It is an unfortunate fact of Irish life that many expert reports die a rapid death following the fanfare of publication. The cycle from investigation to implementation of recommendations is rarely completed.The tragic death of Savita Halappanavar at University Hospital Galway in 2012 led to a raft of recommendations. A welcome response is the publication of National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death. It must now overcome the implementation hurdle.
The standards mark a new beginning for bereavement care for parents who suffer the devastating effects of pregnancy loss or the death of a baby with a fatal foetal abnormality. New support teams in every maternity unit will include staff members who have undertaken specialist education in bereavement care.
Implementation of the new standard has been entrusted to Dr Keelin O’Donoghue, consultant obstetrician and senior lecturer at Cork University Maternity Hospitals. The parents who experience some 500 perinatal deaths each year in the Republic, as well as those who suffer 14,000 miscarriages and the women who undergo at least 3,700 terminations abroad will look to her to ensure an improved perinatal bereavement service is properly funded.
In a letter to The Irish Times Dr O'Donoghue and her consultant colleague Dr Nóirín Russell emphasised the critical point of a need "to balance regard for those for whom continuing a very abnormal pregnancy could result in psychological damage for the whole family, and who travel abroad in secrecy when grieving and vulnerable, with regard for the value of short lives and precious experience of those families who continue their pregnancies".
They also pointed to a deficit in the ability of specialists to make an accurate and early diagnosis of foetal abnormality – the very starting point of an improved service. Neither specialist ultrasound nor foetal medicine services are uniformly available across the State. The new standards must not fail their first test on the grounds of equity.