To ask the Minister of Health what considerations have been put in place for maternity services to ensure when a stillbirth or a miscarriage occurs in hospital, that mothers are not placed in wards where other patients or families are celebrating a birth.

Early Pregnancy Clinics are available in most maternity/gynaecology units across Northern Ireland. These clinics will have telephone triage and self-referral triage in place that successfully help to divert those experiencing pregnancy or loss away from ED units, however it is not possible at this time to provide 24/7 Early Pregnancy Clinics and this can mean that not all patients avail of this service in their time of need.

On Maternity wards, maternity service staff are very aware of the sensitivities for mothers and families around the time of a loss of a baby and how important it is to provide a safe environment to allow a family to grieve without being exposed to others celebrating. While all Trusts endeavour to provide a room in a quieter ward e.g. Early Pregnancy where there is less likelihood of babies in the vicinity, on some occasions a mother may be placed in a ward where there are babies but staff do their utmost to provide a private room as well as all other psychological and physical supports available.

As the infrastructure varies across Trusts, SPPG have summarised each Trust’s response below:

Belfast HSC Trust

The Belfast Trust Maternity Service staff are very aware of the sensitivities for mothers and families around the time of a loss of a baby and how important it is to provide a safe environment to allow a family to grieve without being exposed to others celebrating.

At this time the current facilities in Belfast Trust are outdated and the Service had hoped to be availing of a new maternity hospital but this is delayed. For Mums who have had a stillbirth the Trust provides a side room called the Snow Drop room in the Delivery Suite which offers privacy but it is not sound proofed. Other women who have had early pregnancy loss are cared for in quieter wards e.g. Early Pregnancy where there is less likelihood of babies in the vicinity. However, on some occasions a mother may be placed in a ward where there are babies but staff do ensure that a private room is provided as well as all other psychological and physical supports available.

South Eastern HSC Trust

Within the South Eastern Health and Social Care Trust miscarriages are managed within the Early Pregnancy Problem Clinic (EPPC). This clinic is based from Ward 4E which is our Gynaecology ward. Ward 4E is located in a separate building from the Maternity Hospital.

In the event a woman has a still birth she is cared for in our Bereavement Suite which is located in a specific area of Labour Ward which is designed specifically for this purpose.

Northern HSC Trust

The Northern Trust cares for women who have a stillbirth in the ‘Willow Suite’ which is a bereavement room opened in 2023, outside of the birthing suite. This room was specifically commissioned and designed to provide compassionate and sensitive bereavement care to women and their families during the sad loss of their baby. The woman will remain in the room after the birth until she is discharged home. Regrettably if there is more than one woman, they may be placed in a side room in the maternity ward. Midwives will try to minimise exposure to other patients or families who are celebrating a birth. Women who sadly experience a miscarriage are cared for in a single room in the gynaecology ward for the duration of their care so are also not placed in wards where other women or families are celebrating a birth.

Southern HSC Trust

Within Craigavon Area Hospital (CAH) there is a dedicated bereavement suite, which opened in 2023, known as the Butterfly suite, with two birthing rooms. This suite is designated to families who are bereaved with stillbirth or late miscarriage. While the Butterfly suite is adjoined to the main delivery suite, the entrance to it has double doors with a short corridor and access can be gained via a side entrance allowing direct access to the main corridor to avoid additional stress for parents/visitors by meeting other birthing parents. There is easy access to delivery suite theatres in the event of an emergency situation. The Butterfly Suite in CAH has a separate bathroom, shower and toilet. They have a waiting/living room facility with a tea/coffee machine to welcome siblings and families to visit in a less clinical setting. The area has been sound proof to avoid any noise disturbance. A second room is also available in the event that more than one family would require the facilities at one time. This room is suitable for any gestation usually used for 17-42 weeks gestation. The entrance hall has a butterfly feature light and dim lighting. Soft colours and furnishing are used to make it appear less clinical and more conducive to the needs of bereaved families. Families remain in this room for labour and birth and until they are discharged home.

The Willow Suite in Daisy Hill Hospital (DHH) Newry is a refurbished room with a tranquil setting away from the main delivery suite, yet with quick access to theatres if required. It has an open planned kitchenette with a fridge and a microwave for bereaved families. Fans and recliner chairs are available to enhance comfort. Both rooms have subtle art work and have received very positive feedback from service users.

Women experiencing an early miscarriages (up to 17-20 weeks) are cared for in a side ward in Gynae wards in both CAH and DHH. Some may have an ensuite but the rooms are clinical and require a makeover to meet the standards to maintain comfort, dignity and privacy. They are not sound proof and suitable soft furnishings would enhance patient experience. Women labour and birth in this ward and are discharged home with resources to provide comfort and support. All families are offered a listening visit in Dromore Listening Rooms or telephone support from the Trust’s Bereavement Midwife. Staff aim to be caring, compassionate, and empathetic to all bereaved parents. In the event that the Willow Suite is in use, the family would be offered use of the Butterfly suite within CAH and vice versa.

Western HSC Trust

Western Trust have advised that within both of their maternity units they have a bereavement suite which is not located within the postnatal area. In Altnagelvin it is co located with antenatal and in SWAH it is at the end of the midwife led area. These suites have been designed with additional sound proof measures to reduce the likelihood of noises from the external environment being heard within these rooms. These rooms have been carefully fitted out with the involvement of parents who have lost babies so that they are providing as caring and a compassionate space as they can.

Whilst it is not common, there is a possibility that there may 2 cases of baby loss that occur at the same time. In Altnagelvin if that is the situation, staff will bring these parents to the antenatal ward, and they will be provided with a single room.

In SWAH they will be offered a single room in an area of maternity where there are less women admitted. It may be in the midwife led area or the main maternity ward and staff will do their best to reduce the possibility of them encountering or hearing other babies.

If a women has a miscarriage they will be admitted to the Gynae ward for early miscarriage. In SWAH they will be in a single room of the Gynae /Surgical ward up to 17 weeks and this is located away from maternity.

In Altnagelvin these women will be admitted to the Gynae ward up to 19+ weeks and this ward is located in a floor below Maternity. These women will be offered a single room. Mothers who are admitted in the post-natal period with an infection are admitted to Gynae Wards and their baby can remain with them during his admission to promote bonding and breastfeeding. There is the possibility that a women could be in another single room within the Gynae ward who has had a miscarriage at this time, and whilst staff will do their best not to place these women in rooms near each other, (to lower the possibility of the baby being heard) there are only 5 single rooms in this ward available.