Cumulative exposure to pregnancy and neonatal loss can overwhelm coping capacity among NHS staff, particularly those in junior, allied and support roles, who report lower levels of preparation and access to formal support, indicating a need for a proactive multi-disciplinary approach to provide visible and equitable support tailored to diverse staff needs.
Key Findings
Results
Many NHS staff, particularly junior, allied and support staff, felt underprepared for the emotional and communication challenges of pregnancy and neonatal loss.
The theme 'nobody prepared me for this' was identified as one of six major themes from the data.
Lack of preparation extended to both emotional and communication challenges associated with pregnancy and neonatal loss.
Junior, allied, and non-clinical support staff were specifically identified as more likely to feel underprepared compared to other staff groups.
20 purposefully sampled clinical, allied and non-clinical staff from a single UK NHS trust were interviewed.
Results
Staff described reaching a 'tipping point' where cumulative exposure to pregnancy and neonatal loss compromised their resilience and overwhelmed coping capacity.
'Reaching a tipping point' was identified as one of six major themes.
The tipping point concept reflects cumulative rather than single-incident exposure affecting staff wellbeing.
This phenomenon was particularly noted among staff in junior, allied and support roles.
Exposure varied in type, frequency, and intensity across different staff roles.
Results
Peer support was the most accessible and reliable resource for NHS staff dealing with pregnancy and neonatal loss, whereas organisational support was underused despite being valued.
Two themes captured this dynamic: 'peer support versus inconsistent organisational support' and 'reliance on informal support networks.'
Organisational support was described as inconsistent despite being valued by participants.
Staff relied on informal support networks in the absence of consistent formal support.
The underuse of organisational support was identified as a key gap in the current support landscape.
Results
Bereavement team and multi-disciplinary support were identified as buffering the stressful effects of exposure to pregnancy and neonatal loss.
'Bereavement team and multi-disciplinary support buffer the stressful effects of loss' was identified as one of six themes.
Multi-disciplinary approaches were perceived positively by staff as a source of support.
This finding informed the study's recommendation for a proactive multi-disciplinary approach to staff support.
Results
Staff support needs were heterogeneous, with a 'one size does not fit all' theme indicating that support must be tailored to diverse roles and experiences.
'One size does not fit all' was identified as one of six major themes.
Exposure to pregnancy and neonatal loss varied in type, frequency, and intensity across different staff roles.
The diversity of staff roles included clinical, allied health, and non-clinical support staff.
Findings highlight inequity in access to and appropriateness of current support offerings across staff groups.
Methods
The study used a qualitative reflective thematic approach with semi-structured interviews conducted with 20 purposefully sampled NHS staff from a single UK trust.
Participants included clinical, allied and non-clinical staff.
Interviews were audio-recorded, transcribed verbatim, and anonymised prior to analysis.
Thematic analysis was used, with themes mapped to the study aims.
Purposeful sampling was used to ensure diverse representation across staff roles.
Data collection was limited to a single UK NHS trust, which may affect generalisability.
Discussion
The emotional demands experienced by NHS staff exposed to pregnancy and neonatal loss are inconsistently supported across the organisation.
Inconsistency in organisational support was a cross-cutting finding across multiple themes.
Support gaps were particularly pronounced for junior, allied and support staff.
The study concludes that a proactive multi-disciplinary approach is needed to provide visible and equitable support.
Pregnancy and neonatal loss events studied included miscarriage, stillbirth, termination for fetal abnormality, and neonatal death.
What This Means
This research explores how NHS staff in the UK are affected by their work with patients who experience pregnancy and neonatal loss — including miscarriage, stillbirth, termination for fetal abnormality, and newborn death. Researchers interviewed 20 staff members from different roles (clinical, allied health, and non-clinical support) and found that many felt unprepared for the emotional weight of this work, especially those in junior or support positions who often had less access to training and formal help. Over time, repeated exposure to these losses could build up and push staff past a 'tipping point' where their ability to cope was seriously challenged.
The study found that staff most often turned to colleagues and informal networks for emotional support, rather than formal organisational resources — even though they valued what formal support existed. Dedicated bereavement teams and multi-disciplinary working were seen as helpful buffers, but overall, organisational support was described as inconsistent. Importantly, staff needs varied widely depending on their role and the nature of their exposure, meaning a single standardised approach to support was unlikely to work for everyone.
This research suggests that healthcare organisations need to take a more proactive and tailored approach to supporting staff who are regularly exposed to pregnancy and neonatal loss. Rather than waiting for staff to seek help, visible, equitable, and role-appropriate support should be built into how teams work — with particular attention paid to those in junior, allied, and support roles who may currently be falling through the gaps. Better preparation and more consistent access to multi-disciplinary support could help prevent staff from reaching crisis points in their wellbeing.
Johnson D, Newell S, Family H, Holland M, Westby M, Franks E, et al.. (2026). Examining the mental health support needs of NHS staff exposed to patient pregnancy and neonatal loss: A qualitative study.. PloS one. https://doi.org/10.1371/journal.pone.0358321