‘I planned to have a water birth in my local hospital. I was convinced that it would all go perfectly. I skipped the caesarean chapter in my birth book – in fact, I think I skipped a lot of chapters – and the birth was a maze of confusion. I never expected it to be so long, so hard or so lonely. The minute the interventions started, my birth plan went out the window and I sort of gave up. Tao was born by caesarean and I’ve never really understood why.’
JUNE (28) MOTHER OF TAO (1)
It sounds like a contradiction in terms, but it’s possible. It’s what this book is about, really. You have to inform yourself realistically about birth (Chapters 2, 5, 6), defuse your fears (Chapter 3), understand your preconceptions (Chapter 3), understand your options (Chapter 5), choose and prepare your birth partner(s) (Chapters 8, 9) and write a meaningful birth plan. In this chapter we show you how to write a Blooming Birth Plan: one that can actually help you cope when the unexpected happens; one that will get you through the whole birth, not go out the window when you hit your first speed bump.
There is – to put it mildly – a significant gap between our expectations of childbirth and what actually happens (particularly first time around). In one survey1, 45 per cent of mothers agreed in advance that ‘giving birth is a natural process that should not be interfered with unless absolutely medically necessary’. Virtually all of them had some kind of medical ‘interference’ on the day.
The unpredictability of birth is, however, the one thing most doctors and midwives agree on. ‘A first labour is like setting off to Scotland from London without a map or a car,’ says consultant obstetrician Jayne Cockburn. ‘Your womb has not done it before and you just have to find a way to roll with this on the day.’ No matter how swotty you are about preparing for this birth, you’ll never be truly prepared until you have accepted that your plans might be scuppered by a baby that lies in the wrong position, waters that break too early or a labour that just doesn’t kick off. There are few things more disconcerting than expecting the birth to go in a certain way, then finding yourself haring off down some alien, unknown, painful route that you don’t understand and can’t control. Many of us lose it when this happens: we’ve been so focused on what to expect that we’ve failed to realise we should expect the unexpected.
You may be nodding nervously right now, saying to yourself: ‘Right. Fine. I’ll expect the unexpected.’ But how will you do this? Really? The best way is to draw up a meaningful birth plan – a Blooming Birth Plan. You can start working on your plan as early in the pregnancy as you like, but the process will probably be most effective when you’ve done a few childbirth classes and the Herculean task of getting that baby out is starting to look decidedly real. This will probably be during the last three months or so of your pregnancy, when your worries are more concrete, and you learned more about how to handle them. A Blooming Birth Plan can help close this expectations gap and defuse your last fears.
If you’ve reached the stage where you view childbirth as normal, healthy and manageable this is superb. Confidence is a huge asset for any woman facing the delivery room. But it has to be confidence rooted in realism. Just assuming that the birth will be a joyous epiphany is not enough. You might, for instance, have weighed up your options and decided to give birth anaesthetised to the eyeballs. But what happens if you get to hospital and the anaesthetist isn’t available? What happens if you have to wait two hours in hard labour until you get that epidural? If you only have Plan A (nuclear pain relief), and Plan B (a range of pain coping methods) is called for, you might be in trouble. Your Blooming Birth Plan will contain – in very general terms – your Plan B. It’s your overarching plan for how you’ll cope – generally – with whatever childbirth throws at you.
BIRTH REHEARSAL
A few weeks before their due date, midwife Jenny Smith takes her mothers-to-be through a ‘rehearsal’ of the birth, in a delivery room. ‘I spend a half hour or so with the woman in a delivery room before the birth,’ says Jenny. ‘This way she can visualise, more clearly, what labour will be like, and explore what would happen if the birth is not straightforward. You can try asking your midwife to do this with you: if you have done this, you will be far less worried should things not go smoothly on the day.’
Pretend it’s labour:
‘When eight women from our antenatal group met up with their babies, not one had experienced a delivery that went according to plan…Second time around, I didn’t make a plan, and just hoped that the baby would be delivered vaginally…. .If I’d written a birth plan, it would have been sheer fantasy.’ Journalist Fiona Gibson, in ‘Birth Plan: You’re joking?’ an online article.2
Breathe the words ‘my birth plan’ in front of an experienced mother, and you’ll probably encounter anything from a raised eyebrow to naked derision. First time around most of us write a birth plan because our childbirth teacher tells us to. At a bit of a loss, we write, in essence, ‘I’ll just see how it goes’ (translation: ‘please pretend to consult me, then make my decisions for me’). Because most birth plans are distinctly Utopian. Most of us don’t write a birth plan that goes: ‘I’ll have a forceps delivery with some blood loss.’ But this does happen and when it does, few of us have really thought about how we’ll cope.
You’ll also hear that ‘no one reads a birth plan’. This isn’t strictly true. A good midwife or obstetrician will. They’ll even try to read between the lines to interpret how best to care for you when ‘challenges’ crop up. But you can’t bank on this.
You should do this because the process of writing one can be immensely useful – for you. Even if you put your plan straight in the bin once complete, it would still be worth doing. In your non-gestational life, worry and pessimism are usually negative things but in pregnancy they can be really productive – if you tackle them constructively. Julia has seen many of her clients transform their worries into action while working on their birth plan:
‘Lorraine was a 44-year-old first-time mother who worried obsessively about having a forceps delivery. She researched and took really good care of herself during her pregnancy, but the worry didn’t go away. Working on her birth plan made her realise she had to speak to an obstetrician to tackle this lingering fear. The doctor mentioned her age six times in five minutes. He said a woman her age should be worried about many things as well as forceps (he gave her a list ranging from Down’s syndrome to caesarean rates). After this meeting Lorraine swapped to a different hospital and a new obstetrician she felt understood her needs more. Her healthy daughter was born without the help of forceps or surgery. Lorraine’s birth planning had led her in the right direction. The process can help you really zoom in on a worry, and can lead you somewhere you need to be.’
A BLOOMING BIRTH PLAN – OR, MORE ACCURATELY, THE PROCESS OF WRITING ONE – CAN:
Really, ‘plan’ is a misnomer. A Blooming Birth Plan should really be called a ‘strategy’. Instead of a task where you sit down for ten minutes and list the elements of your Utopian birth, then gripe afterwards about how pointless that was, think of it as a work in progress. It might take weeks to complete. It might change as you get nearer the birth, or as you find out more (about your options, fears, inclinations, or your pregnancy). The resulting document will be a brief but overarching strategy for how you’ll cope during childbirth, not a shiny list of best-case scenarios. It will be flexible, succinct and most of all will answer this crucial question: What will I do if this birth does not go the way I want?
We’ve divided it into four steps. But really, it’s a process. You dabble in it. Think about it. Talk about it. Read. Research a bit more. Have another go. Leave it. Then come back to what you did before.
STEP 1: FACE YOUR WORST CASE SCENARIO | You need to get to the stage where your worst case scenario is no longer the threatening Yetti that it is now. Whatever it is – and yours will be uniquely horrifying to you – you need to look the beast in the eye and work out how you will overcome (or at least cope with) it.
How to do this:
STEP 2: IMAGINE YOUR DREAM SCENARIO | Step one probably didn’t take you much time: you should by this time know those demons pretty well. Now you’ve got to work out your Utopia: the kind of birth you’d really dream of having.
How to do this:
When I did this exercise with Julia, before Sam was born, I found myself imagining giving birth in a stable – a place I associate with security, warmth and safety. Of course, in real life I have no desire to give birth like something out of the New Testament. But that equine moment told me a lot about my fundamental inclinations: I knew I’d cope best if I was allowed just to get on with it, safely but without any scary hospital equipment up my bum. When Julia asks her clients to do this bit, they often list: being outside, being left alone (but feeling supported), being surrounded by women, having a fast labour. The vast majority of her second time mothers dream of giving birth at home or in water. One client, on the other hand, said a planned caesarean would be her ideal.
STEP 3: START SHAPING YOUR PLAN | Look at your two lists. They may seem insanely different, but what actually happens to you on the day will probably lie somewhere between the two.
Worst case:
Dream birth:
Now you start your first sketch of your plan, using these two lists. Take each fear from the Worst case list and work out what you are going to do about it. What have you done that lowers the chance of it happening? What will you do to cope if it still happens? As you do this, bear in mind how you will keep the feeling of your dream birth.
Here’s an example of a first sketch, using the two lists above:
BIRTH PLAN SKETCH
STEP 4: MAKE IT A DOCUMENT | Now distil your final plan into a succinct ‘public’ version that fits on one side of A4 and covers all your most important points. You will take this to the hospital and this is the version the midwives will read (see ‘Your Blooming Birth Plan: a template’ below).
A WORD OF CAUTION…. | Working on your plan might be tough, particularly if you’ve had one difficult birth (and are scared silly of repeating it). When I was Julia’s client, I was so neurotic about having unnecessary interventions (including another caesarean) that even the thought of examining this for my birth plan had me in tears. Julia insisted that we isolate the elements that were frightening to me, then work out a plan for what we’d do about each one. This would, she said, stop the bad scenario being so frightening.
I was sceptical, but made myself break down, in a long email to Julia, the things that scared me most and what I was going to do about each one. By the time I hit the send key my fears were under control. I’d broken down my anxiety into specifics; reminded myself what I was doing to stop each one happening again, and planned how I’d cope with each if it did. This was the point at which I felt ready to handle Sam’s birth whatever happened. With Ted, the process was much less detailed. I had far fewer fears and much more confidence. How much energy your planning takes will depend on all sorts of things. But if you are really anxious, you too may need a bit of help. Go through your worries AGAIN with your midwife, re-read any relevant bits of this book and do more research for yourself, using the information found at the end of each chapter. Knowledge, when it comes to childbirth, really is power.
This process should get you on the way to creating a birth plan that really means something to you. The next challenge is to get the people who are caring for you to read it.
FIVE TIPS FOR A BIRTH PLAN THAT WILL BE READ
During labour, medical interventions can become genuinely necessary – often with little warning. Your plan can help you handle this. It can also help your medical team to have a ‘flavour’ of your inclinations, fears and desires for this birth, no matter what happens. If your midwife, and whoever else is with you at the birth, know that you are particularly anxious about a specific event, then – should this actually happen – they’ll be aware that it’s your nightmare. They’ll be able to talk you through it, explain the process and reassure you that it is best for your baby, and you. This way, instead being plunged into your heart of darkness (the Horror!), out of control and scared, you’ll be walked through it step by step, retaining some sense of control.
Here (and on www.bloomingbirth.net) are a handful of birth plans used by Julia’s clients.3 (Remember, the process is more important, if anything, than the final result.)
SHORT AND SWEET (WRITTEN ON A 3x5 CARD) | LaKenya and Adol I’m LaKenya Bollen, 22 years old, and this is my first child. I have no great fear of pain, so please don’t offer me medication unless I ask for it. However, if an epidural is necessary I would like it to be mobile if possible. I will be supported by my husband and doula during the labour and birth. I would like to eat through labour, move around as I like and deliver where I choose. My baby will be set right on me, skin to skin with no cleaning, and I will breastfeed immediately if at all possible. Thank you.
‘LaKenya’s plan represents a long process of learning about birth and opening her mind to various possibilities. When she began to work on this plan, the only image of birth she had was one where she’d be anaesthetised with feet in stirrups, surrounded by doctors in masks. This scared her. She worked with me to isolate what she wanted for this birth and, by the end, had pinpointed the things that were most important to her. For instance, her older sister was not encouraged to breastfeed right away and regretted it, so LaKenya picked this out as a concern. Her labour took about 14 hours and was tough but triumphant: for the first part she moved, ate (until she didn’t want to), drank and stayed upright. Later, she had a mobile epidural. She delivered the baby sitting on her hospital bed and was delighted by how the birth went. Her baby fed within the first two hours (with great help from the midwife).’
BUSINESS-LIKE AND TO THE POINT | Polly and Kashen
‘Polly is a lawyer. This was her whole birth plan. But it said a lot about her. She’s not overly emotional, and had a rough time with the pain of her first labour. She also had a haemorrhage after that birth, so decided to have a ‘managed third stage’ this time (an injection to speed delivery of the placenta, which can reduce risk of haemorrhage). She chooses to have an epidural once labour is established, but makes it clear that this will not be an open door for other procedures. She’s active in this birth plan, there is room for change and even though it’s brief, it’s not defensive or off-putting. Polly agreed to have her waters broken when things were not progressing very well at the start, and labour then took hold quickly. She ended up without an epidural (she actually refused one when offered). Her pushing stage was challenging but she coped very well, deciding against an episiotomy when she was offered one. She pushed out her 9lb 100z son on a birth stool and says she felt she controlled what she could, and was able to relinquish control when she needed to.’
LONGER AND MORE EMOTIONAL | Kari and Allen
We do not believe that birth is a medical condition: Kari would like to give birth without unnecessary noise, distraction or invasion of privacy.
We agree to remain flexible about the birth of our son. We will stay at home as long as possible having notified you (hospital 24-hour phone number) that Kari is in labour. Our doula Julia (phone number) will be with us at home (back-up doula is:name/number). The maternity unit has already cleared use of a birth tub that we will bring with us.
Kari will be supported by Julia and Allen. Kari handles the unknown best if she can be as informed as possible. If you feel that intervention is necessary, those interventions are to be discussed as thoroughly as time will allow. She would like to be made a central part of the decision process, and should that not be possible, Allen and Julia will be her spokespeople.
Here is a list of Kari’s desires:
If it is a caesarean birth: Julia and Allen will accompany Kari throughout the birth and, if possible, the baby is to be put on Kari’s chest skin to skin immediately after he’s born.
‘Kari’s original birth plan was seventeen pages long and very, very inflexible. She quoted authors, used statistics and told stories of her childhood. That was a good start, but definitely not a final birth plan. Kari and I went through those seventeen pages and saw that she was really just concerned with privacy and control – very common. She had been sexually abused as a child, but had had years of counselling, and her midwife was fully aware of her history. The four pages about her sexual abuse history from her first birth plan became one clear line about vaginal exams in her revised plan. It took us two hours to get her bullet points down to fewer than 20. As with most survivors of abuse, having good support during the birth was crucial. Kari made sure her husband and I (and her back-up doula) would be there to remind her she was safe.
Her line about being flexible was to remind herself not to be rigid, as she had been in the first mammoth birth plan. In the end Kari’s labour was extremely short (three hours!). She went to hospital after only half an hour in labour at home as it was plain that things were progressing very fast. She delivered her son with the midwife, Allen and me in the room. She didn’t use music or aromatherapy and the birth tub never made it out of the boot of the car. She said the pain was more intense than she’d imagined, but the birth was more amazing than she’d ever hoped it could be.
YOUR BLOOMING BIRTH PLAN – A TEMPLATE
This is just a suggestion for your final version. You certainly don’t have to format your plan this way, there’s no standard. The birth plan checklist, below, will jog your memory as you write.
Names (yours and partner)……………………………………………
Brief statement (sentence or two) about your general wishes, or greatest hope, for this birth
Here is a list of ‘issues’. Remember it’s your plan – no one else’s. Do NOT include everything in this list – that would be deranged – just look down it and pick out the points/issues that matter to YOU. Go back to Chapter 5: Your Options for a reminder if you’re unclear about anything.
LABOUR
PAIN RELIEF
PUSHING STAGE
THIRD STAGE (DELIVERY OF PLACENTA)
IMMEDIATE POSTPARTUM
IMMEDIATE BABY CARE
Sometimes your baby just does need help to be born: anything from an episiotomy to a caesarean (see chapter 5, page for information about possible interventions). Accepting this, wholeheartedly, is the biggest step you can take towards coping should it happen. Get your birth partner to read the tips below: when an unwanted intervention happens, your birth partner is your lifeline.
SIX WAYS TO DEAL WITH UNWANTED MEDICAL INTERVENTIONS
Julia planned to have her first baby, Keaton, at home. She had a long and painful labour, transferred to hospital and finally had a forceps delivery. But Julia’s midwife Kim gave her just this kind of support as each unexpected event cropped up: ‘It was very powerful. Knowing I wasn’t being left alone and that someone was acknowledging the change in plans got me through each unexpected thing that Keaton needed during his birth: the hospital transfer, my epidural, the syntocinon drip, forceps, episiotomy and antibiotics for Group B strep. Kim helped me feel that each intervention was what Keaton needed, and that I couldn’t do anything more than I had done to change this. She gave me a lot of reassurance afterwards too. If a medical intervention is really necessary, and a woman has had all her questions answered, this kind of reinforcement can make an otherwise shocking experience entirely manageable.
If your birth takes a turn for the unexpected, it’s vital to be communicating well with the hospital staff. The last thing you want is people patronising you while your feet are in stirrups. And you don’t want to be wasting valuable energy arguing or feeling affronted when you’re moments away from another contraction.
You’ll cope best in labour if you:
You can’t rely on the staff to make this happen. Many will bend over backwards to accommodate and respect you but some may not. No matter what you hear about ‘informed consent’ and ‘patients’ charters’ and ‘woman-led care’ you’re still going to be attended by real human beings who get tired, hungry, frustrated, grumpy, bossy and impatient. If it is a genuine emergency, there may be little time for niceties: you have to accept that these people are doing all they can for you and the baby and you must focus your energy on staying calm and getting through it. But if it’s not a dire emergency, there are things you can do to change any dodgy dynamic. This way, you’ll have a better chance of handling the unexpected, rather than becoming a victim of it.
As soon as you notice yourself feeling bullied/disregarded/bossed by staff, you and/or your birth partner can become (politely) more assertive.
FIVE TIPS FOR BETTER COMMUNICATION WITH HOSPITAL STAFF
‘I got the impression that there was a power struggle going on between the doctor and midwife. At one point they were literally arguing over my bed about what was best for me. I was so disempowered and never felt that I could make any decisions of my own despite a good degree, career and birth preparation.’
ADRIANNE (28) MOTHER OF HEATH (1)
Homebirth expectations run high. You picture the romantic bits: giving birth to your baby on the bed in which he was conceived – a natural, pain-dimmed, aromatherapied dream. Homebirth can be a uniquely satisfying experience but to suggest that it’s the ‘best’ way to give birth, puts considerable pressure on us all. Many women think that if they’re going to have a homebirth they don’t need a birth plan. This is a big mistake. Homebirths do – fairly frequently – end up becoming hospital births. If this happens and you’ve not considered it as a real possibility, it can feel like a traumatic disaster.
This is certainly Julia’s experience with Keaton:
‘I expected to give birth to Keaton in my bed and was so wedded to this that I was actually afraid to leave it in labour. I didn’t: until I had to be transferred to the hospital. Family called to hear just as much about “where” he was born as how we were both doing. Those who knew we transferred to hospital were frantic with worry. A relative of mine actually said: “Ha! You thought you’d be able to birth at home! I told you couldn’t! Bet you won’t try that nonsense again!” With Larson, though I planned a homebirth, I also had a plan for how we’d transfer to hospital if that was necessary. I didn’t get hung up on where he’d be born.’
It’s vital, then, to plan how you will cope with pain (and anxiety) during any transfer, and how you’ll deal with labour – and any medical interventions – once there, including how you’ll cope with a caesarean.
My approach to Ted’s birth was ambiguous. I was never obsessed with homebirth per se, but the idea appealed to me because my main fear was, again, unnecessary interventions. But I had to weigh my gut feelings against my desire for medical safety. In the end I decided to see how labour progressed. My community midwives were extremely encouraging and flexible about this. I got all the homebirth equipment, but also packed my hospital bag and planned how a hospital birth would be. In the event, labour went smoothly: I had a few contractions and called Penny, an experienced midwife, the head of the community team, who was fully aware of my neurotic debates. She came, I went into the living room with her and John, leaned on my birth ball and stayed there until Ted was born a couple of hours later. It didn’t occur to me to go anywhere else and Penny monitored us both carefully throughout. If we’d have gone to the hospital, I know this would also have been fine – because it would have been the right thing to do.
A WORD ABOUT PAIN AT HOME | The other homebirth myth that’s worth debunking here is that it’ll somehow be pain free. It won’t be. I actually found the pain of Ted’s birth the most intense of all three of my babies. But if you are well prepared for it, feeling safe and having reduced your chances of needless intervention, you can certainly cope better with the pain, and will probably have a more positive attitude about it afterwards (women who give birth at home generally express high levels of satisfaction and certainly, if asked to repeat any of my three births, I’d choose Ted’s).
THINGS TO CONSIDER IN ADVANCE | Talk to your midwife before you are in labour and ask:
PREPARING FOR AN UNEXPECTED TRANSFER
COPING WITH ANY TRIP TO HOSPITAL DURING LABOUR | It can be hard to get into a car and be driven to the hospital when you are having painful contractions even if this is something you were expecting to do. Here are some tips:
It is worth taking just a moment to look this one in the eye (and note the details of BLISS, page below). Although about one in ten babies born in the UK need some sort of special care in hospital, and around one in 50 of these need intensive care, few of us have thought about it in advance. ‘Although none of us like to dwell on the possibility that anything might be wrong with our baby, there is a good chance that you – or someone within your circle of friends – will have a baby who requires some extra medical attention in the first few weeks of life,’ says Eleri Adams, consultant neonatologist at the John Radcliffe Hospital in Oxford.
Here are some common problems that could keep you in hospital longer than you expected.
PREMATURE BABY | This is one of the most common reasons why babies need special care. Babies who are born at 37 weeks gestation or more are considered to be ‘term’, i.e. they are fully cooked and ready for the outside world. Babies born before 37 weeks are considered premature. They may not suck properly, their temperature control may be poor and their lungs may not be quite mature enough. As a general guide, if your baby is born between 34 and 37 weeks then there is a reasonable chance that she might be able to stay with you on the postnatal wards (although this is not always the case) and not need special care.
If your baby is less than 34 weeks she will almost certainly need to go to special care. It can be very tough to be separated from your baby and it is likely to be a difficult and emotional time for you (to say the least).
BABY BORN A BIT TOO SMALL | Some babies who are born after 37 weeks are smaller than they should be (‘growth restricted’) and consequently have fewer fat stores. They may not be able to regulate their temperature well, and may have problems controlling the glucose supply in their blood. Your baby may be able to stay with you in the postnatal ward, but the doctors will probably need to do regular blood sugar checks to monitor her progress.
INFECTION | Infections in newborn babies have many, many causes and the symptoms of an infection can be very subtle. This is why paediatricians generally have a low threshold for prescribing antibiotics (‘just in case’). Usually, they have to wait about 48 hours to get the test results that will show them what, if anything, is causing a possible infection. If the test is clear, and there is no infection after all, the antibiotics can stop and you’ll simply go home as normal.
JAUNDICE | Jaundice may be caused by prematurity, the baby being bruised during birth, infection or exposure to certain drugs you were given in labour. The signs of jaundice are the whites of the eyes turning yellowish and the skin below the nipple line turning yellow. Most newborns will become a little bit jaundiced between day two and day seven of life, so if your baby looks yellowish then mention it to the midwife when she visits. She may take some blood from your baby’s heel to check how jaundiced she is. Sometimes babies will need to be put under blue lights (‘phototherapy’) to reduce the jaundice level. If this is the case, you may have to stay in hospital with your baby for a few days. If your baby is less than 24 hours old and shows signs of jaundice you should call the midwife immediately, as this can be more serious.
A WORD ABOUT THE SPECIAL CARE BABY UNIT (SCBU) | You can’t, of course, prepare yourself for every eventuality. But if your baby needs to go to the Special Care Baby Unit (SCBU) or even intensive care, support and information – for you and your partner – are vital. Detailed information about babies that need special care, whether they are unwell when they’re born or are born prematurely, is of course beyond the scope of this book. However, BLISS, the largest UK premature baby charity, provides free support and information for all parents of babies who need special care: BLISS 68 South Lambeth Road, London SW8 1RL 0870 770 0337 email: information@bliss.org.uk Parent Support Helpline: Freephone 0500 618140 (Monday to Friday 10am–5pm) www.bliss.org.uk.
Many neonatal units also have their own home-grown information guides and there are usually local special-care charities (often run by parents whose babies have previously been in special care), that can give you a considerable amount of support. Ask for details at your antenatal visits if you think you might need to find out more (or afterwards, if it happens unexpectedly).
EIGHT TIPS FOR COPING WITH SCBU | Sarah Kilmartin, mother of Margaret, 18 months, who spent her first 3 weeks in intensive care after developing a lung infection at birth, has these tips:
Most of the resources you need to make up your birth plan are in Chapter 5: Your Options, where we discuss the nitty gritty of birth choices. You’ll also need to prepare your BRAIN using Chapter 3: Fear and Pain, as coping with the unexpected is as much about mental preparation as it is practicalities.
Our website www.bloomingbirth.net has more on how to write your plan.
It is very very rare for your baby to die but should this dreadful event happen you’ll get immediate help and support from the nurses, midwives and doctors involved in your care. There are also a number of organisations which you might want to contact in time.
Stillbirth and Neonatal Death Society (SANDS) Support for parents and families whose baby is stillborn or dies soon after birth. 28 Portland Place, London W1N 4DE. Sands National Helpline: 020 7436 5881 (Monday to Friday 10 a.m.–3 p.m.) www.uk-sands.org
Foundation for the Study of Infant Deaths (FSID) Research into infant deaths, and provides a network of support to bereaved parents. Artillery House, 11–19 Artillery Row, London SW1P 1RT. Helpline: 0870 787 0554 General: 0870 787 0885 Fundraising: 0870 443 6814 www.sids.org.uk/fsid
Child Bereavement Trust Provides leaflets, books and videos for bereaved families. Aston House, West Wycombe, High Wycombe, Bucks HP14 3AG. 01494 446648 www.childbereavement.org.uk
Child Death Helpline A helpline for all those affected by the death of a child. Freephone: 0800 282986
Compassionate Friends Telephone support for bereaved families. 53 North Street, Bristol BS3 1EN. 0845 232304 www.tcf.org.uk
Group B Strep Support Helps families whose babies have been affected by GBS. PO Box 203, Haywards Heath, West Sussex RH16 1GF. 01444 416176 www.gbss.org.uk