Culture of silence: midwives', obstetricians' and nurses' experiences with perinatal death. 2016.

Work-related stress and coping among midwives in Slovakia. 2017.

Challenges in day-to-day midwifery practise: a qualitative study from a regional referral hospital in Dar es Salaam, Tanzania. 2018.

Brophy DM, Rust AA. Occupational challenges faced by nursing personnel at a state hospital in Cape Town, South Africa.Cape Town: Cape Peninsula University of Technology; 2015

Effectiveness of psychotherapeutic interventions on psychological distress in women who have experienced perinatal loss: a systematic review protocol. 2020.

Draper ES, Gallimore ID, Smith LK MBRRACE-UK perinatal mortality surveillance report, UK perinatal deaths for births from January to December 2018.Leicester: Department of Health Sciences, University of Leicester; 2020

Support for young black urban women after perinatal loss. 2019.

Using the framework method for the analysis of qualitative data in multi-disciplinary health research. 2013.

Healthcare professionals' experiences of perinatal loss: a systematic review. 2019.

Gray JR, Grove SK, Sutherland S. The practice of nursing research.St Louis: Elsevier; 2017

Higson A. Rising to the better births challenge. Br J Midwifery. 2015; 10:(5)1-35

Hunter A, Schott J, Henley A, Kohner N. Pregnancy loss and the death of a baby: guidelines for professionals.London: Sands; 2016

Experiences of nurses who care for women after a foetal loss. 2016.

Jones K, Smythe L. The impact on midwives of their first stillbirth. J N Z Coll Midwives. 2015; 51:17-22

Kissane DW, Parnes F. Bereavement care for families.New York: Taylor & Francis Routledge; 2014

Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District. 2019.

Midwives' experience of delivery care in late foetal death: a qualitative study. 2018.

Experiences with perinatal loss from the health professionals' perspective. 2011.

Morake VVV, Phiri SS, van der Wath AE. Nursing students' experiences of caring for women with stillbirths at public hospitals in Gauteng Province, South Africa. Afr J Phys Act Health Sci. 2016; 22:(4:1)965-976

National Bereavement Care Pathway Standards.London: National Bereavement Care Pathway; 2018

Midwives' experiences of stress due to emergency childbirths in a Namibian regional hospital. 2017.

Nelson Mandela Bay APP 2017 to 2018 and April 2018 Data (1). Port Elizabeth: Perinatal Problem Identification Program.2018

The worlds need midwives, now more than ever. 2013. (accessed 1 December 2022)

Caring for families experiencing stillbirth: evidence-based guidance for maternity care providers. 2015.

Ramalisa RJ, du Plessis E, Koen MP. Increasing coping and strengthening resilience in nurses providing mental health care: empirical qualitative research. HSAG. 2018; 23:(1)1-9

Shore H. After compression, time for decompression: debriefing after significant clinical events. Infant. 2014; 10:(40)117-119

Shorey S, Andre B, Lopez V. The experiences and needs of healthcare professionals facing perinatal death: a scoping review. Int J Nurs Stud. 2017; 68:25-39

Perinatal deaths in South Africa 2016. Pretoria: South Africa.2018

Subic-Wrana C, Beutel ME, Brahler E How is emotional awareness related to emotion regulation strategies and self-reported negative affect in the general population?. PloS One. 2014; 9:(3)1-10

Wallbank S, Robertson N. Predictors of staff distress in response to professionally experienced miscarriage, stillbirths and neonatal loss: a questionnaire survey. Int J Nurs Stud. 2013; 50:(8)1090-1097

Williamson MG. Exploring midwives' experiences of managing patients' perinatal loss at a maternity hospital in the Western Cape, South Africa.South Africa: University of Western Cape; 2016

World Health Organization. Ending preventable newborn deaths and stillbirths by 2030 universal health coverage in 2020–2025. 2020. (accessed 1 December 2022)

World Heath Organization. Newborn mortality. 2022. (accessed 1 December 2022)

Perinatal loss: experiences of midwives and nurses. 2021.

Supporting the needs of midwives caring for women with perinatal loss in South Africa

02 January 2023
Volume 31 · Issue 1



Midwives play an important role in assisting women to cope with the initial trauma of perinatal loss, but their own coping and support needs can be overlooked. The purpose of the study was to explore the coping behaviours and support needs of midwives caring for women with perinatal loss.


A qualitative, exploratory, descriptive design was used. Data were collected using semi-structured one-on-one interviews with 13 purposively sampled participants from the Nelson Mandela Bay Health District.


Three themes emerged concerning midwives' coping mechanisms in relation to perinatal loss, their views on support from management and the need for psychological and emotional support.


The participants felt the need for unit-based psychological and emotional support. They called for the development of a protocol for midwives to manage perinatal loss events. They felt that the layout of the labour wards needed to be redesigned and that the problem of staff shortages needed to be urgently addressed.

Perinatal loss is a common global public health concern (Kissane and Parnes, 2014). Despite significant reductions in global perinatal mortality rates over the last two decades, the World Health Organization (WHO, 2020; 2022) estimated there were 2.4 million neonatal deaths in 2020 and over 2 million stillbirths. Charrois et al (2020) indicated that 15–20% of pregnancies in the UK end in miscarriage, based on data from a number of sources. In the UK, the extended perinatal mortality rate is 5.13 per 1000 births (Draper et al, 2020). South Africa has high numbers of perinatal losses, with perinatal deaths set at 18 683 in 2016 (Statistics South Africa, 2018) or approximately double that of the UK, at 11.5 per 1000 births. These data indicate that large numbers of women and their families experience the pain and trauma of perinatal loss.

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