Attachment and Meaning-Making in Perinatal Bereavement

Uren, Tanya H.; Wastell, Colin

doi:10.1080/074811802753594682

Cited by 108 publications

(100 citation statements)

References 30 publications

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“…Making meaning can be a critical part of the grieving process, significantly influencing the resolution of grief and subsequent distress. 45,46 Finally, the discovery that bereaved African American women have low rates of treatment-seeking even when symptomatic after loss is worrisome given health disparities in perinatal loss and the known high risk of depression and trauma during subsequent pregnancies. We hope that this finding can serve as a call for additional research on treatment options for mental health disorders faced by vulnerable populations after stillbirth and infant death as such research is virtually nonexistent to date.…”

Section: Discussionmentioning

confidence: 99%

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Gold

Leon

Boggs

et al. 2016

Journal of Women's Health

110

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Introduction: Perinatal loss is often a traumatic outcome for families. While there are limited data about depressive outcomes in small populations, information about depression and posttraumatic stress disorder among large racially and economically diverse populations is sparse. Methods: We collaborated with the Michigan Department of Community Health to conduct a longitudinal survey of bereaved mothers with stillbirth or infant death under 28 days of life and live-birth (control) mothers in Michigan. The study assessed 9-month mental health outcomes including self-reported symptoms of depression and posttraumatic stress disorder along with information about demographics, pregnancy and loss experience, social support, and past and present mental health and treatment. Results: Of 1400 women contacted by the State of Michigan, 609 completed surveys and were eligible to participate for a 44% response rate (377 bereaved mothers and 232 control mothers with live births). In multivariable analysis, bereaved women had nearly 4-fold higher odds of having a positive screen for depression and 7-fold higher odds of a positive screen for post-traumatic stress disorder after controlling for demographic and personal risk variables. A minority of screen-positive women were receiving any type of psychiatric treatment. Conclusion: This is the largest epidemiologically based study to date to measure the psychological impact of perinatal loss. Nine months after a loss, bereaved women showed high levels of distress with limited rates of treatment. Symptoms need to be monitored over time for persisting disorder and further research should identify women at highest risk for poor outcomes.

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Section: Discussionmentioning

confidence: 99%

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Gold

Leon

Boggs

et al. 2016

Journal of Women's Health

110

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“…Similarly, much psychological research has focused on ‘pathological’ or ‘complicated’ grief [10] and on the psychopathology attributable to the experience of bereavement. However, while the death of a loved one is a devastating experience, many people also report positive aspects to this experience [1, 11], such as a growing sense of becoming better, more humane and more able people. Recently there has been increasing interest in systematically evaluating these positive aspects of the aftermath of trauma.…”

Section: Introductionmentioning

confidence: 99%

“…The death of a child is one of the most painful experiences for a parent and may cause more intense grief than the loss of a spouse or parent: in a study of 109 Australian women who experienced the loss of a child either through stillbirth or neonatal death, 91% saw the death as the worst thing that had ever happened in their lives [1]. Research indicates that most mothers still grieve many years after the death, indicating a strong attachment between the mother and the baby even before birth [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Grief and Post-Traumatic Growth in Parents 2–6 Years after the Death of Their Extremely Premature Baby

Büchi¹,

Mörgeli²,

Schnyder³

et al. 2007

Psychother Psychosom

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Objective: To assess grief and post-traumatic growth in parents 2–6 years after the death of a premature baby (24–26 weeks’ gestation) and to evaluate Pictorial Representation of Illness and Self-Measure (PRISM) in the assessment of bereavement. Method: Fifty-four parents were assessed for their experiences during hospitalization and by questionnaires regarding grief (MTS), post-traumatic growth, affective symptoms and the visual representation of the baby and the self of the parents (PRISM). Results: Even 2–6 years after the loss of their extremely preterm infant the parents still suffer a lot from their bereavement, mothers more so than fathers (Mann-Whitney U test, U = 230.5, p < 0.05). Having another child reduced the level of grief (U = 119.0, p < 0.05). Mothers showed more post-traumatic growth than fathers (U = 140.5, p < 0.001). For all parents a shorter distance between the baby and the self (PRISM) correlated with greater grief (ρ = –0.62, p < 0.001); in multiple regression analysis MTS explained 38% of the SBS-variance. Conclusions: Clinicians should be aware that the death of an extremely premature infant triggers not only a painful long-term process of mourning but also of individual personal growth. Adaptation processes after the death differ depending on gender, with mothers experiencing more intense grief but also more growth than fathers. The modified PRISM test is recommended as a visual, non-verbal and easy-to-use instrument to assess bereavement.

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“…When it is experienced as grief it poses the same challenges of finding meaning, making sense of a changed reality and negotiating postmortem relationships (Uren & Wastell, 2002;Murphy & Thomas, 2013), much the same as in any bereavement (Klass, Silverman & Nickman, 1996;Neimeyer, 2000). As such, the boundaries between embodied maternal selves and the preborn are porous and entwined (Lupton, 2012), presenting great challenges to healthcare professionals.…”

Section: Paul Richard Cassidymentioning

confidence: 99%

Cuerpo y ontología: La muerte perinatal y su duelo en el panorama tecno-científico del sistema sanitario

Cassidy

2015

Teknokultura

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This study takes the body (of mother and child), the technoscientific hospital landscape and professional ritual as the locus of an endeavour to understand the embodied experience of perinatal death, in order to better comprehend how alternate understandings and ontologies of motherhood, personhood and bereavement emerge during care enactments. Grounded in a descriptive and ethnographic approach the research analyses data from the entries of 22 members of a pregnancy loss support forum and 10 narrative style interviews. The research traces embodied experience from pregnancy, through diagnosis to the spatialised experience of the hospital, including the birth, postmortem contact and disposal of the corpse. Bounded by the sudden destruction of ontological security many of these women experience an existential crisis that results in a destructed stigmatised self. The research explores how overly medicalised obstetric care enacts understandings of perinatal death and bereavement that further problematizes postmortem relationships, creating toxic identities and embodied selves. Conversely, woman-centred midwifery that takes relational and social understandings as a basis for care can create the material conditions of possibility for a restoration of confidence in carnal self and a reconstruction of social bonds and order. Assembled through practice, discourse and policy, these bodies are individually, socially and politically enacted, but they are also multiple, mutable and enfolded assemblages of nature and culture. The research proposes that healthcare practice would benefit by considering natural stillbirths, just as contemporary obstetrics advocates natural childbirth. KEYWORDSPerinatal death, stillbirth, pregnancy loss, bereavement, hospital care, ontology, motherhood, personhood, hospital care, qualitative research. RESUMENEste estudio considera el cuerpo (de la madre y del niño) y el entorno tecno-científico como lugar paradigmático para analizar la experiencia tras la muerte perinatal, con el fin de comprender como se desarrollan ontologías alternativas de la maternidad, la personalidad y del duelo. La investigación analiza las entradas de 22 miembros de un foro de apoyo a la muerte perinatal y 10 entrevistas narrativas. El articulo aborda la experiencia asociada al embarazo hasta la experiencia con el espacio físico del hospital, incluyendo el nacimiento, contacto posparto y la disposición del cuerpo. Delimitado por la destrucción repentina de seguridad ontológica estas mujeres experimentan una crisis existencial que se traduce en un yo deconstruido y estigmatizado. Exploramos la manera en que la atención obstétrica excesivamente biomédica promulga comprensiones de la muerte y el duelo perinatal que problematizan aún más las relaciones posmortem, creando así identidades encarnadas tóxicas, y por tanto exacerbando el duelo. Por el contrario, la atención centrada en la mujer y liderada por la comadrona puede crear las condiciones para una restauración de la confianza en uno mismo y la maternidad, y una...

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Attachment and Meaning-Making in Perinatal Bereavement

Cited by 108 publications

References 30 publications

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Grief and Post-Traumatic Growth in Parents 2–6 Years after the Death of Their Extremely Premature Baby

Cuerpo y ontología: La muerte perinatal y su duelo en el panorama tecno-científico del sistema sanitario

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