Hamilton Health Sciences (HHS) midwife Spencer Sawyer could be the first hospitalist midwife in the country to specialize in bereavement support for patients during and after a pregnancy loss. Hospitalist midwives work in hospitals, providing direct care to patients during their pregnancy, labour and delivery, and postpartum.

“To my knowledge there are no other dedicated bereavement midwife roles across Canada,” says Sawyer, who cares for patients at HHS McMaster University Medical Centre (MUMC). Located in the same building as HHS McMaster Children’s Hospital (MCH), MUMC is the regional referral centre for high-risk pregnancies and deliveries, handling among the most complex cases in the province. 

“Many high-risk pregnancies benefit from the leading-edge, innovative work by our maternal-fetal medicine team, including our incredible physicians, nurses, and nurse practitioners who often prevent high-risk pregnancies from resulting in loss,” says Sawyer. “But sadly, in some cases, a pregnancy loss is unpreventable.”

The hospitalist midwifery team saw an opportunity for a bereavement specialist in addition to services already available to patients experiencing pregnancy loss. Sawyer felt passionate about taking on that role, and worked with departments including maternal fetal medicine, prenatal diagnostics, labour and delivery, and post-partum care to develop this specialized portfolio of work.

He’s also exploring best practices through research, by pursuing a master’s of midwifery degree part-time at McMaster University. His master’s project, focusing on the specialized role of a bereavement midwife, could pave the way for this position to be introduced at other Canadian hospitals.

“My goal is to grow and improve what we’re doing already for the benefit of other midwives interested in this specialty,” says Sawyer, who joined HHS in 2022. His position is funded through the province’s expanded midwifery care model. 

Bursary supports master’s project on bereavement midwifery

While hospitals overseas, mostly in the United Kingdom and Australia, employ bereavement midwives, the role has yet to find a significant foothold in North America.

A scoping review published in the Canadian Journal of Midwifery Research and Practice in 2023 helped outline the role midwives could play in providing this care, says Sawyer. The review, by the school of nursing at Thompson Rivers University in British Columbia, highlighted the unique role of bereavement midwives in improving bereavement care in pregnancy loss. 

Sawyer hopes to eventually have his master’s project made publicly available to further share the benefits of this specialty. He’s grateful to the HHS Volunteer Association (HHSVA) for awarding him a bursary to do his master’s.

“The HHSVA bursary made it much easier for me to pursue my master’s degree while at the same time developing this role both academically and professionally,” says Sawyer. 

The HHSVA is a non-profit organization that supports patient care at HHS through the operation of cafes, cafeterias, gift shops and hospital parking. All profits generated are donated to enhance patient care. This includes providing educational opportunities for staff so they can deliver the very best patient care. 

“We take great pride in our partnership with HHS in helping to support the delivery of excellence in patient care,” says Tracy Rivers, the HHSVA’s executive director.

“It’s a driving force for our team, and our customers can feel proud knowing that their purchases help raise funds for equipment donations and staff education support, such as health professionals’ bursaries to support some incredible work and studies like Sawyer is pursuing.”

Compassionate care 

When patients receive news that they are losing, have lost, or may be presented with difficult decisions about their pregnancy, Sawyer consults them about their options, provides support, and connects them to other members of the HHS health-care team including genetic counsellors, neonatal specialists, social workers, nurses, psycho-spiritual care providers and the quality of life and advanced care team. 

“These teams provide vital patient support and are the foundation that makes my role possible,” says Sawyer, who’s also available to patients in the postpartum period for clinical care, and as a resource and support person. 

Unique concerns

As a clinician, Sawyer can provide answers to many questions patients may have related to their unique set of circumstances. 

For example, patients and family members are often unsure how to engage with their baby after delivery. “Research suggests that for many families seeing, holding, and making memories with their baby can help them engage with and process their loss, and I can provide them with that evidence-based information, while exploring whether the evidenced-based approach resonates for each individual family,” says Sawyer.

They also often wonder what their baby will look like, and Sawyer can apply the clinical information about a loss to sensitively help families anticipate what it might be like to meet and see their babies. Other niche information includes letting patients know about medications to suppress lactation and explaining parameters for post-partum bleeding so they can assess their own wellbeing more accurately. He’s also available, on call, to answer questions, provide emotional support, and connect them to other HHS health-care professionals.

Inspiring role models

Sawyer was inspired by family members to pursue a career in health care. He spent most of his childhood living with his mother, who ran a single parent household while putting herself through nursing school. “I would help her study, which peaked my own interest in health care,” says Sawyer, adding that his grandmother was also a nurse, in the neonatal unit.

After joining HHS in 2022, Sawyer found himself assisting with some of the more challenging pregnancies, offering emotional and social support, and helping some families navigate loss. 

“Growing up with such strong role models, I really strove to be a helper, and my work as a bereavement midwife fills my cup in a way I never anticipated.”

Sawyer adds that he’s grateful to his colleagues, mentors and managers for supporting his work and contributing to his growth and development as a midwife. “As my work here at MUMC continues, I’m committed to expanding pathways for a greater diversity of midwives to have the opportunities to work in highly impactful, innovative ways.”