As part of our #AlwaysThere campaign we are calling for all women pregnant after loss are offered the same maternity team to care for them and their baby, through pregnancy, birth and afterwards.
Known as Continuity of Carer, this model of care helps to save babies’ lives and create emotional and psychological safety for mothers and partners. Although the roll-out of Continuity of Carer has been affected by the pressures of COVID-19 on the NHS, the pandemic has also highlighted the urgent need for this very model of care.*
Throughout 2020 Sands heard evidence of the impact of the COVID-19 pandemic on pregnant women, and bereaved parents and families. Fewer appointments, having to attend appointments and scans alone, particularly for those pregnant after loss, or when receiving bad news, were cited as concerns by many.
Independent research has shown that mothers who receive continuity of care are:
• 16 per cent less likely to lose their baby
• 19 per cent less likely to lose their baby before 24 weeks
• 24 per cent less likely to experience pre-term birth
As well as improved clinical outcomes, women receiving Continuity of Carer are almost eight times more likely to be attended in labour by a known midwife.
Our Always There campaign aims to save lives and improve care by ensuring all women who are pregnant following loss can choose to have the same maternity team who are always there to care for them and their baby.
For any pregnant mother, having familiar faces caring for her can help develop a vital relationship of trust and this is particularly important for those who are pregnant following loss. When a single midwife or team of midwives cares for a woman and her family, there is more opportunity to hear and understand their individual needs and concerns.
NHS England has committed to providing Continuity of Carer but we are concerned that progress in rolling this out has been slow. We know this has been in part due to the COVID-19 pandemic and that a barrier to achieving Continuity of Carer for all women in England is lack of resource and staff to deliver it - the NHS is already short of around 2,000 midwives.
As services recover from COVID-19, the transition to a midwifery-led Continuity of Carer model must be properly resourced and supported, so every woman who is pregnant following a previous loss has the same team who are always there for them throughout their maternity experience. The latest additional annual funding of £95m for NHS maternity services is the perfect opportunity to make this happen.
- Sands Chief Executive Clea Harmer
Continuity of Carer can make a big difference for bereaved parents
Carrie Waddingham, from Leeds, received support from Sands after her twin babies died when she was 16 weeks pregnant in 2018, due to twin reversed arterial perfusion (TRAP sequence), a rare condition of monochorionic twin pregnancies.
She became pregnant again later that year and was cared for by the same maternity team throughout pregnancy and the birth of her son, who was born safe and well in 2019.
During our second pregnancy I suffered with severe anxiety and PTSD from the previous experience and my midwifery team were so good and I was able to get the right support for my mental health, extra checks and scans for peace of mind. It was nice to always see members of the same team and I was really happy to see the midwife I had in community to induce my labour and then again for post-natal check-ups. It felt really nurturing and made me feel at ease in a really emotional and tense situation. It didn’t feel like I was on a conveyer belt but that my pregnancy and birth really mattered.
- Carrie Waddingham
The effects of not receiving this model of maternity care were revealed in a survey by Sands in 2019, which found that more than 80% of women had not met any of the midwives who looked after them in labour, before their labour began.
Comments made by bereaved mothers in the survey included:
“I didn't really know what was happening or what was normal. I knew I felt dreadful and lots of things were going wrong but there was never any continuity or holistic approach to my care. I just drifted from one bad thing to the next hoping everything would ultimately be ok. It wasn't and the outcome was catastrophic for me and my baby.”
“I spoke if my concerns on many occasions to varied midwives but not one of them shared the correct information with me or acted like reduced movements were anything to be worried about. I trusted my care providers and felt like I was being an over anxious first time IVF mum.”
For more than 40 years Sands, has always been there; walking with bereaved parents as they navigate their lives without their babies, providing a safe space to grieve and commemorate their babies, working with the NHS to provide empathetic bereavement care and campaigning to save babies lives.
Join the campaign at sands.org.uk/alwaysthere and follow #AlwaysThere on social media.
*Continuity of Carer means that women receive care from the same midwife or small team of midwives throughout antenatal care, labour and birth, and the postnatal period. More information available on the NHS England website.