It is heartbreaking to look at loss in its sweet small face. We are midwives, and sometimes difficult is a path on the roadmap to love and support families. Stillbirth is one of the most common adverse pregnancy outcomes, at 1 in 160 births in America. In developed countries, the most dominant risk factors associated with fetal demise are non-Hispanic black race, nulliparity, advanced maternal age, obesity, preexisting diabetes, chronic hypertension, smoking, alcohol use, having a pregnancy using assisted reproductive technology, multiple gestation, male fetal sex, unmarried status, and past obstetric history. Although some of these risk factors may be mitigated, many can not. A significant proportion of stillbirths remains unexplained even after a thorough evaluation due to decreased autopsy rates and protocols that hinder classification and assessment. The approach and timing of birth after a loss depends on the gestational age at which the demise occurred, obstetric history, and what the parents desire. Midwives should weigh the risks and benefits of each choice with their clients and consider community standards. Client support should be holistic. Additional considerations should be made to fulfill the laws and regulations of your state. Referral to a bereavement counselor, community support group, or mental health professional can be helpful and should be navigated with an individualistic approach. Exploration into the experience of the birth team, including the birther, partner, siblings, midwife and assistants should be considered. Midwives should be well versed in culturally sound mourning and communication skills when attending a demise.