Introduction:
The loss of a neonate is a deeply challenging event with cultural, spiritual and personal implications that differ significantly among populations. As neonatal intensive care units (NICUs) become increasingly multicultural, midwives are required to adopt culturally appropriate approaches to support families as cultural differences influence practices around death, expressions of grief and family dynamics.

Methods:
This is a narrative review synthesizing the existing literature on transcultural practices in NICUs to support families during neonatal loss. Studies between 2014-2024 were retrieved from Pubmed, Science Direct and Google Scholar, using relevant MeSH terms. Eligibility criteria included English language. Data sources included peer-reviewed articles, case studies, and reports from NICUs globally, emphasizing practices that have shown success in culturally diverse settings.

Results:
Findings highlight substantial cultural variations in grieving practices, revealing the need for midwives to adapt their approach to neonatal loss based on each family’s cultural context. In many Asian and African cultures, grieving is a communal experience, with extended family members playing active roles in mourning and supporting the immediate family. These cultures often emphasize collective grieving rituals, where community involvement is seen as essential for healing. In contrast, Western cultures tend to prioritize individual expressions of grief within the nuclear family, with a focus on privacy and personal coping mechanisms. Essential elements that contribute to effective, culturally sensitive care, included the use of interpreters, flexibility in end-of-life rituals, access to culturally informed psychological support and building trust through cultural sensitivity. Finally, midwives must also practice cultural humility, reflecting on personal biases to ensure inclusive support.

Conclusions:
For midwives, understanding and respecting cultural diversity is essential in providing compassionate, culturally appropriate care. This approach strengthens families' resilience, facilitating meaningful healing. Integrating cultural competency training in midwifery education is crucial to equip practitioners with the skills to support grieving families effectively and empathetically.