Examining the mental health support needs of NHS staff exposed to patient pregnancy and neonatal loss: A qualitative study.

Abstract

Pregnancy and neonatal loss, including miscarriage, stillbirth, termination for fetal abnormality, and neonatal death, affects a substantial proportion of pregnancies in the UK. Although the impact on patients is well documented, less attention has been paid to the experiences of NHS staff providing care during these events. To explore staff experiences of exposure to pregnancy and neonatal loss, perceptions of available support, support previously used, and needed or wanted. This qualitative study used a reflective thematic approach. Semi-structured interviewed were conducted with 20 purposefully sampled clinical, allied and non-clinical staff from a single UK NHS trust. Interviews were audio-recorded, transcribed verbatim, anonymised and analysed using thematic analysis, with themes mapped to the study aims. Results: Six themes were identified: (1) nobody prepared me for this (2) reaching a tipping point; (3) peer support versus inconsistent organisational support; (4) reliance on informal support networks; (5) bereavement team and multi-disciplinary support buffer the stressful effects of loss; and (6) one size does not fit all. Exposure varied in type, frequency, and intensity across roles. Many staff, particularly junior, allied and support staff, felt underprepared for the emotional and communication challenges of pregnancy and neonatal loss. Participants described reaching a "tipping point" where resilience was compromised. Peer support was the most accessible and reliable resource, whereas organisational support was underused despite being valued. The emotional demands experienced by NHS staff are inconsistently supported. Findings highlight a "tipping point" where cumulative exposure to pregnancy and neonatal loss can overwhelm coping capacity, particularly among staff in junior, allied and support roles who often report lower levels of preparation and access to formal support. A proactive multi-disciplinary approach is needed to provide visible and equitable support tailored to diverse staff needs.