Aman­da For­ti, one of CRANAplus’ remote clin­i­cal edu­ca­tors, fre­quent­ly hears of the chal­lenges health pro­fes­sion­als face in sup­port­ing preg­nan­cy loss in the rur­al and remote setting. 

Red Nose designed the Heal­ing Through Com­mu­ni­ty project to sup­port both clin­i­cians and fam­i­lies through preg­nan­cy loss. 

Amrit Dhillon, Nation­al Project Man­ag­er of the ini­tia­tive, explains, ​“The project is look­ing at improv­ing equi­ty across bereave­ment care for five vul­ner­a­ble pop­u­la­tion groups: First Nations, refugees and migrants, cul­tur­al­ly and lin­guis­ti­cal­ly diverse, young mums and rur­al and remote.” 

“The research con­sis­tent­ly shows these are the com­mu­ni­ties most at risk of expe­ri­enc­ing loss, and least like­ly to have access to the care and sup­port they need. Our aim is to close the gap and make sure no fam­i­ly is left unsupported.” 

Red Nose has cre­at­ed a suite of sev­en short videos to edu­cate clin­i­cians on how to pre­pare for the con­ver­sa­tion, through to how to sup­port those dif­fer­ent pop­u­la­tion groups, han­dover and self-care. Along­side these, there are prac­ti­cal care guide­lines for quick access to key infor­ma­tion and a range of tar­get­ed, patient-cen­tred resources.

Amrit says, ​“We didn’t want to cre­ate resources that would sit on a shelf. Our goal was to devel­op tools that are prac­ti­cal, tan­gi­ble and ready to be used, whether in a clin­i­cal set­ting or as part of edu­ca­tion and train­ing. We’re con­fi­dent that’s exact­ly what we’ve achieved.” 

The project is ground­ed in gen­uine co-design method­ol­o­gy, bring­ing togeth­er clin­i­cal part­ners and com­mu­ni­ty mem­bers with lived expe­ri­ences to share and lead the work. Aman­da has con­tributed as a mem­ber of the steer­ing com­mit­tee as a rep­re­sen­ta­tive for CRANAplus and the rur­al and remote health work­force, and as a sub­ject mat­ter expert in the field of midwifery. 

Amrit says, ​“CRANAplus has been a real part­ner for us in this. Work­ing with Aman­da has been invalu­able. She brings prac­ti­cal, clin­i­cal appli­ca­tion and clin­i­cal edu­ca­tion exper­tise into the con­ver­sa­tion, as well as the deliv­ery and design of resources.” 

Aman­da has embed­ded not only her own knowl­edge, but that of the remote health pro­fes­sion­als she encoun­ters on CRANAplus courses. 

“I talk to our Mater­ni­ty Emer­gency Care and Mid­wifery Upskilling par­tic­i­pants about what they need and what’s impor­tant to them in the rur­al and remote prac­tice set­tings, and then I feed that back through the com­mit­tee in order to devel­op resources that are most appro­pri­ate for the health prac­ti­tion­ers that are work­ing in those spaces.” 

Amrit says it’s been impor­tant to ensure the lived expe­ri­ence and clin­i­cal voic­es remain at the cen­tre of the deci­sion-mak­ing process through­out the whole project.

‘We invest­ed heav­i­ly at the begin­ning in com­mu­ni­ty con­sul­ta­tion,” she explains. 

“For six months we were sim­ply lis­ten­ing, talk­ing with com­mu­ni­ty and peo­ple across dif­fer­ent pop­u­la­tion groups, hear­ing their sto­ries and real­ly under­stand­ing the chal­lenges and bar­ri­ers they faced. 

“From lived expe­ri­ence sto­ries, we learned that peo­ple enter into the health sys­tem in dif­fer­ent ways. Some peo­ple may enter through a mater­ni­ty ser­vice, some ED, some com­mu­ni­ty care. 

“Our aim was to cre­ate a resource that would sup­port clin­i­cal knowl­edge no mat­ter which set­ting you were in, plus also resources that could be accessed at the time, when you step into the room with a patient in five minutes.” 

The feed­back so far has been encour­ag­ing, with a num­ber of ter­tiary hos­pi­tals nation­al­ly already embed­ding the tools, and nation­al frame­works around stillbirth/​perinatal edu­ca­tion inte­grat­ing them as key resources. 

Amrit says, ​“From a clin­i­cal per­spec­tive, they’re see­ing it as valu­able tools that give that cul­tur­al safe­ty lens, as well as see­ing it as an easy, imple­mentable resource.” 

“Then from com­mu­ni­ty, I’ve heard lots of sto­ries from patients and fam­i­ly mem­bers that have seen the videos and say, ​‘I can see myself in that video’. When some­one says they can see them­selves, that just makes me know I’ve done a good thing. 

“It’s been real­ly insight­ful to hear com­mu­ni­ty feel that they can bet­ter under­stand and nav­i­gate that sys­tem that can feel quite complex.” 

Aman­da is grate­ful to now be able to embed these resources into CRANAplus edu­ca­tion to pro­vide remote health pro­fes­sion­als with the con­fi­dence to han­dle sit­u­a­tions in the most appro­pri­ate way, to ulti­mate­ly improve out­comes for families. 

“We know how preg­nan­cy loss can influ­ence the short- and long-term psy­cho­log­i­cal well­be­ing of women and fam­i­lies and how the degree of care pro­vid­ed is impor­tant; how­ev­er, the sen­si­tiv­i­ty, inclu­sion, and cul­tur­al appro­pri­ate­ness of that care also have a sig­nif­i­cant impact.” 

“I enjoy work­ing with Red Nose because their co-design approach is tru­ly inclu­sive, which is evi­dent in the cre­ation of these high-qual­i­ty, evi­dence-based, cul­tur­al­ly rel­e­vant resources. 

“It’s real­ly impor­tant that we do this stuff well.”