The video is set entirely within a hospital waiting room, a setting that deviates from the typically warm and scenic tropes of the folk genre. This choice immediately establishes a tone of "foreboding and artificial coldness". Several key visual elements emphasize the theme of loss:

The official music video for "Small Bump," directed by Emil Nava and released in 2012, is a masterclass in minimalist storytelling that mirrors the song's profound grief. While the track itself is a folk-pop ballad about the tragedy of miscarriage, the video elevates this narrative through stark clinical imagery and a haunting sense of isolation.

Ed Sheeran wrote "Small Bump" from the perspective of a parent, though it was actually inspired by a close friend who suffered a miscarriage five months into her pregnancy. The lyrics are famously known for their "twist" ending; the first several verses celebrate the anticipation of parenthood—detailing fingernails the "size of a half grain of rice"—before the final lines reveal the child was "torn from life".

Other people in the hospital are shown fading in and out via CGI. This serves as a metaphor for the fragility and transience of life, specifically reflecting the "small bump" that was there and then suddenly gone.