Pregnancy and infant loss are deeply personal and devastating experiences. Unlike other types of loss, they often go unrecognised in society. As healthcare providers, it's crucial to validate the pain and grief of these families, regardless of gestational age. Acknowledge their loss and recognise that their baby was a person they deeply loved.

Early losses are sometimes perceived as less significant than later ones. However, even the earliest pregnancy losses can be profoundly challenging due to early parental attachment. Additionally, you may not know the couple’s full pregnancy history—perhaps they have endured several previous losses or have been trying to conceive for years. There is no right way to grieve such a loss, so allow the family to grieve in their own way.

When supporting a family who has experienced stillbirth, remember that this is their experience, not yours. Even if you have faced a similar loss, it's essential to focus on them and recognise that each loss is unique. It's appropriate to say, "I'm so sorry. I had a similar loss, and I am here to guide you through this." Whether or not you have experienced perinatal loss, avoid sharing your opinions or advice unless asked. Be mindful not to impose your values or beliefs on the family, as everyone grieves differently.

It's okay to cry with your patients, but if you feel overwhelmed, quietly excuse yourself until you can regain composure. If you are unable to provide compassionate care for any reason, communicate this to your charge nurse or supervisor. Every woman, especially those facing such a tragic loss, deserves appropriate and respectful care.

Key highlights of compassionate care include:

• Acknowledge the loss
• Use the baby’s name
• Validate the familial roles - refer to parents as the mum and dad
• Validate emotions - let parents know that their emotions are valid
• Be present - Let the family know you are available to talk, listen, or just sit with them in their grief.  Make sure that the family has your full attention.
• Be empathetic
• Be respectful - Be mindful of the words you use.  It is important to use language that is clear and easy to understand.  Avoid using medical terminology whenever possible.  Respect the family’s choices regarding viewing, holding, or taking photographs of their baby.  Provide them with the information, discuss their options, and support their decisions.
• Be culturally competent - Be sensitive to the family’s cultural and religious preferences.  Different cultures and religions have varying customs and rituals related to pregnancy and infant loss. Taylor your care considering the needs, preferences, and cultural or religious background of your patients.  When in doubt, ask!
• Be patient - The family will have many difficult choices to make in the next few days.  Be patient, these are huge decisions. Allow the family some time to absorb the news of their loss.
• Provide privacy - Many families need some time along to grieve and process their emotions.  Ask them for their preferences, then allow them the space they need. It is a good idea to provide a pen and notepad so they can write down any questions they have.  Make sure that the family knows when you will return, that you are available, and how to get ahold of you should they need you sooner.
• Take care of yourself - Finally, remember to take care of yourself.  You can’t take care of others if you don’t take care of yourself.  Providing care to families experiencing pregnancy loss can be emotionally taxing.  It is important to take care of yourself physically and emotionally to avoid compassion fatigue.  Sharing your experiences with your coworkers who have experienced similar experiences can be therapeutic. Visit our Clinician Wellbeing page.

To take our free eLearning module on Language and Communication. This module will provide you with a better understanding of how to communicate with bereaved families

Women experiencing stillbirth may require extra care and attention. Ensure her basic needs, such as food, water, and comfort, are met. Consider asking dietary services to provide a comfort cart with snacks and beverages for the patient and her family. Make it easy to stay hydrated by frequently refreshing her water pitcher.

Physical pain may be more intense for women experiencing perinatal loss. Ensure her pain management needs are addressed. After delivery, encourage the parents to shower and rest when needed. Keep tissues handy as there will be many tears, and offer washcloths or face wipes for her comfort. Remember to also attend to the needs of the spouse or partner, giving them privacy but checking in frequently.

The loss of a child is a deeply emotional and traumatic experience for both parents. Partners often feel the need to be strong for the mother and may be overlooked. Provide compassionate care to partners and include them in decision-making as much as possible.

Siblings can grieve deeply after a stillbirth. While personal opinions may vary, it is ultimately up to the parents to decide how involved siblings should be. Experts recommend giving children the option to meet or hold the baby, as they are best able to determine their readiness. Forcing a child to participate in something they are not ready for may cause more harm.

Grandparents grieve the loss of their grandchild and the heartbreak their own child is experiencing. Include them in the process and encourage them to interact with the baby.

Ensure the patient has the option to have extended family members, friends, or support persons present. For some families, the presence of loved ones provides comfort and reduces the sense of isolation.

For a list of resources for all the family refer to our Grief Resources page. 

Discovering a fetal heartbeat is absent while caring for a pregnant patient is a distressing situation. Respond quickly and compassionately with these steps:

1. Be Honest: Inform the family about difficulties in finding the baby’s heartbeat.
2. Explain Next Steps: Describe the next actions, such as having a physician perform an ultrasound.
3. Provide a Timeline: Let the patient know when you will return and adhere to this schedule.
4. Communicate Gently: Deliver the news clearly but gently. Be prepared to answer questions.
5. Provide Privacy: Ensure the family has a quiet space to process the news, and offer a pen and notepad for them to write down questions.
6. Explain What to Expect: Share information about upcoming medical care, tests, or procedures to help lessen the trauma.

To learn more about language and communication, refer to our free eLearning modules.

Families experiencing miscarriage, stillbirth, or neonatal death may not absorb all verbal information. Providing both written and verbal information:

• Improves understanding by ensuring a comprehensive grasp of the situation.
• Promotes informed decision-making regarding testing, funeral arrangements, and other care aspects.
• Accommodates different learning styles.
• Provides repetition, which is important as grief can impact concentration and focus.

Ensure the physical environment is peaceful, private, and comfortable for the family. Avoid high traffic areas and rooms near the nursery. Keep the room at a comfortable temperature, and use dimmed or natural lighting to create a calming space. Ensure tissues are available and inform ancillary staff about the patient's situation discreetly.

Whenever possible, provide continuity of care. This allows the family to develop a trusting and supportive relationship with their nurse or other healthcare provider. Trust and familiarity facilitate open communication and a sense of safety. Ideally, the nurse caring for a family experiencing perinatal loss should not have other assignments.

Families experiencing perinatal loss often need more support than the nurse or physician can provide. Offer referrals for special ceremonies, spiritual support, social workers, and other resources. Connect them with local or virtual support options for perinatal loss.

Anticipating a stillbirth is emotionally draining. A birth plan helps grieving families feel more in control and outlines their options. Let the family know there are no right or wrong decisions, and respect their choices.