Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101

Braun V, Clarke V. Successful qualitative research: a practical guide for beginners.London: SAGE; 2013

Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis?. Qual Res Psychol. 2021; 18:(3)328-352

British Psychological Society's code of human research ethics.Leicester: British Psychological Society; 2014

Corless IB, Limbo R, Bousso RS Languages of grief: a model for understanding the expressions of the bereaved. Health Psychol Behav Medicine. 2014; 2:(1)132-143

Farren J, Jalmbrant M, Falconieri N Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. Am J Obstet Gynecol. 2020; 222:(367)1-22

Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J. Stillbirths: economic and psychosocial consequences. Lancet. 2016; 387:604-616

Hedtke L. Reconstructing the language of death and grief. Illn Crisis Loss. 2002; 10:(4)285-293

Hogg S. All babies count: spotlight on perinatal mental health.London: National Society for the Prevention of Cruelty to Children; 2013

Hunter A, Tussis L, MacBeth A. The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: a meta-analysis. J Affect Disord. 2017; 223:153-164

Hutti MH, Myers JA, Hall LA, Polivka BJ, Kloenne E. Predicting need for follow-up due to severe anxiety and depression symptoms after perinatal loss. J Obstet Gynecol Neonatal Nurs. 2018; 47:(2)125-136

Layne LL. He was a real baby with baby things: a material culture analysis of personhood, parenthood and pregnancy loss. J Mater Cult. 2000; 5:(3)321-345

Martel SL. Biopower and reproductive loss: speaking risk, silencing death-in-birth. Cult Stud. 2014; 28:(2)327-345

Moscrop A. ‘Miscarriage or abortion?’ understanding the medical language of pregnancy loss in Britain; a historical perspective. Medi Humanit. 2013; 39:(2)98-104

Moulder C. Miscarriage: women's experiences and needs.London: Routledge; 2001

Murphy S. “I'd failed to produce a baby and I'd failed to notice when the baby was in distress”: the social construction of bereaved motherhood. Women's Stud Int Forum. 2019; 74:35-41

Nadeau JW. Metaphorically speaking: the use of metaphors in grief therapy. Illn Crisis Loss. 2006; 14:(3)201-221

Neville S, Adams J, Cook C. Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field. Contemp Nurse: J Aust Nurs Prof. 2016; 52:(6)657-668

NHS. Overview: postnatal depression. 2018. (accessed 6 June 2022)

NHS Digital Secondary Care Analysis. NHS maternity statistics, England 2018-19. 2019. (accessed 6 June 2022)

Noonan M, Doody O, Jomeen J, Galvin R. Midwives' perceptions and experiences of caring for women who experience perinatal mental health problems: an integrative review. Midwifery. 2017; 45:56-71

Oates M, Shakespeare J, Seth-Smith F Guidance for commissioners of perinatal mental health services: practical mental health commissioning.London: Joint Commissioning Panel for Mental Health; 2012

Office for National Statistics. Birth characteristics in England and Wales 2020. 2022. (accessed 6 June 2022)

Office for National Statistics. Infant mortality (birth cohort) tables in England and Wales. 2021. (accessed 6 June 2022)

O'Leary J, Warland J. Meeting the needs of parents pregnant and parenting after perinatal loss.London: Routledge; 2016

Sands. Audit of bereavement care provision in UK maternity units. 2016. (accessed 6 June 2022)

Sawicka M. Searching for a narrative of loss: interactional ordering of ambiguous grief. Symb Interact. 2017; 40:(2)229-246

Seigal C. Bereaved parents and their continuing bonds: love after death.London: Jessica Kingsley; 2017

Smith LK, Dickens J, Bender Atik R, Bevan C, Fisher J, Hinton L. Parents' experiences of care following the loss of a baby at the margins between miscarriage, stillbirth and neonatal death: a UK qualitative study. BJOG. 2020; 127:(7)868-874

‘Sunshine’, ‘angels’ and ‘rainbows’: language developed by mothers bereaved by perinatal loss

02 July 2022
Volume 30 · Issue 7



A perinatal loss is a life-changing event that can have psychological consequences for a mother both after the loss and in a subsequent pregnancy.


This qualitative study aimed to examine mothers' lived experiences of the holistic journey of perinatal loss and subsequent pregnancy.


Qualitative data were collected via online surveys (n=40) and face-to-face semi-structured interviews (n=5), then analysed using reflexive thematic analysis.


Under the overarching theme ‘finding the words: language, labels and legitimate distress', three themes were developed that captured the ways in which participants used language to challenge societal silence and legitimise the personhood of their loss, while creating a community of support.


Midwives play a key role in women's experiences during the perinatal journey after a loss. The language used can either validate or be dismissive of distress. The researchers recommend midwives adopt labels developed by rather than for bereaved parents in order to provide empathic care.

Perinatal loss is a term that includes losses that occur during pregnancy or shortly after birth. As many as one in five pregnancies end in miscarriage, resulting in up to 45 000 hospital admissions annually in England (NHS Digital Secondary Care Analysis, 2019). In England and Wales, almost 2500 stillbirths were recorded in 2020 and over 1700 neonatal deaths were recorded in 2018 (Office for National Statistics 2021; 2022). Despite the prevalence of perinatal loss, western societies often fail to recognise the significance of such losses and their psychological impact on those who experience them (Martel, 2014; Heazell et al, 2016; Farren et al, 2020). Depression and anxiety levels have been found to be significantly elevated in women who are pregnant following a loss (Hunter et al, 2017). A pregnancy after a loss is not only potentially a time of anxiety as a result of previous pregnancy experiences (Moulder, 2001), it is also a time when the individual may still be grieving their loss.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month