Breaking bad news and perinatal loss communication

It is 02:15. You have repeated the ultrasound and there is no fetal cardiac activity. The parents are watching your face. Your first sentence will be remembered long after every investigation result is forgotten. This is not a performance of perfect words. It is the disciplined work of making devastating truth understandable, bearable and accompanied.^[3][11]

Overview and scope

Bad news is information that seriously changes a person's view of their present or future. In perinatal care, the event may be early pregnancy loss, termination for fetal anomaly, stillbirth, anticipated neonatal death or an unexpected neonatal death. The parent's meaning—not gestational age—determines the grief.^[1][11][12]

Your task has four parts:^[3][4]

• Tell the truth clearly. Ambiguity prolongs terror.
• Contain the immediate moment. Slow down, acknowledge emotion and maintain physical safety.
• Restore agency. Offer genuine choices about care, contact and remembrance.
• Do not disappear. Name the next person, place and time.^[3][4]

References14ShowHide

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