We are very sorry you have to access this guide. The death of a baby is a devastating loss and we know how much more distressing this is likely to be at a time of uncertainty and worry over how medical and public services operate.

Please remember to follow government advice about social-distancing and self-isolation from Public Health England, NHS Scotland and other nations. If you have concerns about yourself or someone else developing symptoms please refer to NHS 111 advice about coronavirus.

During the coronavirus pandemic, our bereavement support services remain available to anyone affected by the death of a baby, bereaved parents, family members and healthcare staff.

Our freephone helpline is available to call on 0808 164 3332 or email helpline@sands.org.uk

The opening hours are 9.30am to 5.30pm Monday to Friday and 5.30-9.30pm Tuesday and Thursday evenings.

At Sands we understand that making arrangements following the death of your baby is not something you expected to be doing and it can be hard to think about the choices you have. At this time, when there are government restrictions to prevent the spread of COVID-19, there are some changes to what you might expect, for example around the breadth of choices available to you. We have written a guide to support you during your time in hospital, making choices about a post mortem, when registering a stillbirth or neonatal death and when arranging for a funeral, cremation or memorial service.

Giving birth to your baby who died before labour began

If your baby has died before labour, you will need to attend hospital to deliver your baby. The choices about where you can give birth and who can attend hospital to support you may be affected by the current COVID-19 situation. Your midwife or doctor will be able to talk with you about what is possible locally and what to expect when you go to hospital. They can tell you about how visiting will work and what support you can expect from healthcare professionals after your baby is born.

You can read general information for any woman giving birth from Royal College of Obstetricians and Gynaecologists here and from Royal College of Midwives here.

If you feel unsure about making decisions about the birth choices available, maternity staff are there to listen and to support you. It may help to talk it through with family and friends.

Care if your baby died during labour or soon after birth

If your baby died during labour or soon after birth, maternity staff will talk with you about your care while you stay in hospital, what support you can expect from health care professionals, and about visiting. Every effort will be made to give you the support you need and help you through the choices you make about yourself and your baby.

You can request a Sands Bereavement Support book from your hospital, which is available to download through a free app or as a physical book. Hospitals may also still be able to provide you with a memory box to offer you the option of making memories during time with your baby. You can also order a memory box or a Sands Bereavement Support Book through the Sands online shop for free or by contacting the Sands Helpline helpline@sands.org.uk

Registering a baby after a stillbirth or neonatal death

From March 2020, the UK government has put guidance in place that affects the functioning of public building offices in the UK in response to the coronavirus (COVID-19) pandemic. This will mean that, in order to reduce the risk of transmitting the virus, registration for births and deaths may not take place in person and could possibly take place or over the telephone, or be assisted by funeral directors.

Who can register a birth, stillbirth or death?

Appointments to register stillbirths or deaths may be taking place under new guidance in your local office. You must not go to a register office in person unless advised by a registrar as most public buildings are closed. Always contact the register office first for guidance. 

Registrations may be postponed for babies who are born alive and in a special care unit, however as of March 2020 stillbirths and deaths are being registered mostly over the telephone. This means your Midwife or Local Authority will be able to connect you with a Registrar who will take information about your loss and issue the legal forms needed to arrange the funeral. Please note that the way this service operates will vary according to Local Authority so how long things will take will vary across the UK. It is expected that services will function with some delays until the impact of the pandemic has passed.

Appointments to register stillbirths or deaths may be taking place under new guidance in your local office, so do check with them prior to attending in person. Each local authority will have contact details for enquiries on their current procedures, so ensure you consult their web page or, alternatively, go to www.gov.uk/register-stillbirth for up-to date guidance.

In Scotland, arrangements are different. Registering births is postponed and stillbirths and deaths are being registered remotely via phone and email, see National Records of Scotland (NRS) registration services here.

You can download NRS’s list of current contact for registration offices here.

Download National Records of Scotland have specific guidance on registering a stillbirth here.

Funeral arrangements for your baby

Making arrangements for a baby’s funeral is something which parents do not expect to do and which feels against the natural order of things. You may never have arranged a funeral before and feel overwhelmed by the amount of things to consider. Please be assured that feelings like this are normal and does not change the bond you have with your baby. Your healthcare team, funeral director and friends and family are there to support you, as is the Sands Helpline, app and online community.

Government guidance around social distancing has changed how funerals work in some respects. There are important considerations around arranging and holding a funeral that are outlined below. The National Association of Funeral Directors recommends that, in order to minimise contact and the risk of spreading COVID-19:

  • Funeral arrangements be made over the telephone
  • If arranged in person, all people attending observe social distancing guidance
  • If a funeral must be arranged in person, please respect the social distancing guidance – keep two metres apart, wash hands frequently, cough or sneeze into a tissue/crook of your elbow and limit the number of people attending in person to arrange the funeral.

People presenting symptoms of coronavirus should self-isolate and must not attend the appointment in person. This is to protect the public but also the workforce who need to stay healthy and support other bereaved families.

Further information on funeral arrangements can be found here.

Cremations and collection of ashes

Whether to hold a cremation or burial for your baby has, to date, been a family’s choice. The Coronavirus Act active from March 2020 suggests new guidance around what may happen when cremations take place. This will mean that you may have different conversations around cremation or burial with your hospital or funeral director:

  • Ashes being held at crematoria until such time as collection is deemed safe when people are once again allowed to leave home freely
  • Crematoria may offer extended opening hours to manage demand if more cremations need to take place

The government is committed to ‘managing the deceased with respect and dignity’, but in the event of increased pressure may have to direct others not involved in the funeral sector to manage services and preserve public health. This may mean your baby’s journey to a final resting place will be different to what you know of the procedures if you have arranged funerals before. Having said this, your wishes will be heard so that these new procedures bring you as much comfort as possible.

Discussions in Parliament have aimed to protect the interests of faith groups who would not normally opt for cremation. The aim to protect the wishes of the deceased is a key concern for legislators managing the coronavirus crisis and will be an important conversation to have when making arrangements that enable you to say goodbye.

At Sands, we are here to support you and would like to remind you of the options to discuss your concerns with our trained staff via our Helpline, email or Facebook page.

Attending a baby’s funeral

The funeral you arrange for your baby can have as many personal elements as you wish but will need to consider keeping vulnerable people safe. In line with Government guidance, the National Association of Funeral Directors recommends that funeral services consider limiting attendees to members of the immediate family who are not in any of the high-risk categories and are not self-isolating. The immediate family for you baby’s funeral would be:

  • Parent/s
  • Brothers/Sisters
  • Grandparents

Limiting attendees must be done sensitively and take account of individual circumstances. This may mean that a baby’s parents can be consulted on the people whom they feel are closest to them when saying goodbye to their baby and suitable arrangements can be made. Webcasts may be available at a cost for those not attending.

While this will be a very difficult time and you may find it challenging to think of details, we suggest you recruit help from your family to observe other practical arrangements at your baby’s funeral that would avoid the spread of COVID-19:

  • Avoiding the use of limousines or vehicles where people from different households would travel in close proximity
  • Not advertising the funeral details publicly to reduce the risk of other, well-meaning mourners arriving unexpectedly. They may be turned away at the door, which could be distressing for them and the bereaved family. It will also place funeral key workers at unnecessary risk of harm
  • During the service, all mourners should remain two metres apart from anyone not living in their household. We understand it is so hard, but do try and refrain from making physical contact with anyone outside of your household
  • All charitable collections should be done online. Sands fundraising team will gladly support you if you email them at fundraising@sands.org.uk or share the link www.sands.org.uk/give-memory

Memorials for babies

A memorial service is a way of celebrating the life of a loved one who has died, and can include very personal choices that may not be available when funerals face restrictions designed to keep the public safe from covid-19 transmission. Funerals and cremations need to be held within specific timeframes, but there is no time-limit for holding memorials for loved ones.

This means that a baby’s memorial service may be planned for the months to come when the rules around public gatherings may change. This is something you may wish to think about when planning who to include in funeral arrangements while protecting vulnerable family members and friends from coronavirus. There is no time-limit for holding memorials for loved ones.

Whether you hold your baby’s memorial service now or in future, you may consider holding memorials in the following ways:

  • Using video call, by means of a group platform that enables people to participate from home
  • Making a recording or video of you and the people you live with commemorating your baby with readings, songs, or any other activities special to you and sharing it with those who can’t be there
  • Agreeing for your family and friends to engage in the same activity on a specific day to commemorate your baby (crafting, gardening, art or music for example)
  • Creating something that your loved ones can see and create their own versions of, with a view to merging the various items at a later date

During this time, while you are advised not to visit your baby’s grave or special place, you may want to think about using some of the ideas above to remember your baby.

Please see guidance on visiting crematoria, graves & memorials here.

Reviews and investigations after a baby is stillborn or dies after birth

Post mortem

A post mortem (also called an autopsy) is the medical examination to help understand any factors that might have contributed to your baby’s death. There is more information about how and when this might happen on the Sands website here.

During the coronavirus pandemic, how and when these examination take place may change. Please speak to healthcare staff supporting you about changes that will affect you. There may be a longer wait for the investigation to happen and it likely that there will be a longer wait for results.

Hospital review

As a bereaved parent, you should be told by your hospital that a review is going to take place and be offered the opportunity to ask questions or provide information about your care for the review panel consider.

During this pandemic, with pressures on staffing, it is likely that some reviews may not happen as soon after a death as would be ideal. If you have not been informed about progress with reviewing your baby’s care, you can ask your health carers about it. You might think about noting down anything about your care that you want to remember while it is fresh in your mind, to share when the review does take place.

Other investigations after a death

As with the post mortem and hospital reviews, other investigations and reviews  may be delayed in the current crisis. Your health care team should keep you informed about everything that is being done to understand your baby’s death, and what you can expect.

We hope this guide has been helpful and once again would like to express our sincere condolences at this immensely distressing time. Sands is here to support you and we would love to hear from you if you feel we can be of help.