The third edition of the Sands (Stillbirth and Neonatal Death Charity) Guidelines will be published in June 2007. This article discusses some of the issues that are covered. These are: The current debate about whether parents should see and hold their baby following a stillbirth or late miscarriage and the principle of choice. The increased risk of perinatal mortality in some minority ethnic groups and the need to provide culturally sensitive care and professional interpreters. The importance of recognizing and meeting the needs of bereaved fathers. The Human Tissue Authority Codes of Practice and asking for consent for post mortem examination. The experience of women having a mid-trimester miscarriage and whether they should be cared for in a gynaecology ward or a labour ward.
In this age of migration, many societies are characterized by linguistic and cultural diversity. Public institutions, such as health care systems, face the challenge of integrating new arrivals, immigrants, refugees or asylum seekers, into the host society. The purpose of this study was to examine how interpreters see their work within the context of the integration of immigrants into the host society (Switzerland) in general, and into the local health system in particular. We investigated the roles that interpreters working in a Women’s Hospital in Switzerland take on and are aware of in their work. The interpreters described four main roles: word-for-word interpreting, intercultural explanation, building patient–provider relationships, and accompanying immigrant patients. An additional cross-cutting theme emerged: interpreters facilitating the integration of immigration. Only the first of these is generally regarded as their “official” role. The interpreters take on the additional roles as necessary during a consultation, in response to the needs of the patient and the health professionals. Further discussion is needed about whether these additional roles should be recognized and promoted as part of their work since they are important and there is no one else to take them on. Interpreters who take on the additional roles related to integration have the potential to be important actors in health care services whose patient populations that are increasingly linguistically and culturally diverse.
The death of a baby around the time of birth is a major catastrophe for parents. Their grief is likely to be profound and long lasting. Many parents welcome the opportunity to create memories of their dead baby and treasure the brief time during which they were able to see or hold him or her. NICE guidance consists of four documents which make different statements about parents seeing and holding their baby. Lack of consistency about an important aspect of practical care and the potential for choice to be removed, is unhelpful to parents and to the professionals caring for them. Informed choice must remain the overriding principle of care.
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