One thing we rarely talk about is what happens when a pregnancy has a negative outcome; that is, when a baby is stillborn or dies neonatally (within 28 days).
The original aim of the Pregnancy Outreach Worker Service was to help reduce infant mortality. Everything the POW service does is aimed at reducing risks and improving outcomes, by providing social and emotional support. POWs make sure that mums-to-be are able to access all the services to which they are entitled, and are armed with as much knowledge as possible for a healthy birth.
However, there will always be some outcomes despite our best efforts we don’t have the power to change: sadly sometimes, a baby dies.
The first three months of this contract year have been unusual, in that we have already seen three neo natal deaths (out of a total of 94 births). We must put that into context though. The rate of neo natal deaths in the West Midlands is 3.9% (in every 1000 births) so sadly, by the law of averages, it is bound to be something we experience, as we support 600 pregnant women a year.
The unusual element is just that it’s been in such a short space of time, for example, last year we saw no neonatal deaths during the whole year so however much you know it’s an unavoidable factor and it’s important to be prepared it’s not something you get used to.
When a baby dies, the standard support that all mothers receive switches from maternity services to counselling services. However, POW support – which is focused on mum more than baby – continues. So in this situation, we are able to bridge the gap and carry on supporting for as long as mum needs us to.
Who supports the support workers?
For the two POWs who were supporting these three clients, it’s been a learning experience, too.
Blossom’s client Amala* had a completely normal pregnancy but her baby died unexpectedly, shortly after birth.
Sophia was seeing two clients whose babies passed away within weeks of each other. Hope’s* baby was born prematurely and died 12 weeks later. Maram* found out at the 20 week scan that her baby had abnormalities and probably wouldn’t make it.
Both POWs found that the support that the client needed switched from chats and practical help to simply having someone there, who didn’t necessarily have to say anything at all.
The nature of the work means that the POWS themselves are able to provide a very good support network for each other. They talk to their colleagues, who understand and have the benefit of experience. Managers are also on hand in the office to talk to at any time, and there is a phone support service they can call at any time for free, confidential counselling.
Sophia was with Maram as she learnt what was happening to her baby. She helped explain the details to her and supported her when she made the decision to continue with the pregnancy. It was tough for everyone involved and Sophia found that she often needed a bit of support herself after meetings.
*names have been changed
If you have been affected by this subject and would like to talk to someone about it, we recommend Sands, the stillbirth and neonatal death charity. They support anyone who has been affected by the death of a baby before, during or shortly after birth.