15-05-2025
Parents, midwives call for better bereavement care training after stillbirth
Warning: This story contains information and images relating to stillbirth.
For Ellen Pinkstone, the loss of her stillborn baby was a heartbreaking moment.
But what happened next only made matters worse.
Ms Pinkstone, 23, gave birth to her son, Sage, in September 2023 at Port Macquarie Base Hospital on the New South Wales Mid North Coast.
Ms Pinkstone and her partner, Aiden Dempsey, spent three days recovering in hospital after the birth and spending time with their stillborn son.
She said her nightmare experience was made even worse by the "traumatising and distressing" treatment of hospital staff.
The words of one staff member cut her deepest at a time she just wanted to see her son.
"She said she would go get 'it' from the morgue," Ms Pinkstone said.
Ms Pinkstone said Sage was taken to and from her care in a bag with handles.
"The black bag, tightly wrapped around his fragile form and carried away, swinging back and forth," she said.
"It was undignified.
Ms Pinkstone is now calling for better bereavement support as well as training of staff.
In Australia, six babies are stillborn each day, affecting more than 2,000 Australian women and families each year.
Blair Whitechurch never imagined her first delivery as a student midwife would be the most traumatic experience of her life.
The 43-year-old mother of two is no stranger to childbirth.
But the first baby she helped deliver as a student midwife — a girl named Rose — was stillborn at 39 weeks.
Ms Whitechurch said she had felt completely unprepared.
"I did all the wrong things. I vomited and fainted," she said.
Rose's birth in March 2022 was the first of about 30 deliveries Ms Whitechurch would need to attend as part of her training.
She said her study to that point had failed to prepare her for the reality of a stillbirth.
"I felt emotionally terrorised for her [the mother]. I felt so ill equipped to support her and I felt emotionally unprepared for me to see what I saw," she said.
"I was completely out of my depth."
Australian Nursing and Midwifery Union strategic lead for midwifery, Jasmine Kirk, has backed Ms Whitechurch's claims that students do not receive enough bereavement training.
"Ideally it would be covered multiple times to different levels of complexity," Ms Kirk said.
She said training during midwifery degrees could be minimal.
"That can be as minimal as a single slide in a single lecture or a sentence in an online course," she said.
Eliza Strauss, a midwife of 20 years, runs independent bereavement training sessions nationally.
She said many health professionals told her they did not know how to help during a stillbirth.
"They often mention maybe it was an hour's lecture, or they watched a video on stillbirth … things haven't really changed," Ms Strauss said.
"It really needs to go to state and federal levels to get government involved to include bereavement training in workplaces and universities."
The federal government released a National Stillbirth Action Plan in 2020 that included a push for national guidelines on bereavement care following stillbirth, as well as a national evidence-based, culturally safe stillbirth education program for health professionals.
It identified a need for consistent education and training that reflected best practice in stillbirth prevention and care.
A spokesperson for the federal Department of Health said the government had invested $23.2 million over four years to support families who experienced stillbirth or miscarriage.
The spokesperson said mandating bereavement training would be a decision for state and territory governments and individual training universities or medical colleges.
The government also was developing new Australian postnatal care guidelines that would provide health professionals with evidence-based, best practice guidelines on providing optimal care to women during the postnatal period,
This included bereavement care after pregnancy loss, stillbirth or neonatal death.
After her experience, Ms Pinkstone contacted to the NSW Health Care Complaints Commission, which gave the hospital "clear expectations" to improve its practices to ensure an emotionally safe environment for patients and staff.
The commission found the hospital's use of a portable carrier was not best practice.
It concluded that the hospital had implemented changes "to promote enhanced engagement and inclusion during this delicate time".
A Mid North Coast Local Health District spokesperson said the health service recognised there had been shortcomings in the care.
The health service has apologised to Ms Pinkstone and "thoroughly reviewed" her concerns and implemented changes.
This includes the use of a cot on wheels instead of a portable carrier, and improving bereavement care to families experiencing loss.
"Mid North Coast Local Health District will continue to improve our individualised bereavement care to women and families," a spokesperson said.
"[The district] is guided by NSW Health policies and procedures on stillbirth. A district-led guideline is being developed."
Ms Pinkstone welcomed the hospital implementing changes, but said the experience still haunted her.
"The hardest part of our son being stillborn wasn't that he was stillborn, it was that we were treated so poorly," she said.
"The bereavement care wasn't there."
The first comprehensive national guidelines for the treatment of early pregnancy loss have just been released, which aim to improve data collection and medical research.
According to the Stillbirth Centre of Research Excellence, the needs of parents who have stillborn children are frequently not met, and there is little guidance for clinicians on how to provide optimal care for these families.
Some hospitals, such as Melbourne's Royal Women's Hospital, have dedicated rooms and bereavement experts, but some say more work needs to be done.
Two years after meeting stillborn baby Rose, midwife Blair Whitechurch was overjoyed to help the same family deliver a second, healthy baby named Winter Rose.
"We talked a lot about Rose, we were all just overjoyed by the fact Winter Rose was here … the vibes were very high in the room that day," she said.
Ms Whitechurch said it had been a special experience to come full circle with that family, while still continuing her part-time study.
"It was just so nice to see them finally get their dream," she said.
