Pregnancy loss

The information on this page will be most helpful to you if your pregnancy loss has happened after 14 weeks of pregnancy. However there may still be some useful information if you are experiencing an early pregnancy loss.

The pregnancy loss midwives are still available to anyone who has lost a baby at any gestation, so please feel welcome to get in touch with us if you would like our support.

Please be aware though, that your care will be provided by the Early Pregnancy Unit.

Finding out that your baby has died or is dying is a devastating shock. We are so sorry that you are going through this. Usually, but not always, you will be well yourself, and therefore there is time for you to discuss what happens next with your midwife and doctor.

If you are alone when you hear the news, your midwife or doctor will help you to contact your partner or a relative/friend to come and support you.

Your midwife will ask for your permission to take a blood and urine sample from you. She may also ask to take a swab from your vagina. These test are needed to give us important information, however, at this point it may not be possible to know the reason your baby has died.

We have special bereavement rooms at both sites, and we will encourage you to make yourselves at home here before and after the birth of your baby, and for as long as you need to be in hospital. During your labour however, you will be cared for on the labour ward.

The way that you give birth to your baby will depend on your individual circumstances. You will be able to talk about your options with your midwife and a senior doctor.

It is usually recommended that your labour is induced, and that you aim to have a vaginal birth. This may come as a shock for you. A normal birth is usually safer for you, allows you to have a faster recovery and avoids added risks in future pregnancies if you were to have a caesarean section.

We assure you that you will have dedicated one to one care from a midwife throughout, and you will have access to effective pain relief of your choice. Your midwife and doctor will talk you through this at every stage.

Induction of labour

If you agree to have your labour induced, you will usually be offered a tablet to take by mouth in the first instance. This prepares your body to go into labour and takes some time to work. We will usually suggest that you go home after taking this, and return to hospital the next day or the day after. It is important that you call the labour ward if:

• You feel unwell or worried
• You think your waters may have broken, if they haven’t already
• You think that your labour has begun

During this time at home, many women feel very frightened about what is to come. Please don’t hesitate to call the labour ward at any time, for any reason.   If you feel that you would prefer to stay as an in-patient, and that going home is too distressing, please speak to your midwife as we can usually help you.

When you return to the hospital, we will usually use a vaginal pessary to continue your induction. After this you will be given a tablet form of the same drug at regular intervals until your labour is established.

Your midwife will available to support you and your partner or birth companion at all times. You are not alone.

If you choose not to be induced

If you are healthy, and would prefer to wait for labour to begin naturally, we will support you with this. Due to the increased risk of you becoming unwell, we recommend that you have regular blood tests and a check-up at the hospital (usually twice a week). If there is a long wait before labour commences, your baby’s condition may deteriorate in your womb. This may make it more difficult for a post-mortem to provide useful information, if you would like to have one.

Remember, your midwife, doctor, or a member of the pregnancy loss team will be able to help you make these important decisions.

Pain relief

All women experience labour and birth differently, and there is no right or wrong way to cope. Your midwife will advise you of your options and will support you in your choices.

You may wish to try gentle methods of self-help during the early stages of labour, such as massage, breathing techniques and relaxation.

We can offer a stronger pain relief in the form of an injection or via a drip. This will not take away pain completely, but may help you to rest and relax. Your midwife can discuss the benefits and side effects of these with you.

When your labour is established, it is usually possible for you to have an epidural, if you wish. Your midwife will help you decide, and we will have an anaesthetist available to talk to you about this in more detail.

Your midwife will suggest ways for you to make memories with your baby, and you may choose which, if any, are best for you.

You may be unsure about whether you want to see and/or hold your baby when he or she is born. This will be different for all parents, and again, there is no right or wrong. Your midwife will offer for you to see and hold your baby, but if you prefer not to, she will make sure your baby is cared for sensitively and respectfully in a dedicated room. If you choose to spend time with your baby, we will help you with this and we will not rush you.

You may wish to see a photograph of your baby before you decide, or you could ask your midwife to describe your baby to you, so that you know what to expect.

You or your midwife may bathe and dress your baby, and we will take photographs for you to take home. If you would prefer not to have these straight away, we will keep them in your notes in case you change your mind in the future.

Some parents choose to take their baby home with them for a short time, prior to having a funeral (and prior to a post-mortem if this is requested). If this is something you would like to consider, please let your midwife know.

In most cases, the decision whether to have a post-mortem for your baby is entirely up to you. Rarely, a coroner may request that one is performed, but this is very unusual.

Your midwife and doctor will talk to you in more detail about why you may wish to have a post-mortem, and they will help you to decide.

If you do have a post-mortem, your baby will be transported to Guys and St Thomas’ Hospital in London, where the examination will be undertaken by specialist pathologists. Your baby will be returned to us in approximately a week to 10 days, allowing you to have a funeral for your baby if this is your wish.

The results of the post mortem will take approximately 10-12 weeks. These will be discussed with you at your follow up appointment.

Babies born after 24 weeks of pregnancy, and babies born alive at any gestation, must be registered with the local registry office. Your midwife will be able to help you understand what is required of you, and will give you the appropriate contact details.

Babies who have died before birth, before 24 weeks of pregnancy, do not need to be registered by law. Your midwife will be able to give you a certificate of birth as a keepsake if you would like.

The hospital is able to arrange a funeral for your baby if you wish. Sadly, we are not able to offer a service. For this reason, many parents choose to arrange their own private funeral.

Babies born under 24 weeks of pregnancy without signs of life can have a private funeral or a hospital funeral; a hospital funeral will include group cremation with other babies under 24 weeks, including very little babies. Sadly we are not able to offer a service, or any ashes for you to take home. These babies’ ashes would be scattered at the Woodvale Garden of Remembrance.

Babies born over 24 weeks of pregnancy, or born with signs of life at any stage of pregnancy, can have a private funeral or a hospital funeral. In these cases solo cremation is possible, and you will be able to take your baby’s ashes home.

Your midwife can give you information about local funeral directors who will be able to help you. A funeral director will be experienced in organising this, and will guide you each step of the way. Although most of these will not charge you to arrange your baby’s funeral, there may be some additional costs if you choose to have certain extra services.

When you are well enough to be discharged from hospital, you will be offered a range of services tailored to your needs. A community midwife will offer to visit you at home, but if you would prefer not to have this, please let your hospital midwife know.

After you go home, it is important to contact us on labour ward if you are worried about any of the following:

• Feeling unwell
• Heavy bleeding
• Vaginal discharge that doesn’t seem normal
• Excessive pain, that is not helped by taking mild analgesia such as paracetamol
• Anything else that you feel you need urgent advice about

A member of the pregnancy loss team will get in touch with you, either by phone, email or letter. We will be available to you in whatever way you need.

We will make a follow up appointment for you with your obstetric consultant, for around 10-12 weeks after your baby was born. This appointment will be to discuss any test results, including post-mortem if you had one. You may also want to discuss the possibility of a future pregnancy, and what extra care you may need.

If you would like one of the pregnancy loss midwives to accompany you to this appointment, please let us know. It can be helpful to write a list of questions in preparation for this appointment, as many parents find they forget to ask some of the things they had planned to. Don’t worry if you do, you are welcome to get in touch with one of us afterwards and we can help you.

Pregnancy after a loss can be a joyful but sometimes very difficult journey. We are available to support you through this time and are happy to meet with you to discuss your birth plan and any worries you may have. We will do all that we can to make this time easier for you and your partner.

SANDS (Stillbirth and Neonatal Death Society)
Support for parents and families whose baby is stillborn or dies soon after birth. SANDS offers a helpline, local groups run by and for bereaved parents and a range of information resources including publications and leaflets.
Website: www.sands.org.uk
Phone: 020 7436 5881

Tommy’s
Provide support, advice and information about infant loss. Tommy’s is the leading charity on research in to pregnancy problems and loss.
Website: www.tommys.org
Email: mailbox@tommys.org
Phone: 0207 398 3400

The Miscarriage Association
Offers a helpline and network of support groups and telephone contacts across the UK, and a range of leaflets, fact-sheets and other resources.
Website: www.miscarriageassociation.org.uk
Phone: 01924 200799

Ectopic Pregnancy Trust
Provides support and information to couples who have suffered an ectopic pregnancy.
Phone: 020 7733 2653

ARC (Antenatal Results and Choices)
Provides support and further guidance to parents throughout the antenatal testing process
Website: www.arc-uk.org 
Phone: 020 7631 0285

Oscar’s Wish Foundation
A local charity providing support for bereaved parents, siblings and extended family. Oscar’s Wish Foundation occasionally plan events to remember you baby, and offer you a community of support as and when you need it.
Website: www.oscarswishfoundation.co.uk