Sonographers and stillbirth

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.