An Exploratory Study of the Psychological Impact and Clinical Care of Perinatal Loss

Abstract

Perinatal loss is a unique and potentially traumatizing experience that can leave bereaved parents struggling with a host of mental health difficulties. In this exploratory study of the predictors and mental health outcomes associated with perinatal loss, we examined a cohort of women who experienced a perinatal loss within the previous 5 years. Results suggest perinatal loss is associated with considerable distress and impairment for some women, with greater severity primarily predicted by maladaptive coping skills, low social support, and intense emotionality following the loss. The majority of women in this sample were satisfied with the care they received in the hospital after their loss, including their engagement in reportedly contentious bereavement rituals in the medical setting. Limitations of this research are noted, and suggestions for future research and clinical care are provided.

Notes

Note. CG = complicated grief; PTS = posttraumatic stress; Dep/Anx = depression/anxiety; PTE = potentially traumatizing events; Acute = acute emotional response to loss; Neg cope = negative coping strategies; Support = perceived social support; PPL = previously experienced perinatal loss; HSS = perceived hospital staff sensitivity; See = seeing the baby after the loss; Hold = holding the baby after the loss; Picture = having pictures taken of the baby after the loss. All dichotomous variables (other kids, PPL, see, hold, and picture) were coded as 1 = yes, 2 = no. HSS was rated on a Likert scale where 1 = low sensitivity/satisfaction and 5 = high sensitivity/satisfaction.

∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

Note. PTE = potentially traumatizing events.

^a Entered into regression hierarchically in descending order.

Additional information

Notes on contributors

Shannon M. Bennett

Shannon Bennett, M.A. is a doctoral candidate in clinical psychology at Boston University. She is the principal investigator of the NIMH-funded Coping with Perinatal Loss Program, an intervention research program at Boston University and UCLA. Her primary areas of research interest include the development, efficacy, and dissemination of cognitive-behavioral interventions for emotional disorders, particularly anxiety, traumatic stress, and complicated grief. Her current research and clinical work focuses on children struggling with anxiety disorders, and mothers who have suffered a perinatal loss.

Brett T. Litz

Brett T. Litz, Ph.D. is currently a Professor in the Department of Psychiatry at Boston University School of Medicine and the Psychology Department at Boston University as well as the Associate Director of the Behavioral Sciences Division of the National Center for PTSD at the VA Boston Health Care System. Dr. Litz is the Principal Investigator on several research studies funded by the National Institute of Mental Health, the U.S. Department of Defense, and the Canadian Ministry of Veterans Affairs to explore the efficacy of early intervention strategies for survivors of trauma.

Shira Maguen

Shira Maguen, Ph.D. is an Assistant Professor at the University of California at San Francisco School of Medicine and a Staff Psychologist at the San Francisco VA Medical Center. Her research interests include risk and resilience factors and PTSD in military veterans, the mental health impact of terrorism, prolonged grief disorder, personal growth following loss and trauma, and barriers to mental health care in veterans.

Jill T. Ehrenreich

Jill Ehrenreich, Ph.D. is an Assistant Professor and Director of the Child and Adolescent Anxiety and Depression Treatment Program at the University of Miami. Her primary research interests are in the assessment and treatment of anxiety disorders in children and adolescents, particularly in regard to parenting and family factors related to both etiology and treatment of anxiety. She is also interested in treatment of comorbid conditions, such as depression, amongst adolescents with anxiety disorders and prevention of anxiety disorders in youth.