A dedicated care pathway for pregnancy after loss was established through the perinatal medicine clinics by Professor Keelin O’Donoghue at Cork University Maternity Hospital (CUMH) in 2009. Our research shows that from 2011-2017, of the 131 women with a previous stillbirth, 84% booked through this pathway, while the remainder went for private obstetric care. Over time, women with second trimester loss have also been referred into perinatal medicine clinics and in more recent years, although still not dedicated to only pregnancy after loss, care is provided in these clinics by a number of specialised consultants including Professor Noirin Russell, Dr Claire McCarthy and Dr Laura Linehan. The Clinical Midwife Specialists in Bereavement and Loss also support this clinical service. 

Through 2024 and 2025, following feedback from services users, the CUMH Bereavement Committee explored the potential of using a dedicated alert symbol for pregnancy after loss that was different to the teardrop alert symbol used in pregnancy loss. In 2024, the National Women and Infants Health Programme, HSE also issued a bereavement symbol pathway. 

In 2026, the new CUMH Pregnancy After Loss symbol was introduced and adopted across the hospital. The aim of this symbol is to highlight a history of previous pregnancy loss to healthcare providers at all stages of pregnancy. The symbol is used on charts, electronic health records and room doors (e.g. antenatal, labour ward, or postnatal rooms). It is only used with an individual’s permission – its use is optional, and people can change their mind about its use at any time. 

The symbol is used to alert CUMH staff to pregnancies after:  

• Second trimester pregnancy loss 
• Stillbirth 
• Neonatal death 
• Termination of pregnancy for fetal anomaly. 

The Pregnancy After Loss symbol is used to promote compassionate, sensitive, and trauma-informed care, and reduce the need for people to repeatedly explain their history. It encourages staff to read notes carefully, open sensitive conversations, and respect how people wish to talk about their pregnancy loss. 

An information leaflet about the symbol and a Pregnancy After Loss card is now offered within outpatient clinics, including at the Pregnancy Loss Clinic follow up appointment, or at any interaction in subsequent pregnancies. This can include the Early Pregnancy Clinic, Emergency Room, Antenatal Clinic and Fetal Assessment Unit. The Pregnancy After Loss card is intended to be held by the person and brought to each maternity service visit or interaction. It can also be attached to their paper chart or shown to staff. The cards have the Pregnancy After Loss teardrop on the front and on the back is a space for them to write any additional information they wish to share, including their baby’s name. 

The Pregnancy After Loss symbol complements the teardrop alert sticker or symbol which is displayed on hospital records and in relevant hospital clinical areas to alert staff to cases of second trimester pregnancy loss, stillbirth and neonatal death. Use of such alert symbols is recommended with the National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death.