, Maternity Care Assistants, Gynaecological Nurses and even our porter. They are now able to provide peer support for staff looking after women and their families who are experiencing loss. Our intention is to continue to run regular training so that we can provide more experts for the Labour Ward and beyond.

“As a student I was fortunate to spend some of my elective placement with the Bereavement Team. During this period I experienced just how much support this team provides for women and their families who have suffered baby loss. Since qualifying as a midwife I have participated in their study days and have become a Snowdrop Companion, an expert in supporting women and their families at their time of loss on Labour Ward. The Bereavement Team work tirelessly to maintain strong links with the midwives and the families that they care for and I am grateful for the support they have shown me throughout my journey. They are an incredible asset to BHRUT.” Midwife KG, reproduced with permission

For the past 6 years, the Bereavement Team have organised an annual Baby Loss Study Day and each year invite speakers from outside the Trust. The study day is paid for using charitable funds raised by our former clients. It has been hosted by SANDS, ARC and Child Bereavement UK. This year it will be hosted by SANDS. This is a multidisciplinary teaching for all healthcare staff as pregnancy loss can affect anyone. We advertise locally and through social media and have many student midwives and midwives attending from all over the country. We always have at least one parent speaker on the programme and last year it was Lauren and her husband. This year our Baby Loss Study Day is on 1st October.

Last year for the first time we had a stall in the atrium of the hospital for Baby Loss Awareness Week. As well as remembering lost babies and raising awareness, we used it as a charity fundraising event and had some charity buckets. One of our midwives made delicious cupcakes for us and people gave us donations for them. We had examples of memory boxes on display and had two light up trees. People were invited to write messages on heart shaped tags in memory of lost babies and hung them on the trees. Some of the tags written were for baby’s lost decades ago. People came and told us their stories, saying that they wished that our service had been around when they had been through their losses and we were able to offer support even though the loss was a very long time ago. We sold battery operated candles and at 7pm we joined in with the Wave of Light. We had invited clients and their families, past and present, to come and join us. Some of them came during the day and others came for the Wave of Light. It was lovely to see them and in a lot of cases they bought their rainbow babies with them. It was an emotional day for staff and visitors alike. We will be doing it again this year.

We sit on the Bereavement Midwives Forum, which is a national forum that is committed to making bereavement services available to all Trusts across the country. The forum liaises with SANDS, the Department of Health and the All Party Parliamentary Group on Stillbirth. We were invited to become Stakeholders for the SANDS National Bereavement Care Pathway and were involved with helping to decide what should be in the pathway. With the championing of Miss Burrell, we were selected as a pilot site which commenced in October 2017. 11 sites were initially selected and we were 1 of 2 in London. The pathway has now gone live. We are proud to have been involved in what will hopefully mean that all women suffering loss will receive the same level of care, no matter where they are in the country.

Back in 2013 we were shortlisted for a Royal College of Midwives (RCM) award. Although we did not win it was an honour to be shortlisted and our work recognised. Then in 2016, we were recognised for our achievements by being to chosen to represent BHRUT by doing poster presentations at both the MBRRACE-UK Launch and the RCOG Each Baby Counts Forum. For the last 3 years we have been nominated and shortlisted for a Butterfly Ward but unfortunately did not win. This year we are hoping to take home the award!!!!!
Thank you.

What Others Have Said

We lost our daughter Vera ‘Little V’ Marston on 20.08.17 at 22+5, we found out due to reduced movements and delivered our baby girl in the snowdrop suite – after bringing V into the world we were introduced to Claire, Louise and Celia who helped us with key choices of our daughter. Their work is invaluable to people like us, and they are a credit to the bereavement community in their professionalism, dignity and kindness in our darkest hours, it was an honour to share our lightest and happiest times welcoming our rainbow baby girl. We owe them so much.