Bereavement teams to be placed in all maternity hospitals

Minister for Health says standards for pregnancy loss are a ‘new beginning’

Bereavement specialist teams will be established in all maternity hospitals to support parents dealing with a pregnancy loss or the death of a baby with a fatal foetal anomaly.

Minister for Health Simon Harris published new National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death on Wednesday and said they marked a new beginning for bereavement care services for parents who suffered such a "devastating" experience.

The standards will be overseen by an implementation group chaired by consultant obstetrician Dr Keelin O'Donoghue. They were developed in response to recommendations in two reports following the death of Savita Halappanavar at University Hospital Galway in 2012.

Mr Harris said the new standards clearly defined the care parents and families should expect to receive following a pregnancy loss or perinatal death.


“I am pleased that the standards will ensure that clinical and counselling services will be in place to support women and their families in all pregnancy loss situations, from early pregnancy loss to perinatal death, as well as situations where there is a diagnosis of a life-limiting or fatal foetal anomaly,” he said.

There are about 500 perinatal deaths in the State each year, as well as 14,000 miscarriages and at least 3,700 terminations abroad.

The Minister said he was grateful to the many families who generously shared their experiences during the consultation process and offered suggestions on how care could be improved.

Dr O’Donoghue, consultant obstetrician and senior lecturer Cork University Maternity Hospitals said the standards were a direct expression of the health service’s commitment to compassionate care for patients.

The new bereavement support teams will comprise staff members who have undertaken specialist and extensive education in bereavement care and will include a dedicated clinical midwife specialist in bereavement care for each maternity unit.

Dr O’Donoghue said the standards also acknowledged the impact of pregnancy loss and perinatal death on staff and the importance of having formal structures in place to support them.

The standards will ensure bereavement care is offered in accordance with the religious, secular, ethnic, social and cultural values of the parents.

Hospitals must also ensure a system is in place to provide bereavement care and end-of-life care for babies.

High-quality palliative and end-of-life care appropriate to the needs of the baby and the wishes of his or her parents will also be ensured under the standards.

A copy of the standards has been sent to the husband of Savita Halappanavar, Praveen Halappanavar.

Mr Harris said there needed to be absolute clarity in hospitals in relation to what information they could provide to families dealing with fatal foetal anomalies.

He said he did not think this had always been the case and that there had been different practices in different hospitals. Mr Harris has engaged with the Termination for Medical Reasons group on these issues, he said.

The group said the standards were a “positive step forward”. Every Life Counts, which supports parents who have been told their baby may not live long after birth, said the standards showed the need for perinatal hospice care.

Dr O’Donoghue said perinatal palliative care was mentioned throughout the standards.

"In other parts of the world, that's been referred to as perinatal hospice care. It really is the same thing. In Ireland, because of our circumstances whereby many parents have not chosen termination of pregnancy or have not had the choice to do so in Ireland, we have developed skilled experience in looking after parents during pregnancy and afterwards in these situations.

“So I would like to think we have equal regard for those parents who choose to continue their pregnancy and that we regard their short lives and the precious experiences that they have as well as those families diagnosed with a major foetal anomaly who choose not to continue in their pregnancy, and obviously support them in the extra trauma that they face in currently having to travel outside the country.”

Ciarán Browne, general manager of the HSE’s acute hospital division and chair of the standards development group, said it had been the “most emotionally tough group” he had ever chaired in his life and he thanked all those who had worked on the standards.