How Do I Support My Patient Who Just Lost a Baby
If you are a perinatal professional and you have ever stood in a hospital room, clinic hallway or quiet postpartum space wondering what to say next, you are not alone.
Miscarriage and stillbirth happen every day in perinatal care. Yet for many professionals, these moments feel heavy, intimidating, and deeply personal. You may feel pressure to be calm, composed, and helpful while internally questioning whether you are saying the right thing, doing enough, or unintentionally causing harm.
The truth is, wanting to support your patient after the death of their baby already makes you a safe provider, someone they will be able to lean on. But compassion alone is not enough. Loss care requires skill, education, and support. And if we are being honest, there is a large percentage of hospital staff, doulas, community workers, nannies, and other perinatal professionals that are NOT trained in baby loss support and education. This is not a fault of the individual but of our system that does not seem to prioritize the death of our babies and the mental health and postpartum support our mothers and birthing people truly need. This blog post is here as a quick run-through of how to support your patient who just lost a baby.
Understanding what your patient is experiencing
Miscarriage and stillbirth are not just medical outcomes. They are life-altering losses. And these are only two of the many types of baby loss; for writing sake, I have chosen two of the most well-known. You can learn more about all the types. From a clinical perspective, miscarriage is the loss of pregnancy before 20 weeks. Stillbirth is the death of a baby after 20 weeks. From a human perspective, both represent the death of a child, the collapse of the parents’ futures, and the sudden loss of identity as a parent with a postpartum body. Still, no living baby to prove our parenthood.
Research in perinatal grief and trauma shows that pregnancy and infant loss can involve acute shock, dissociation, medical trauma, loss of bodily trust, identity rupture, and potential long-term grief responses. Your patient may appear calm one moment and overwhelmed the next. They may ask practical questions and forget what you told them, then suddenly withdraw. These responses are not signs of coping poorly, these are “normal” trauma responses. Understanding this matters because it changes how we show up, and it also changes how we support our families in understanding what is going on within them and around them.
Why perinatal professionals often feel unprepared
Most perinatal education focuses on prevention, intervention, and outcomes. Very little time is spent on what happens when the outcome is death.
Professionals often tell me, “I was trained to save lives, not sit with grief,” “I am afraid of saying the wrong thing, so I have trouble saying something comforting”, “I feel helpless and I’m not sure how to help myself after supporting a bereaved family”, '“I take these losses home with me because I don’t have any time to debrief or go to therapy.”
I want to remind you that this is not a personal failing. It is a systemic gap, one that we talk about over and over here at Evelyn James and Company and every cohort that goes through our training. Loss support has historically been treated as intuitive rather than teachable. But grief care is a clinical skill set, and when professionals are not trained, they often default to silence, distancing, or overly clinical language. And unfortunately, this is something families remember forever. The lack of conversation and eye contact, the fumbling with words, or the lack of directness out of trying to spare them any more pain and avoidance, which hurts and also invalidates the experience they are having.
We always want to acknowledge (validate), be present ( sitting and witnessing them), and provide continuity of care when possible.
Acknowledge the loss clearly and compassionately
Naming the death matters. Supporting the family in learning the language of what is happening to them, what happened to their baby in simple, clear language really helps families feel seen. We want to make sure not to use euphemisms that will ultimately create distance between you and the family.
Some helpful examples include, I am so sorry your baby died, I am so sorry your pregnancy has ended, I wish this were different for you.
These statements may feel uncomfortable, but research shows that acknowledgment reduces isolation and prevents disenfranchised grief.
Be present without trying to fix
Your role is not to make this better. It is to bear witness, allowing your vulnerability to lead and create a safe space for the families to express themselves. Making sure not to rush to reassurances or meaning-making. Grief experts, including Megan Devine, emphasize that pain does not need reframing. It needs validation.
Statements like everything happens for a reason or at least you can try again often come from discomfort and lack of education around trauma and grief-centered communication.
Sometimes, the most therapeutic thing you can say is
I am here with you
You do not have to talk right now
This is incredibly hard, but I am with you
Understand that grief has no timeline
There is no evidence-based timeline for grief after miscarriage or stillbirth. Grief is not linear, which means it does not move neatly through each stage of grief like we may have been taught. It definitly never ends because enough “time has passed” according to our society. This really needs to be talked about over and over again throughout that first year at least. Moms and birthing people need to be reminded that they do not need to compare their journeys, and they also need to set down their expectations on when they should be better, or it shouldn’t feel so hard anymore. Expectations cause so much suffering, and it doesn’t need to be that way. We want them to set down any pressure of moving on or returning to normal because this pressure is actually associated with increased risk of prolonged anxiety and depression.
Your patient may need support long after discharge. A trauma-informed approach recognizes this and prepares families for ongoing care, not just immediate survival. This is what we are doing with our pilot program to extend postpartum support to the entire first year, regardless of the outcome, utilizing doulas. This will not only lower prolonged grief but will support mothers in getting the support they need for their mental health and navigating life after loss.
Supporting patients in the immediate aftermath
In the hours and days after loss, your patient may be in shock. Cognitive processing is often impaired.
Helpful actions include
speaking slowly and clearly
repeating information when needed
offering written resources
reducing unnecessary decisions
asking permission before touching
allowing silence
Offer choices whenever possible. Trauma research shows that restoring agency is critical for nervous system regulation.
Examples
Would you like me to explain what happens next now or later
Would you like time alone or would you like me to stay
Would you like to hold your baby
Memory making and honoring the baby
Many professionals fear that offering memory-making will increase pain. Evidence shows the opposite. Memory-making supports meaning, integration, and reduces long-term regret.
This can include:
>holding the baby
>photos or handprints
>naming the baby
>rituals or blessings
>keepsakes
Organizations like Now I Lay Me Down to Sleep exist because families later treasure these moments even when they feel unsure at the time. Your role is to offer without pressure and respect the family’s wishes, but also make sure to ask at least twice and remind them that they can change their minds at any time; they just need to let you know.
Supporting patients after discharge
One of the greatest gaps in perinatal loss care is what happens after the patient leaves your care. Support often drops off while grief intensifies. There may be a follow-up call and the 6-week checkup if they attend, but that, to me, is below the bare minimum. What irks me is the whole “ we don’t have funding for bereavement training or support.” Really? huh. Anyways….
Professionals can help by
>normalizing ongoing grief
>providing referrals to grief-informed therapists or support groups
>educating patients about delayed emotional responses
>encouraging follow-up care
>checking in when appropriate
Referrals to organizations like Postpartum Support International or Share Pregnancy and Infant Loss Support can provide critical continuity virtually.
Caring for yourself as a professional
You cannot support grieving families without acknowledging the emotional cost of this work. This is huge, heavy, emotional work that requires time and care. Repeated exposure to supporting loss can really wear on you and lead to:
>secondary trauma
>compassion fatigue
>burnout
>moral injury
If you feel grief, anger, numbness, or exhaustion, these are signs of being human, not weak. Ethical care includes caring for the caregiver…you. Without you, truly I don’t know what any of us would do. You are a lifeline, a lifesaver, a safety net, a support person; we need YOU to be healthy and supported.
Training programs that address emotional boundaries and professional self-protection are essential for sustainability in this field. Which is why our training covers this in depth and helps you create a burnout plan.
Why training matters and why good intentions are not enough
Perinatal loss support should never rely on improvisation.
Families deserve professionals who are trained, confident, and supported. Professionals deserve education that prepares them for the hardest moments of their work.
This is why Evelyn James and Company exists.
How Evelyn James and Company supports professionals like you
At Evelyn James and Company, we specialize in pregnancy and infant loss education for perinatal professionals.
Our new 12-week advanced professional training program, The Evelyn James Postpartum, Baby Loss & Maternal Mental Health Practitioner Program, was created specifically to address the gaps you feel when supporting families after miscarriage, stillbirth, and infant loss.
This program is designed for
doulas
nurses
midwives
therapists
social workers
perinatal professionals across disciplines
Inside the program, professionals learn
How to communicate clearly and compassionately after loss
What to say and what to avoid
How to support families from hospital to home
How to recognize trauma responses
How to maintain ethical boundaries and scope
How to protect themselves from burnout
We believe continuity of care should extend through all outcomes, not just healthy births. This training exists because families like mine deserve better and because professionals like you deserve support, too.
Final words to perinatal professionals
If you are asking how I support my patient who just lost a baby, it means you care deeply.
You are not expected to have perfect words.
You are not expected to fix the unfixable.
But with the right training, you can offer what matters most
presence
clarity
compassion
and care that lasts beyond the moment
And that changes lives.
Reputable Resources and References
Books
It’s OK That You’re Not OK by Megan Devine
Bearing the Unbearable by Joanne Cacciatore
The Body Keeps the Score by Bessel van der Kolk
Keepsakes & Bereavement Room Products
Pregnancy Loss Affirmation Coloring Book
Organizations
Postpartum Support International
Share Pregnancy and Infant Loss Support
Now I Lay Me Down to Sleep
Refuge in Grief
Professional Education
Evelyn James and Company
Pregnancy and Infant Loss Education
12 Week Advanced Professional Training Program
References
Gold, K. J., Boggs, M. E., & Plegue, M. A. (2023a). Gaps in stillbirth bereavement care: A cross-sectional survey of U.S. hospitals by birth volume. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-023-03861-8
