Last year Sands Improving Care team carried out a comprehensive, on-line survey of standards of bereavement care in UK maternity units. The aim was to find out the extent to which maternity units were following the recommendations in the 2007 edition of the Sands Guidelines.

The report was published in June 2010 and was circulated to all UK maternity units, Primary Care Trusts and Health Boards, Strategic Health Authorities, the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, the Nursing and Midwifery Council, directors of midwifery education, and other relevant organisations.

The main findings of the survey were that in most maternity units provision and the organisation of care for bereaved parents has improved greatly over the last few decades. Most of the units that responded are able to provide care in line with the standards set out in the Sands Guidelines. This indicates that these standards are realistic: there is no good reason why all units should not achieve them.

However, in about 20 per cent of the units that responded, care is still poorly resourced and organised, and in others it is patchy. In addition, the fact that care in most units is good is of absolutely no help or comfort to those parents whose baby dies in a unit where care and resources are poor or inadequate.

Findings of particular concern were:

• 52% of maternity units have no dedicated bereavement support midwife
• 45% of units have no dedicated room on the labour ward for mothers whose baby has died, where they cannot hear other mothers and babies.
• In a small number of units, women having a miscarriage are cared for in areas that are clearly unsuitable, for example, on a medical or general ward or in an A&E department.
• 82% of units have no information in formats suitable for parents with visual impairments
• 86% of units have no information in formats suitable for parents with learning disabilities.

Only 25 per cent (77 in total) of the maternity units contacted actually completed our questionnaire. Possible reasons for the low response rate may have been the length of the questionnaire and the fact that respondents had to get information from colleagues in other departments. Where staff are already overstretched this may have been too much to ask. Nevertheless, this low response rate is disappointing, especially as it may indicate that in many units care for these parents is not considered a resourcing priority. If this is true, it is seriously worrying.

Much of the survey focused on the way that resources are allocated and care is organised. However hard individual midwives and other staff work, and however committed they are, they cannot provide high quality care for parents if the resources and systems they need are not in place. They are in an impossible and very stressful position.

We hope that the report will encourage NHS commissioners and managers to review and improve the care and facilities they offer to bereaved parents and to ensure that they are as good as they can be.

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