05 Aug The experiences of parents who suffer pregnancy loss and whose babies die during the pandemic
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Adopted June 2020 · Completed 2021
The experiences of parents who suffer pregnancy loss and whose babies die during the pandemic
A qualitative study of late-term miscarriage, stillbirth, and neonatal death — the PUDDLES study
The COVID-19 pandemic changed the way maternity care was delivered, often in virtual or remote ways. With these changes came a significant psychological impact on women and their partners — particularly in circumstances where they suffered a late-term miscarriage, a stillbirth, or when their baby died shortly after birth. This study aims to better understand the experiences of bereaved parents during the COVID-19 pandemic.
countries in the PUDDLES global collaboration
bereaved parents interviewed in the UK arm of the study
types of loss studied: late-term miscarriage, stillbirth, and neonatal death
Background to the study
This research is a global initiative to understand the experiences of bereaved parents during the COVID-19 pandemic. Researchers at King’s College London are leading the international collaboration, with the results intended to inform strategies to improve care for bereaved parents during this or any future similar outbreak.
About PUDDLES
PUDDLES — Experiences of Parents who Suffer Pregnancy Loss and Whose Babies Die during the Pandemic — is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic. The collaboration spans seven countries: UK, Australia, Brazil, Canada, India, Italy and New Zealand.
The death of a baby before or soon after birth is a highly distressing outcome of pregnancy for parents, families and their healthcare providers. The quality of bereavement care can have lasting consequences for parents’ wellbeing — and the pandemic placed unprecedented strain on already vulnerable families.
Project aims
1
Understand the experiences of perinatal bereavement — late-term miscarriage, stillbirth and neonatal death — during the global COVID-19 pandemic, and whether there are differences between women and their partners
2
Explore whether bereavement is affected by the timing of perinatal loss — whether loss was late-term miscarriage, stillbirth, or neonatal death
3
Understand the interaction between bereaved parents and healthcare services, including what support networks parents drew upon during the Government-instituted lockdowns
How the research was carried out
This is a cross-sectional qualitative study of women and partners who experienced a late-term miscarriage, stillbirth, or neonatal death during the COVID-19 pandemic (from 30 January 2020 onwards). In-depth semi-structured interviews were undertaken with 24 bereaved parents in the UK:
Late miscarriage (all mothers)
Stillbirth (13 mothers, 1 father, 1 joint interview)
Neonatal death (all mothers)
Data were analysed using a template analysis to investigate bereaved parents’ access to services, care and networks of support during the pandemic.
Connection to the wider COCOON collaboration
PUDDLES is a nested qualitative study within the wider COCOON Global Collaboration, which brought together collaborators from multiple countries to investigate the impact of COVID-19 on new, expectant and bereaved parents and the care they received. The study is being led by the Department of Women & Children’s Health at King’s College London.
Why this research matters
At the time the study began, there was very little information on the psychological impact and mental health of bereaved parents during the COVID-19 pandemic. Preliminary research had found that pregnant women were:
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Concerned with their pregnancy and birth plans given urban and quarantine constraints
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Avoiding visiting healthcare providers due to concerns about coronavirus exposure
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Worried about postpartum care — yet perinatal bereavement during the pandemic had not been widely explored
Given the rapid progressive spread of COVID-19, it was important to address the potential outcomes for both mothers and partners who experienced pregnancy loss and/or perinatal death. The results of this study inform strategies to improve bereavement care during this or any future similar outbreak.
Research outputs
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Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic
BMC Pregnancy and Childbirth — December 2021 · Silverio, Easter, Storey, Jurković, Sandall et al. - →
Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: a qualitative study
BMC Pregnancy and Childbirth — August 2024
Meet the research team
 Professor Jane Sandall CBE Theme lead; Professor of Social Science and Women’s Health, King’s College London; midwife and NIHR Senior Investigator |
Claire Storey (International Stillbirth Alliance) · Davor Jurković, Gynaecology Diagnostic Outpatient Treatment Unit, UCLH · Members of the PUDDLES Global Collaboration across 7 countries
Related content
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COCOON — continuing care in Covid-19 outbreak: a global survey of new and expectant parent experiences - →
The changing maternity care study — how has virtual and remote care changed maternity care practices during Covid-19? - →
Open disclosure with women and families after unexpected harm in NHS maternity care (DISCERN) - →
Maternity and perinatal mental health research at ARC South London
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived June 2026.