Optimising Psychosocial Interventions for Parents Following Perinatal Bereavement: A Qualitative Study of Midwives' Perspectives

Aim: To explore midwives' experiences of providing psychosocial interventions to parents following perinatal bereavement in maternity care settings. Design: A descriptive qualitative study. Methods: Twenty-two midwives were recruited from three maternity services in Ireland using purposive and snowball sampling. Semi-structured interviews were conducted between July and November 2024. Reflexive thematic analysis was used to analyse the data. Results: Four themes were identified: (1) Building relationships as a foundation for psychosocial intervention delivery; (2) Psychosocial intervention as the core element of perinatal bereavement care; (3) Negotiating intervention delivery in a constrained system; and (4) Navigating emotional labour and professional growth. Midwives advocated provision of compassionate and relationship-based psychosocial interventions, but often faced systemic barriers, limited guidance, and insufficient training. Supportive structures and psychosocial intervention focused training were seen as critical to sustaining care quality and midwives' wellbeing. Conclusion: Applying the Socio-Ecological Model (SEM) revealed that midwives' delivery of PSIs to support grieving parents after perinatal bereavement is influenced by multi-level factors, underscoring the need for policy integration, institutional support, and contextually grounded, midwife-led approaches. Implications for the Profession and/or Patient Care: Integrating SEM into intervention design can guide the development of multi-component PSIs that address multilevel influences and align with both parents' needs and midwives' capacities. Impact: This adds to the understanding of how midwives deliver psychosocial interventions in perinatal bereavement care. Midwives view the delivery of these interventions as central to their role, while acknowledging the need for the development of, and training in structured, midwife-led psychosocial interventions in perinatal bereavement care. Reporting Method: COREQ. Patient or Public Contribution: Patients and members of the public were involved in study design, data collection and validation of findings. Their contributions included reviewing protocols and recruiting materials, facilitating recruitment and participating in advisory groups, ensuring the relevance and sensitivity of the research.