Yesterday I met a young couple who lost their baby last
year. By luck I happened to look at the
booking letter and noticed the annotation SB next to the details of her
previous pregnancy. It was a busy clinic
with lots of extra scans added to the list and she was attending for a 32 week scan. I could so easily have welcomed them into the
room with a breezy ‘so why are we scanning you today?’ Thank goodness I didn’t. I asked them if they would like me to put a SANDs
sticker on the handheld maternity notes.
They did and told me about their little boy, his name, the day he was
born, how much he weighed and how beautiful he was.
I can’t tell you how much I love the SANDs teardrop
stickers.
None of us go to work to cause pain but it is too easy to inadvertently
do so if the sticker is not in place.
When we are busy we do not always look through the notes in
detail, particularly when someone is attending for a routine growth scan amongst
many others. We grab the notes, look
through the previous scan reports but don’t look at the booking letter. There is seldom time for wading through pages of notes. So we don’t see that this lady has had a
still birth.
Where was the SANDs teardrop sticker?
In my experience, the
hospital notes are generally marked with a teardrop sticker, most likely put
there on Labour Ward or Postnatal Ward when the still birth or neo natal death
happened but the handheld maternity notes often are not. When the handheld
notes are the only ones available to the sonographer that vital alert is
missing. Placing the sticker on the
notes can only be done with patient consent but I have never met a mother or
father who was not happy to have it. You
may find the conversation awkward but ignoring their loss or asking questions
about her previous pregnancy without knowing what happened is more likely to
add to parents’ distress than talking about their baby. A quote from a bereaved mother in the National
Perinatal Epidemiology Unit’s Listening to Parents Report (on the SANDs
website) sums it up;
‘I am pregnant again.
I would like a ‘label’ on my notes indicating a previous neonatal death
to staff, especially sonographers so that they… understand what we have already
gone through.’
If you find that the
sticker is missing, ask the parents if they would like one and put it on. Don’t have any in the department? Ask the midwives. If they don’t have any, visit https://www.uk-sands.org and order
some.
