Max’s Legacy; Baby-Loss Awareness

and Bereavement Aftercare

Racheal Crane, Maternity Support Worker, JPUH Research and Evaluation Scholar 2022/2023 @RachealCrane8 racheal.crane@jpaget.nhs.uk
Claire Whitehouse, MSc RN, IACRN Senior Nurse for NMAHP Research, JPUH. Honorary Fellow UEA. Visiting Fellow Staffs Uni. @ClaireW_UK

Background
• 25% of pregnancies end in miscarriage, with more than 80% of miscarriages occurring within the first 12
weeks.
• Many miscarriages are unexplained and there is a major lack of research in this area.
• The impact on families can be devastating and the impact on health staff caring for this group can also be
difficult.
• Continuity of information and support services available to families at the point of baby-loss, or afterwards,
can be varied.
• There has been no previous evaluation of the support provision for families or staff at JPUH.

Aims
• To understand the experiences of everyone who is involved in miscarriages including pregnant people, their
families and staff, and to make recommendations for future care, services and research.

Method
• Collaboration and discussions with local baby-loss charities (TIME Norfolk, Angels and Rainbows) (July 2022).
• Surveys with multi-professional members of staff within maternity services (survey open August 2022 –
January 2023).
• Focus groups with families, relatives (December 2022).
• Observation of practice (between May 2022 – February 2023)

Results
Quantitative data
• Staff survey responses; Total = 54.
2 clerical, 34 maternity team (including but not
limited to ODPs, sonographers, midwives, support
workers), and 18 medical colleagues.
• Lived experience face to face interviews with
medical colleagues following survey responses:
Total = 8.
• 2 x pilot focus groups; attended by 16 parents and
relatives.
Staff surveys
• 73% off staff have been involved in
assessing/triaging/scanning a patient/woman Picture supplied by the team at Project Robby
who may be experiencing miscarriage.
• 100% of the 73% above felt they need more
support, with medics often feeling alone. Time
between breaking bad news and moving on to
next patients was cited as the biggest trauma for
staff and dealing with personal baby-loss trauma.
• 95% of staff felt it would be beneficial to debrief
either formally or informally within the team.
• 99% of respondents would like baby-loss
information and training at mandatory training
days.
• 100% of those interviewed considered a Rainbow
Clinic essential for family and staff support.

Qualitative feedback examples from staff, parents and relatives following implementation of
support and change of environment

Outcomes Recommendations / future research

1. Change of environment trialed from A&E side room to Central Delivery Suite for those experiencing loss 1. A resourced Rainbow clinic at JPUH
from 12-16 weeks pregnant. This has become standard practice since July 2022. 2.Continuation of the bereavement support worker post
2. Formal monthly support group formed for parents and families – hugely successful with 10-15 people with increased support for the staff.
attending each. 3.Continuation of the monthly support groups for
3. Formal trial of a bereavement support worker role at JPUH February-March 2023. families and relatives
4. Invited to speak at four external conferences (Norfolk and Waveney ICS Research Conference, Chief 4.Continued collaboration with local charities and Trusts
Midwifery Officer for England National Research Strategy launch event for East of England, TIME Norfolk in the region.
baby-loss study day and The Inaugural National Maternity Support Worker Conference
5. Awarded the National Chief Midwifery Officer for England Maternity Support Worker Excellence Award in Research and evaluation
November 2022. 1. Investigate the benefits of peer support compared
6. Awarded JPUH Reconditioning Games Gold award, December 2022 with traditional therapies for baby-loss support
7.Formal collaboration with local charities, bi-monthly contact and planning. 2. Use the creation of this service in conjunction with
8. Increased communication and open discussion about the impact of baby loss on women, their families and the recently launched the Chief Midwifery Officer for
the staff caring for them England strategic research plan.

Acknowledgements: JPUH Research Scholarship programme team, Kirsty Cater (Deputy Regional Chief Midwife for East of England), Katy Dogbey (Consultant Midwife), Laura Woods
(Peer support), Project Robby, Jacky Copping (Deputy Director of Nursing, JPUH) and everyone who has been involved so far.