Following the loss of your baby – medical termination for fetal abnormality
We wish to extend our sympathy to you and offer you our support at this difficult time.
We hope this information will offer you help and guidance in your time of need.
If you need any help, please do not hesitate to ask any member of staff involved in your care.
Feelings
Losing a baby is an experience that many will share, but we all react differently. For some, expressions of grief will be overwhelming and public. For others they may be very private, but no less deeply felt. Partners, family and friends may all find it difficult to show their emotions. Many of us need to share our emotions in order to be able to cope with them. These feelings are real and painful, but they are also acceptable and understandable.
Grief may produce physical symptoms, for example disturbed sleep, lack of appetite, nausea or palpitations. These are all normal reactions and may be eased by sharing your feelings and experiences with professionals, family and friends.
Grief throws our lives out of balance and there are bound to be good days and bad days. Try not to panic—all this is normal. Take time to think through any decisions, as major changes at this time could be unsettling.
What to bring into hospital
Your stay may be a few days, so bring enough clothing, nightwear and toiletries for this time. There may be a television and music system; you are welcome to bring CDs/ DVDs. You may like to choose something for your baby to wear; if your baby will be very small, we can give you an outfit and blanket.
Induction for Delivery
At your stage of pregnancy, we feel it is safer to make the uterus (womb) contract to deliver your baby rather than using a surgical method, which might damage the cervix (neck of the uterus) or the uterus itself. We know it is a very difficult time and throughout the procedure your husband, partner or friend can be with you on the ward. You will receive a lot of support from the staff and plenty of pain relief when and if required.
Two days prior to the induction, you will be given a tablet called Mifepristone, which is an anti-progesterone tablet. This allows the uterus to become more sensitive to the later medications we use. After being given the tablet you will go home but will be asked to return if you are unwell. You will be admitted for the induction process two days later.
Occasionally the tablet may cause some bleeding or even contraction pains (similar to strong period pains) and if this occurs you should ring Ward 16B at Stoke Mandeville Hospital on 01296 418110 and we will possibly admit you sooner.
More commonly you may experience some milder pain and in this case you could stay at home and use Paracetamol for pain relief. It is advised that you do not use Aspirin or the Ibuprofen -type of tablets as they may interfere with the medication.
When you return to the ward two days later, Prostaglandin tablets will be inserted into the vagina by the staff caring for you. These tablets are given to start the uterus contracting. After that you will be given regular medication until delivery. The time interval until delivery can be very variable—usually later in the evening but very occasionally it may take longer. You should plan to stay overnight in case this is necessary. Facilities will be available for your partner to stay with you overnight if required. You will be given plenty of pain relief, usually by injection, although some women may require an epidural anaesthetic (an injection of spinal anaesthetic which is given into the lower back). If you are being cared for on Ward 16B and require an epidural, you would be transferred to the Labour Ward at this time.
At the time of delivery the placenta (afterbirth) may come away on its own but occasionally it may be necessary to take you to theatre to have this removed under a general anaesthetic.
The amount of blood loss at the time of delivery is variable and on rare occasions may be quite heavy necessitating a blood transfusion.
If your blood group is Rhesus negative, an injection of Anti-D will be given to you following delivery.
You may go home once you are feeling well and the timing of this will depend on whether you needed to have a general anaesthetic, and your physical condition. The nursing/ midwifery staff will keep you informed at all times.
Seeing and Holding your Baby
You may be anxious about seeing your baby, but most parents are pleased to have this precious memory. You will be offered the opportunity to see and hold your baby if you would like to do so. It is possible to take your baby home; if you would like to do this please ask staff caring for you.
Photographs and Mementoes
We take photographs of your baby for you. These photographs are taken with a digital camera and will be available immediately. If at this time you do not wish to have the photographs, they are then kept in your notes for up to 25 years in case you change your mind. The photographs will be scanned into your electronic notes and can be made available to you at a later date. You can also take your own photographs.
It may be possible to provide hand and footprints if you would like them. You may also like to keep your baby’s identity bands—please ask.
Naming your Baby
It may not always be possible to identify the sex of your baby at the time of the birth. Therefore it may be advisable to choose a name that is suitable for either a boy or a girl.
Blessing your Baby
Your baby can be named and blessed by the Hospital Chaplain or a Minister known to you. This blessing can occur either with or without you being present. A blessing card will then be given to you.
Book of Remembrance and Remembrance Service
You may like to enter your baby’s name in the hospital chapel ‘Baby Book of Remembrance’ which is situated in the Prayer Room. You may wish to write your own thoughts or a special poem in this book. Please speak to a Chaplain or a Bereavement Officer about what you would like to enter.
An annual Baby Remembrance Service is held, normally in October. You will receive an invitation for this.
Arrangements for your Baby’s Funeral
There are a number of options available to you for your baby’s funeral, which the Bereavement Officer, Chaplain, Midwives or Nurses will be happy to discuss with you. The Bereavement Officer can also help you to find a Funeral Director in your area. If you have met one of the Chaplains during your stay they may be able to carry out the funeral for you. We can also help you find a funeral celebrant if you prefer.
The Post Mortem (PM) Examination
This can be performed from 15 weeks gestation and may give you or the doctors reasons why your baby died; over half of PMs give some useful information. They may also then be able to tell you whether the same problem is likely to affect any pregnancy you may have in the future. If no cause is found this usually means future pregnancies have a good chance of success.
If you choose to have this examination, it would be performed by a specialist Paediatric Pathologist at the John Radcliffe Hospital, Oxford and you will be given the results at your follow -up appointment.
Follow-up care
The hospital staff will answer any immediate questions you may have, but it is difficult to think of everything at this time. You may have a visit from your Community Midwife, but this will be discussed with you prior to discharge.
An appointment will be made for you to see your Consultant 8-10 weeks later. It is important that you ask any questions you like—it may help to make a note of them beforehand so that you do not forget anything. At this appointment you will be able to discuss the results of any investigations that have been carried out and any implications they may have for future pregnancies. This appointment may or may not include a physical examination.
Aftercare
You are advised to see your GP after discharge. Bleeding may continue for 2-4 weeks and sometimes may be quite heavy, although some women continue with a light loss until their next period. You are advised to wear sanitary towels, not tampons, to assess blood loss and prevent infection. You are advised not to resume sexual intercourse until the bleeding has stopped.
It is important that you contact your GP if you experience any of the following:
- Prolonged heavy bleeding with clots
- Vaginal discharge that looks or smells offensive
- Rise in temperature
- Pain when passing urine.
You may start to produce milk about 3 days after delivery. This can obviously be very distressing for you and medication is available to stop this process occurring if you wish. You may also want to take a mild painkiller such as Paracetamol. You will be more comfortable if you wear a well fitting bra until the process is finished. You can also buy breast pads to soak up any leaking milk.
You may have already been introduced to the Bereavement Support Midwife, who will be available for guidance and support after your discharge from Hospital.
Financial help
You may be entitled to maternity leave or benefits; please see moneyadviceservice.org.uk. Returning to work is an individual choice depending on your emotional and physical wellbeing; be guided by professionals, family and friends.
Having sex and trying for another baby
You should avoid having sex until all of your symptoms have gone. Your periods should return within six to eight weeks, although it may take several months to settle into a regular cycle.
If you don’t want to get pregnant you should use contraception immediately. If you do want to get pregnant again, you may want to discuss it with your GP or hospital care team. Make sure you are feeling physically and emotionally well before trying for another pregnancy.
Please Note:
This leaflet explains some of the most common side-effects that some women may experience. However, it is not comprehensive. If you experience other side-effects and want to ask anything else related to your treatment please speak to Ward 16B on 01296 418110 or the Bereavement Support Midwife.
Useful Contact Numbers
Bereavement Office
Stoke Mandeville Hospital 01296 316646
Chaplaincy Department
Stoke Mandeville Hospital 01296 316675
Wycombe Hospital 01494 425072
Bereavement Support Midwife
077 1712 7740.
Please leave a message and your call will be returned.
Consultants’ Secretaries
Stoke Mandeville Hospital
01296 315000 and ask for the Obstetric & Gynaecology Secretaries
Wycombe Hospital
01494 526161 and ask for the Obstetric & Gynaecology Secretaries