Stillbirth disclosure and bereavement planning — structured SAQ (15 marks)

(a) Disclosure using SPIKES (6 marks)

One mark for each complete step.[1]

• Setting: confirm diagnosis, private quiet room, sit at eye level, ensure time, ask who should be present and arrange an interpreter if required.
• Perception: “Can you tell me what you understand from the scan so far?”
• Invitation: “Would you like the main finding first, then for me to pause, or would you prefer all the detail now?”
• Knowledge: warning shot, then: “I am so sorry. The scan confirms that your baby has died.” Use short chunks and distinguish confirmed fact from unknown cause.
• Empathy: stop, allow silence, name emotion: “I can see how shocking this is. I am so sorry.”
• Strategy and summary: agree the next immediate step, check understanding, provide written information and name who will return and when.[1][2]

(b) Immediate care and choices (4 marks)

One mark per domain, maximum four.[3]

• Check the mother's physical stability, symptoms, analgesia and immediate mental-health safety; ensure she is not left alone unless she asks.
• Explain that birth is still required and discuss timing and mode without rushing decisions that are not urgent.
• Ask about culture, spirituality and people to contact; use the baby's name if invited.
• Offer seeing, holding, washing or dressing, photography, prints, casts, keepsakes and rituals as choices without coercion; document preferences and revisit once if initially declined.[2][3]

(c) Ongoing support (3 marks)

One mark per complete point.[3]

• Named bereavement contact and booked follow-up to review investigations, questions and recurrence implications.
• Written physical recovery, lactation, grief, partner and sibling resources; primary-care handover and crisis contacts.
• Discuss postmortem and review processes without blame, record outstanding results and exactly how each will be communicated.[3]

(d) Staff support (2 marks)

One mark per complete point.[4]

• Immediate voluntary peer check-in and factual team huddle; identify any clinician too distressed to continue safely.
• Offer supervision, reflective practice or employee assistance; ensure learning-focused review, training and workload support rather than forced emotional debriefing.[4]