Child death review and fetal and infant mortality
Child death review and fetal and infant mortality review teams shape what families carry — often without ever meeting them.
Every review is routine for you. For the family, it was the worst day of their lives.
Whether this review is your fifth or your five hundredth, it may be the family’s first. Your team reduces child and infant mortality by reviewing deaths, identifying system gaps and contributing factors, and recommending changes to community resources, service delivery, and policy. Much of that work happens without the family in the room, and it still determines how their child is described in the record, whether they are contacted, and what changes as a result of their loss.
When your team does conduct interviews, you enter a home during the hardest period of a family’s life. Review team composition, authority, and interview practice vary by state and jurisdiction, but the guidance below applies broadly.
How bereavement affects brain function
Bereavement impairs memory, concentration, and the ability to process and retain information. The people you serve may struggle to absorb what you tell them in the moment. Slow down, keep communications clear, and provide written information whenever possible.
Cultural and religious practices
Honoring cultural and religious practices respects family values and mourning rituals, reduces trauma, and builds trust. Practices vary widely — in the timing of burial, who cares for the body, whether the name of the deceased is spoken aloud, and how long formal mourning lasts. Ask the family what matters to them rather than assuming, and follow their lead.
The language of the record
The words your team uses persist in the record and shape how the death is understood by everyone who reads it afterward. Portions may also reach the family, through published reports, testimony, or records requests. Use “died by suicide” or “died of suicide” rather than “committed suicide,” which frames the death as a crime, and use the child’s name rather than a case number.
Practical Tips
When your team is conducting a review
Approach each review as an opportunity to reduce harm..
Use practices that acknowledge the family’s loss, avoid unnecessary repetition of painful details, and keep interactions respectful throughout the process.
Use the child’s name.
Confirm with the caregiver that you are saying it correctly and ask whether there is a preferred name or nickname. Using the name honors the child and their importance to the family.
Explain the process clearly and confirm consent.
The person being interviewed should understand what the review is, what their participation involves, and that it is voluntary. Participation must never be coerced.
Pace your questions
Keep questions simple, ask one at a time, and speak slowly. Bereaved people need more time to take in a question and answer it than you may expect.
Understand that every interaction is a hallmark memory.
Every contact with the family has the potential to create lasting memories, both caring and painful. Manage each interaction accordingly.
Acknowledge the death and listen.
Giving people room to talk — or not talk — can be a relief. No one expects you to solve anything or to say the right words. There are none.
Do not provide therapy or counseling
Short-term psychotherapy for stabilization and long-term bereavement care should come from licensed professionals. Your role is to review, to refer, and to listen.
Coordinate across disciplines and agencies.
Communicate with the other agencies on your team about the needs and care of the family. Coordination reduces the number of times a family must retell what happened.
Decide who contacts the family, and how.
Families should not receive duplicate or conflicting outreach from multiple agencies. Agree in advance on who makes contact, what they will say, and what the family can expect next.
Ensure the family is referred to a medical provider
Bereavement affects physical health. Newly bereaved parents and caregivers face elevated risk of cardiac events and other conditions, and changes in sleep, appetite, mood, and concentration are common.
Refer families to bereavement care.
Provide a written list of mental health professionals with expertise in bereavement and trauma, including providers who work with children and adolescents. Most people are not ready for long-term engagement for six to nine months following a death, but short-term sessions can help sooner.
Give families basic information about what to expect.
Understanding what is common after a death helps families make sense of what they are experiencing.
When your team is conducting a review
Telling families what the review is for
Families frequently want to know that their child’s death produced something. Many will never learn that a review took place, and some will assume silence means their child’s death was unremarkable.
Confidentiality requirements differ significantly by jurisdiction, and much of what your team discusses cannot be shared. What can almost always be shared is the purpose: that deaths are reviewed in order to identify what failed and to recommend changes, and that their child’s death is part of that record. Where your jurisdiction permits more — a published report, an annual summary, a notification when recommendations are adopted — offer it.
Say plainly what you can and cannot tell them, and do not promise what the process cannot deliver.
Caring for yourself
Taking care of yourself is fundamental to your work and to your long-term health. The effects of sustained exposure to stress, death, and trauma are not only psychological — they are physical. Sleep disruption, immune dysfunction, cardiovascular strain, and cumulative emotional fatigue are occupational realities in roles like yours.
Practical steps matter. Getting enough sleep, drinking water, moving your body, and spending time with people you care about are not small things. Reaching out to a mental health professional is not a sign of weakness. These are acts of professional maintenance. Caring for yourself makes you better able to do your work.
Because review teams carry this exposure together, some of it can be addressed at the team level. Building breaks into long review meetings, providing water, and closing meetings deliberately rather than abruptly are small changes that take little from the agenda.
A few more things to keep in mind
Resources
For grieving people and those who support them
10 Ways to Support
10 Ways to Support a Grieving Person
Bereavement 101
Find a space that suits you and your work.
Community Homepage
Information for professionals who serve bereaved people
