Presentation

At the time of informing parents that their baby or child has died, inform them what steps will be taken next. Parents in shock will feel confused, and may be unable to absorb much; they will need direction and guidance. No matter how planned or discussed, all deaths cause shock and an element of disbelief.

Parents need to be given the choice to participate in the care of their child as much as they wish after the death. They may need support to do this. Time needs to be available for them to be with their child before he/she is transferred from the ward/unit. Don’t hurry parents; allow them as much time as they need, alone or with siblings, grandparents, family and friends. This time is an important part of their grieving process. Make appropriate private space available where parents can be with their child.

Fathers and mothers may not know how to be with their dead child. Watching you, observing your sensitivity and interactions with their child may encourage them to be involved. Help them to talk about how they feel, to cry, to speak to their child, to express their emotions, if they want to. Your emotions matter to parents, they show you care.

Explain how they can return and contact you if they have any further questions, and how to make arrangements if they would like to see their child again.

Memories

Creating memories can be invaluable to the parents, to siblings and to the rest of the family. Some units introduce the concept of a Journey Box for memory objects before the death, other units may create a memory box with the family after death. All memory-making in any form must include, and be with the permission of, the child’s parents. Siblings can be involved with choices. It is important to check with parents what they would like to keep, ensuring their wishes and their culture is respected.

Always tell the truth. Honesty is a vital ingredient and establishes trust in you as a member of the professional team. Tell parents everything you know about their child’s death. Be honest about what you don’t know. Suggest you can seek the information or ask relevant colleagues to speak to parents.

Post-mortem examination

Often, one of the most difficult conversations is around post-mortem examination. Some parents have told us of their regret that the opportunity to have a post-mortem was not discussed. When offering this as a choice to parents or when a coroner’s autopsy is necessary, sensitive communication and explanation is paramount.

Further guidance for you as the professional can be found in Module 4 and in the Human Tissue Authority Code of practice 3: Post-mortem examination.