Country's first early pregnancy bereavement nurse now helping parents nationwide
A trailblazing Wolverhampton nurse who became the country's first early pregnancy bereavement nurse is now helping parents across the country.
Emily Cooper, who "lives and breathes the role", was the first of her kind when she was appointed at The Royal Wolverhampton NHS Trust.
After supporting hundreds of grieving families, the 33-year-old is now using her knowledge to guide others and has presented online national training for the role, with another session planned for next month.
An estimated 254,000 babies die in pregnancy or at birth each year in the UK, and the independent Pregnancy Loss Review for the government published in July 2023 came up with 73 recommendations.
Among these are private spaces for patients – on female-only wards – the development of ‘baby loss kits’, cold storage facilities for baby remains, education, training and information, and consistency around clinical care and mental health support.
Emily’s role came about following patient feedback which led to a pilot in 2019 on Maternity, Ward D7 Gynaecology at New Cross Hospital.
She is part of the 10-strong Early Pregnancy Assessment Unit (EPAU) and Gynaecology Assessment Unit (GAU), which solely concentrates on emergencies. It also includes a Saturday clinic to relieve pressure on the Emergency Department (ED).
At New Cross Hospital from January to April 2023 there were 252 early pregnancy losses (under 16 weeks) recorded on the wards. Data from RWT Midwives was approximately 110 (post 16 weeks) for the whole of 2022.
“The team is incredible,” said Emily. “We provide a lot of physical and emotional support – for example sometimes women have an ectopic pregnancy, it’s ruptured one of their fallopian tubes and that’s where their life is at risk.”
A mum herself to 20-month-old son Max, Emily supports 35 women per month on average but she is unable to see everyone, as some might have been discharged straight from ED, or they are not always referred, or they decline support.
“I contact every lady who’s been treated in hospital for a loss within three to five days of discharge and I get an 80 per cent uptake,” she said.
Emily was the only person in her role in the country for three years until last year, when she was joined by three more.
“I live and breathe the role, I’m very passionate about it and I’m very keen to influence other hospitals,” she said.
Emily has a mixed caseload. Some suffer an early loss – five to six weeks – and others are termed later losses, from nine to 16 weeks. Some might be mums prior to losing a pregnancy.
There are ectopic pregnancies (baby growing outside of the womb) which tend to be up to eight weeks but can be life threatening, and referrals where the baby’s heart has stopped, detected at the 12-week scan, despite experiencing no symptoms.
“With classic missed miscarriages, the shock hits them pretty hard,” said Emily. “That could bring on Post Traumatic Stress Disorder (PTSD) for future pregnancies and that’s why the support is so important.
“A lady who lost her first baby and gets pregnant again might come back to me because she’s now terrified, so I counsel her through to her 12-week scan again.”
Emily added: “If the baby has no heartbeat but it’s recognisable and the lady has no symptoms, we start labour and I’m here with those ladies throughout to try to make them as comfortable as possible.
“I’m also here for those who will go through labour – knowing the baby has no heartbeat – to support them.
“Ninety-nine per cent of parents want to spend time with their babies afterwards and I have mini Moses baskets for them. Some are so distraught they don’t want to see the baby but might change their minds so I arrange for that to happen at a later date.
“Memory making is shown to be really important in recovery, so we have memory boxes with teddies etc, I use the term baby with them, give them blankets and support them to make funeral arrangements if appropriate.
“A big focus is once they’re home because it’s easy to hide behind the physical side of things.”
Emily is in high demand and she added: “I do a lot of steps! I also do teaching sessions on the wards. The biggest advice I give is to acknowledge the loss.
“We have an open conversation – it’s OK for ladies and their partners to be angry and/or sad, but communication is key. I say ‘I’m so sorry for your loss. Talk to me about how you feel.’”
Emily has been qualified six years after being drawn to Gynaecology patients during her training at RWT. She was previously a Healthcare Assistant in a private hospice.
She is also part of a charity established by RWT Midwifery staff called Looking After Parents and Siblings (LAPS) which raises money to support families who have lost babies.