Understanding Compassion Fatigue in Practice
Supporting people through reproductive and perinatal loss can be deeply rewarding work. It can also be emotionally demanding.
Whether we work in healthcare, social care, counselling, pastoral care, funeral services, or other professions touched by loss, repeated exposure to grief and trauma can have a cumulative impact. Compassion fatigue is one way that impact may show up.
Understanding the signs of it is an important part of sustainable practice. So too is learning how to resource ourselves, strengthen protective factors, and build the support structures that help us remain present in this work over time.
Also read: When Loss Has No Name: Understanding Ambiguous Loss
What Is Compassion Fatigue?
It describes the stress that can arise through repeated exposure to the trauma of others, rather than direct exposure to a traumatic event. It can affect midwives, doulas, therapists, doctors, nurses, social workers, first responders and others whose work brings them into close contact with grief, trauma, and suffering. It is often discussed alongside related concepts such as secondary traumatic stress.
Healthcare professionals working in perinatal bereavement care experience a distinctive emotional burden. Systematic reviews consistently describe the psychological impact of supporting families through miscarriage, stillbirth and neonatal death, alongside the need for education, supervision and organisational support to sustain practitioners in this work.
In many ways, this is the cost of doing this work well. Compassion fatigue has been described as the “cost of caring” for people in emotional pain and is closely related to vicarious trauma, where we ourselves are affected indirectly through repeated exposure to the trauma and suffering of others. Regularly supporting people through loss, grief and trauma can have a cumulative impact on us. Over time, it may influence how we think, feel, relate to others, and make sense of the world around us.
For those of us working in perinatal bereavement care, this matters. We are present during some of the most significant moments in a family’s life, and we inevitably carry pieces of what they share with us.
Also read: How We Can Strengthen Support for Families Experiencing Pregnancy Loss
Common Signs of Compassion Fatigue
We can be affected emotionally, physically, spiritually, cognitively, and in our relationships. Compassion fatigue symptoms include:
- Exhaustion
- Irritability and anger
- Reduced empathy or emotional numbing
- Difficulty concentrating or making decisions
- Diminished satisfaction with work
- Avoidance of certain situations or conversations
- Withdrawal from colleagues, friends, or loved ones
- Changes in coping behaviours, including increased alcohol use
Research across helping professions suggests that it can affect wellbeing, relationships, and professional practice. Similar patterns have been described among nurses, doctors, social workers, mental health professionals, paramedics, and other first responders whose work involves repeated exposure to trauma and suffering.
Symptoms may also involve self-blame, perfectionism, and emotional suppression, particularly when support is limited. Left unaddressed, it can contribute to anxiety, depression, post-traumatic stress symptoms, and reduced quality of care.
Also read: Signs of Unresolved Grief and How It Affects Us Over Time
Noticing the Early Signs
Compassion fatigue usually develops gradually rather than after a single difficult case. Because the changes are often subtle, it can be difficult to recognise them in ourselves.
Signs can look like dreading a type of appointment we once managed with ease. Feeling emotionally numb or less engaged than usual. Wanting to move a conversation along rather than staying present with a family’s experience. Noticing increased irritability with colleagues, or a sense that we’re going through the motions rather than connecting meaningfully with our work.
Reflective questions can help us notice these shifts early:
- What feels harder than it used to?
- Who have we found ourselves avoiding lately?
- Where have we noticed ourselves pulling back or disengaging?
- What aspects of our work are currently draining us most?
Compassion fatigue has also been linked to workplace loneliness and limited social support among colleagues. Feeling increasingly disconnected from colleagues, supervision, or other sources of professional support can sometimes be an early sign that the emotional demands of the work are beginning to take a toll.
Also read: Anger after Pregnancy Loss: What It May Be Communicating and How We Can Respond
Sustaining Ourselves in This Work
While compassion fatigue cannot always be prevented, there are practical steps that can help reduce risk and support sustainability over time:
Prioritise supervision and peer support
Strong professional support networks are among the most consistently identified protective factors. Supervision, consultation, reflective practice, and peer debriefing create opportunities to process difficult experiences rather than carrying them alone.
Create space between encounters
A few minutes between appointments, a short walk, or a moment of stillness can be enough to mark a transition rather than carrying one family’s story directly into the next conversation.
Recognise disengagement as a warning sign
Detachment can feel protective, but it may also diminish the quality of care families receive. Noticing when we’re pulling away is an important piece in professional sustainability.
Attend to our own wellbeing
Movement, rest, meaningful connection, and time away from work all matter. They’re not optional extras, but important components of sustainable practice.
Also read: Disenfranchised Grief and Acknowledging the Pain No One Sees
Continuing Professional Development
Compassion fatigue is not a personal failing. It’s a recognised and well-researched consequence of working closely with people experiencing trauma, loss, and profound emotional pain.
Like any aspect of professional practice, recognising and responding to it benefits from ongoing learning, reflection, and support. Developing sustainable ways of working is not something we do once. It’s an ongoing part of caring for others while also caring for ourselves.
Notes for the Journey is a fortnightly professional development resource for practitioners whose work brings them into contact with pregnancy loss, stillbirth, neonatal death, and other forms of reproductive loss. Each edition includes a reflection, a research insight, a practical takeaway, and a question to carry into your work.
If you’d like to continue exploring practitioner sustainability, reflective practice, and bereavement care alongside us, you can subscribe to Notes for the Journey here.
People Also Ask
What’s the difference between compassion fatigue and burnout?
Burnout typically arises from chronic workplace stress, including excessive workload, inadequate resources, and organisational pressures.
Compassion fatigue is more specifically related to the emotional impact of supporting people experiencing trauma, grief, or significant distress. The two often overlap and can compound one another, but they are not the same phenomenon.
How quickly can compassion fatigue develop?
It varies from person to person. Factors such as the nature of the work, level of exposure, available support, and personal circumstances can all influence how quickly this feeling develops.
For some practitioners, signs may emerge relatively early in their career or following periods of particularly intense exposure. For others, it develops gradually over many years. In most cases, it builds progressively rather than appearing suddenly.
Can compassion fatigue be fully prevented?
Not entirely, and it’s worth acknowledging that plainly. Work that brings us into close contact with grief, trauma, and suffering carries an inherent emotional impact.
What can be reduced is the severity and duration, through supervision, peer support, reflective practice, workload awareness, and ongoing attention to personal wellbeing.
Is compassion fatigue more common in some roles than others?
Possibly. Research suggests that roles involving repeated exposure to grief, trauma, and suffering, particularly when combined with limited opportunities for supervision, debriefing, or peer support, may carry increased risk.
This feeling is not confined to clinical professions. Midwives, sonographers, social workers, counsellors, chaplains, abortion care providers, funeral directors, and others whose work brings them into contact with reproductive and perinatal loss may experience it as well.
While research specific to reproductive and perinatal loss remains limited, studies consistently highlight the emotional impact of supporting individuals and families through miscarriage, stillbirth, neonatal death, and other experiences of loss.
Can compassion fatigue affect how we communicate with bereaved families?
Yes, and this is one reason it deserves attention beyond our own wellbeing. Emotional numbing, irritability, or a reduced capacity for empathy may contribute to individuals and families feeling rushed, unheard, or as though their loss has been treated routinely.
Recognising it in ourselves is also a way of protecting the quality of care and support we offer.
References
Bhugra, D. (2025). Compassion fatigue: Result or cause of burnout? And do doctors get it?. Journal of the Royal Society of Medicine.
Cocker, F., and Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13 (6), 618.
Figley, C. R. (Ed.). (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
Gandino, G., et. al. (2019). Healthcare professionals’ experiences of perinatal loss: A systematic review. Journal of Health Psychology, 24(1), 65 – 78.
Gao, H., et. al. (2026). Nurses’ and midwives’ experiences of supporting parents following perinatal bereavement: A qualitative systematic review. International Journal of Nursing Sciences, 13(1), 41 – 54.
Gold, K. J. (2007). Navigating care after a baby dies: A systematic review of parent experiences with health providers. Journal of Perinatology, 27(4), 230 – 237.
Sorenson, C., et. al. (2016). Understanding compassion fatigue in healthcare providers: A review of current literature. Journal of Nursing Scholarshop, 48(5), 456 – 465.
Stringer, H. (2025, August 27). Addressing compassion fatigue. American Psychological Association.
