We have noted with sadness recent reports regarding the storage of pregnancy remains for far longer than should be the case.
Even more disturbing is evidence that in some hospitals, parents have been told that remains will be cremated when in fact they are incinerated along with clinical waste. While incineration of pregnancy remains is perfectly legal (though now under review), it is clearly wrong to misinform parents in this way.
There are recognised guidelines on how hospitals should treat the remains of pregnancies that are miscarried or terminated. This must include providing clear information for parents about options for disposal, and how the remains will be disposed of if parents prefer not to make a decision.
We can only hope that the cases highlighted in recent enquiries will lead to a more general review of policy and practice across the NHS and a renewed drive to ensure that they always take account of the needs, feelings and wishes of the parents involved. We absolutely support the cremation or burial of ALL pregnancy remains rather than disposal as clinical waste and have offered our support to the Department of Health and the Human Tissue Authority in working to this end.
On Monday 24 March, the TV programme Dispatches (1) will look at care for women and couples who lose a baby in pregnancy or at or shortly after birth. Titled “Exposing hospital heartache”, the programme’s focus will be on cases where care falls far short of what patients expect and need.
It’s important to note that these cases are the exception rather than the rule and there is much excellent and sensitive care for patients with pregnancy loss. But there are gaps and it is important for poor care to be identified so that NHS Trusts are prompted to improve it.
Here’s how they can – and should – do it:
- Learn from patients and patient organisations as to what good care means: high clinical standards, good communication, sensitivity, compassion
- Follow existing guidance on the respectful disposal of pregnancy remains, including that published by the Human Tissue Authority (2), RCN, SANDS and the current Scottish government protocol (3)
- Follow the lead of other hospitals which practice excellent care
- Seek guidance and advice from organisations like the M.A. and SANDS (the stillbirth and neonatal death charity)
- Make use of the patient support and information we provide, as recommended in the recent NHS England report (4)
- Ensure good training and support for staff who care for patients who lose a baby in pregnancy or at birth
Let’s all combine our personal and professional knowledge, wisdom and experience to ensure excellent and sensitive care for all patients faced with the loss of their baby.
(1) Dispatches: Exposing hospital heartache will be shown on Channel 4 on Monday 24 March at 8 p.m.
(2) At www.hta.gov.uk/legislationpoliciesandcodesofpractice/codesofpractice/code5disposal.cfm
(3) At www.sehd.scot.nhs.uk/cmo/CMO%282012%2907.pdf
(4) A review of support available for loss in early and late pregnancy, NHS England Improving Quality, February 2014