Planning the next pregnancy
Sheila Broderick (1), Ruth Cochrane (2)
(1) Retired Women’s Health Counsellor, (2) Consultant Obstetrician, University Hospital Lewisham, London, UK
Care in a future pregnancy after the death of a baby needs to be sensitively planned.
Some bereaved parents cannot contemplate another pregnancy, or another at the same hospital. A letter from a consultant obstetrician is required with details of her loss and a plan for future care, wherever that is. A small team of an obstetrician, a senior midwife and an experienced counsellor creates a sense of trust and a degree of safety. Parents are not confronted with staff who may not know their ‘story’. Women, their partners and their wider families will all be anxious: caring for them can be challenging but hugely worthwhile. Some women want to be seen weekly, some less often. It may take them time to trust that the plan will work, particularly if their previous experience of care was not good. Once a baby has died no parent can assume that they will have a live baby. Repeated pregnancies with a ‘good’ outcome do not equal confidence. A woman who had a term stillbirth in her first pregnancy because of a true knot in the cord was just as anxious in her third pregnancy, even though the second baby was fine. Parents may want to revisit the place where they gave birth. The last time they were there was when they were bereaved. Parents then have the opportunity to deal with feelings that might overwhelm them before the next birth. If the mode of delivery is different from the last, it is valuable to take parents through the process, including e.g. visiting the anaesthetic room and the theatre. Understanding what will happen will lessen their anxiety. Knowing in advance what to expect can be very helpful.
Giving parents as much control as possible in an area where they have experienced having no control is vital in a future pregnancy. Having supportive advocates, knowing what to expect and believing that their feelings and concerns will be at the forefront of their experience will be empowering for them.
Ethics approval not sought, as this content describes our professional experience.