The Weekly Advertiser Horsham

Education is key...

- BY SARAH MATTHEWS

“When a baby dies, midwives now offer to help create ‘memories’ and mementoes for the family, and doing this is a skill in itself” – Michelle Coutts

eaders investigat­ing a new model of maternity care for the Wimmera-southern Mallee have highlighte­d a need for bereavemen­t training along with enhanced education to prevent pregnancy loss and stillbirth.

Wimmera Health Care Group nurse-midwife unit manager Michelle Coutts – who is heading up a project to design and implement the new model as part of a complete overhaul of maternity services in Horsham – said midwives provided support, care, advice and education to pregnant women across the continuum of pregnancy, labour, birth and the postnatal period.

She said while loss and death were not usually associated with midwifery, throughout their careers many midwives would care for women and their families who experience­d a miscarriag­e or gave birth to a baby who died, or was not expected to survive once born.

Mrs Coutts made the comments in light of October being Internatio­nal Pregnancy and Infant Loss Awareness Month.

Each year, about 110,000 Australian­s experience a miscarriag­e, 2200 endure stillbirth, 600 lose their baby in the first 28 days after birth and many more face the grief of terminatio­n for medical reasons.

Mrs Coutts said historical­ly, midwives were not trained to provide bereavemen­t care.

“It’s often something that some of us learn from experience within the area and from mentors,” she said.

“It’s really important that we change that because the ramificati­ons of providing inadequate care and support at this heartbreak­ing time can contribute to mental-health problems for the parents, and also for other family and friends involved.”

Mrs Coutts said project leaders were already discussing revised education and training for midwives as part of a redevelope­d model of maternity care at Wimmera Base Hospital.

She said she considered having an ‘excellent understand­ing of the grieving process’ a vital component of midwifery.

“It acknowledg­es that people experience and display grief in different ways and helps tailor care that meets individual needs,” she said.

“Grief and loss can happen at any time during pregnancy or at the time of birth.

“It’s really important that the parents feel they are supported to make decisions that reflect their own wishes, morals and beliefs and be fully informed about them.

“Parental grief is something that can only be fully understood by the parents experienci­ng it.”

Mrs Coutts said through bereavemen­t care, midwives had an opportunit­y to help parents find meaning in their loss.

“When a baby dies, midwives now offer to help create ‘memories’ and mementoes for the family, and doing this is a skill in itself,” she said.

“This might involve taking photos, hand and foot prints, taking a lock of hair and helping the parents dress or bath their baby.

“It can also involve offering them clothes and blankets that they would like to keep or use for if and when their baby is buried.”

Mrs Coutts said providing parents with bereavemen­t care required a collaborat­ive approach, with obstetrici­ans, gynaecolog­ists and other profession­als such as social workers working closely with midwives to provide the best possible care.

She said along with bereavemen­t training, the health-care group’s midwives would also benefit from advanced education projects such as the ‘Safer Baby Collaborat­ive’, designed to pinpoint the best ways to help prevent pregnancy loss and stillbirth.

Reducing stillbirth

Safer Care Victoria and Victorian Agency for Health Informatio­n worked on the project with participat­ing Victorian health services – including East Grampians Health Service in Ararat – to reduce stillbirth rates during the third trimester.

The project focused on five areas of practice: Improving rates of smoking cessation in pregnancy; diagnosis and management of fetal growth restrictio­n; increasing public awareness of the importance of fetal movements; raising awareness of safe maternal sleep positions; and promoting appropriat­e timing of birth and mitigating unintended consequenc­es or harm.

Mrs Coutts said the project summary showed many stillbirth­s might be avoidable, and as a result many new resources and training programs would be developed for doctors and midwives.

She said the project, which concluded in May this year, would also form the backbone of any new education around loss and stillbirth at Wimmera Health Care Group.

“It is also important to keep in mind that while we know so much and there have been so many advances in research and technology and improvemen­ts in clinical care over the past few decades related to perinatal loss and stillbirth, there will always be deaths where we will never know the reason as to why a baby died,” she said.

“I think we are getting better as individual­s and a society in recognisin­g that a parent is still a parent regardless of whether their baby has lived or died.

“It’s important we continue to talk about pregnancy and infant loss to ensure parents are not suffering in silence.”

People can visit www.bettersafe­r care.vic.gov.au/improvemen­t/projects /mbc/safer-baby for more informatio­n about the Safer Baby Collaborat­ive. L

 ?? Picture: SANDS AUSTRALIA ?? POIGNANT TRIBUTE: On Friday at 7pm throughout the world, people will light candles to form a ‘wave of light’ for Internatio­nal Pregnancy and Infant Loss Remembranc­e Day.
Picture: SANDS AUSTRALIA POIGNANT TRIBUTE: On Friday at 7pm throughout the world, people will light candles to form a ‘wave of light’ for Internatio­nal Pregnancy and Infant Loss Remembranc­e Day.

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