Caring for families experiencing perinatal loss: what do students need to know?
Authors:   , Jones Julie 
Published: August 2022

Background Perinatal loss and bereavement care is an area that significantly impacts families and the health professionals caring for them. The care provided can make an enormous difference to families experiencing perinatal loss, so it is imperative that midwives and health professionals are trained adequately. There is inconsistency and lack of equity in the education provision for this and in turn the care that families receive. Aim This research aimed to assess the existing provision of bereavement training for student midwives and create a proficiency framework which comprehensively includes all aspects of knowledge required and to inform the training that is required and discuss how this can be incorporated into the 3 year BSc (Hons) Midwifery course. This research was undertaken involving three phases. Method Phase 1 Phase one used an online survey to assess what is already provided in relation to perinatal loss teaching but at a high level. This included the number of hours dedicated to the subject and who provided the training. Phase 2 Phase two utilised the Delphi technique to create a comprehensive Perinatal Loss Proficiency Framework (PLPF). This was created through the input from experts in the field with extensive expertise and experience. Phase 3 Phase three then explored the implementation of this and the teaching and learning strategies which should be employed. The participants were 2nd and 3rd year student midwives using nominal group technique (NGT). Data Analysis Phase 1 Survey analysis was carried out using the survey tool giving statistical analysis. This was further supported through opportunity for free text responses to give further context. Phase 2 The data from the Delphi technique came from open ended questions and required thematic analysis carried out using Braun and Clarke (2006) six phase model. Phase 3 Nominal Group Techniques is a consensus technique which facilitated analysis of the data and allowed consensus to be reached within the group discussion. Findings Phase 1 There is very little time allocated to bereavement training for student midwives and provision varies greatly nationally. This variance was across who facilitated the sessions, when they were delivered, and the time allocated to this provision. Phase 2 The resultant four themes were practical clinical skills; emotional and spiritual support; communication; paperwork. These themes were populated with competencies created from the data contained within the thematic analysis. The inclusion of practical clinical skills incorporated many aspects of care not yet included in existing training provision. This created the Perinatal Loss Proficiency Framework (PLPF). Phase 3 The participants allocated various elements to either practice or university as the most appropriate learning environment. All themes had elements allocated to both learning environments so aligning with the way midwifery education is delivered. They also proposed a three year training programme using the PLPF as a structure for this. Conclusions There is inconsistency and lack of equity in the education provision for this and in turn the care that families receive. The PLPF can be tailored to suit differing specialities as discussed, but for midwifery the full framework is applicable. Midwives will meet women and families at all gestations suffering all losses so need to have the skills to care for them. It is essential that there is widespread dissemination of these findings and support for implementation. Through this there can be a more standardised approach to perinatal loss in education and in practice nationally and internationally. This is essential in order to support the nurses, midwives and other health professionals providing the care and improve care for the families receiving it. Recommendations for Practice • There needs to be greater consistency of training provision for healthcare professionals providing care for families experiencing perinatal loss which can be facilitated by implementation of the findings from this research. • The Perinatal Loss Proficiency Framework (PLPF) should be incorporated into all pre-registration midwifery courses. • The PLPF should be amended for use in specialities i.e. gynaecology and incorporated into pre-registration nursing courses using applicable content. This can also support inter-professional learning. • The PLPF should be used to create a post graduate module on perinatal loss; this should be created in conjunction with charities within the field of perinatal loss in order to gain accreditation. This can provide a basis and requirement for Bereavement Specialist Midwife qualification.