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

Objective:
To examine NHS staff experiences of exposure to pregnancy and neonatal loss, and their perceptions of available, used and desired support. Design: Qualitative study using semi-structured one-to-one interviews Setting: Single NHS trust, United Kingdom.

Population:
Twenty purposefully sampled clinical, allied and non-clinical staff from maternity, gynaecology, fetal medicine, neonatal intensive care, theatres, sonography, and support services

Methods:
Interviews were audio-recorded, transcribed verbatim, anonymised and analysed using thematic analysis. Themes were mapped to the study aims.

Main outcome measures:
Experiences of exposure to pregnancy and neonatal loss; perceived support available; support previously used; and needed or wanted.

Results:
six themes were identified: (1) nobody prepared me for this (2) reaching a tipping point; (3) reliable 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 and departments. Many staff, particularly junior, allied and support staff, felt underprepared for emotional and communication challenges. Participants described reaching a “tipping point” where resilience was compromised and additional support was needed. Peer support was the most accessible and reliable resource, whereas awareness and use of organisational support were limited. When accessed, organisational support was valued, but staff emphasised the need for diverse and flexible approaches.

Conclusion:
The emotional demands experienced by NHS staff are inconsistently supported. A proactive multi-disciplinary approach is needed to provide visible and equitable support tailored to diverse staff needs.