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Peer-reviewedCC BY 4.0PLOS One

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

  • Debbie Johnson1
  • Sarah Newell2
  • Hannah Family3
  • Madeleine Holland4
  • Maggie Westby5
  • Eleanor Franks6
  • Laura Turner
  • China Harrison
6 affiliations
  1. 1Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
  2. 2University Hospitals Bristol and Weston, BristolUnited Kingdom
  3. 3National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, United Kingdom
  4. 4National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, United Kingdom
  5. 5School of Healthcare, University of Leicester, Leicester, United Kingdom
  6. 6Desitin Pharmaceuticals Ltd, Fairbourne Drive, Milton Keynes, United Kingdom
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Abstract

Background: 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. Study aims: To explore staff experiences of exposure to pregnancy and neonatal loss, perceptions of available support, support previously used, and needed or wanted. Methods: 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. Conclusion: 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.

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Cite

BibTeXRIS
BibTeX
@article{johnson2026examining,
  title = {{Examining the mental health support needs of NHS staff exposed to patient pregnancy and neonatal loss: A qualitative study}},
  author = {Debbie Johnson and Sarah Newell and Hannah Family and Madeleine Holland and Maggie Westby and Eleanor Franks and Laura Turner and China Harrison},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0358321},
  url = {https://doi.org/10.1371/journal.pone.0358321},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Examining the mental health support needs of NHS staff exposed to patient pregnancy and neonatal loss: A qualitative study
AU  - Debbie Johnson
AU  - Sarah Newell
AU  - Hannah Family
AU  - Madeleine Holland
AU  - Maggie Westby
AU  - Eleanor Franks
AU  - Laura Turner
AU  - China Harrison
PY  - 2026
DA  - 2026/09/17
JO  - PLOS One
DO  - 10.1371/journal.pone.0358321
UR  - https://doi.org/10.1371/journal.pone.0358321
AB  - Background: 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. Study aims: To explore staff experiences of exposure to pregnancy and neonatal loss, perceptions of available support, support previously used, and needed or wanted. Methods: 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. Conclusion: 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.
SN  - 1932-6203
ER  -