Reflection: Supporting a Woman Through Pregnancy Loss

Submitted by: Anonymous - Hospital Midwife, Early Pregnancy Unit

What was the nature of the CPD activity and what did you hope to learn from it?

I was working in the Early Pregnancy Unit when Amy (pseudonym) attended for a scan at 10 weeks gestation. She had experienced some light bleeding and was anxious but hopeful. During the scan, the sonographer found no heartbeat—Amy had experienced a missed miscarriage.

I was present when Amy received this devastating news. She broke down, and her partner sat in shocked silence. After the sonographer left, I stayed with them to explain what would happen next and provide support. I felt the weight of their grief and wasn't sure how to provide meaningful comfort during such a traumatic moment.

Through this experience, I hoped to learn how to support women and their partners through pregnancy loss, communicate sensitively about difficult topics, and provide compassionate care during one of the most painful experiences a couple can face.

What did you learn from the CPD activity?

I learned that sometimes there are no right words—what matters most is being present and acknowledging the loss. I said 'I'm so sorry for your loss' and sat with Amy and her partner in their grief without trying to minimise it or offer false comfort. This simple presence was what they needed.

I learned to provide information sensitively and at the right pace. Amy and her partner needed time to process the news before they could think about next steps. I gave them space to cry and ask questions, then gently explained their options for managing the miscarriage when they were ready to hear it.

The experience taught me the importance of validating grief regardless of gestation. Amy said 'I know it was only 10 weeks, but we'd already planned our future with this baby.' I assured her that her grief was valid and that the length of pregnancy doesn't determine the depth of loss. This validation meant a lot to her.

I also learned about practical support during pregnancy loss. I ensured Amy and her partner had privacy, provided written information they could read later, gave them contact details for support organisations, and arranged follow-up care. These practical acts of kindness helped them feel supported.

How did you change or improve my practice as a result?

I now approach pregnancy loss with greater sensitivity and awareness. I've learned to use appropriate language—saying 'your baby' rather than 'the pregnancy' or 'products of conception,' which acknowledges the significance of the loss to the parents.

I've improved my ability to sit with grief without trying to fix it. I no longer feel the need to fill silences with platitudes like 'at least you can try again' or 'it wasn't meant to be.' I've learned that these comments, though well-intentioned, can minimise grief and aren't helpful.

I've also developed better knowledge of support resources for pregnancy loss. I now provide information about miscarriage support groups, counselling services, and online communities where women can connect with others who have experienced similar losses.

Following this experience, I completed additional training in bereavement care and now feel more confident in supporting women and families through pregnancy loss at any gestation. I've also become an advocate for improving bereavement care in our unit.

How is this relevant to the Code?

This reflection demonstrates several aspects of the NMC Code:

Treat people with kindness and compassion (1.1): I provided sensitive, compassionate care to Amy and her partner during an extremely distressing time.

Respect people's right to privacy and confidentiality (5): I ensured Amy and her partner had privacy to grieve and process the news without interruption.

Communicate effectively (7.1): I adapted my communication to meet Amy's needs, providing information sensitively and at an appropriate pace.

Work in partnership (2.1): I involved Amy in decisions about how to manage her miscarriage, respecting her preferences and supporting her choices.

Maintain knowledge and skills (22.3): I recognised a need to develop my skills in bereavement care and undertook appropriate training.

Do you have any further comments?

Amy contacted me a few weeks later to thank me for my support. She said that having someone acknowledge her loss and treat her baby as real and significant helped her begin to process her grief. This feedback reinforced the importance of compassionate, sensitive care during pregnancy loss.

This experience taught me that midwifery isn't just about bringing babies into the world—it's also about supporting women and families through loss, grief, and trauma. These moments require just as much skill, compassion, and professionalism as joyful births.

I've learned that how we care for women during pregnancy loss can have a lasting impact on their emotional wellbeing and future pregnancies. Compassionate, sensitive care that validates grief and provides appropriate support can help women and families navigate one of life's most difficult experiences.