Perinatal Loss: The Impact on Maternal Mental Health

Abstract

Importance Psychological reactions to perinatal loss, although often self-limited, may lead to significant psychological morbidities. Obstetrician-gynecologists and other maternal health providers play a key role in recognizing the range of psychological responses to perinatal loss and providing education, support, and treatment options to their patients. Objective This review aims to define psychological reactions associated with perinatal loss, examine psychotherapy and psychopharmacologic treatments for psychiatric morbidities, discuss interpregnancy interval following perinatal loss, and highlight brief, psychological interventions that can be implemented by maternal health providers. Evidence Acquisition Search terms “perinatal loss psychology,” “reproductive loss grief,” “perinatal psychopharmacology,” “psychopharmacology grief,” and “interpregnancy interval” were utilized to search PubMed, Google Scholar, and PsycINFO. Results Grief is an expected, normal response to perinatal loss. Psychological morbidities, including major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder, are also associated with perinatal loss. Risk factors for these conditions include history of a psychiatric illness, childlessness, unknown cause of perinatal loss, limited social support, and marital/relationship discord. Careful interviewing and brief screening measures can help identify patients who may suffer from depressive or anxiety disorders following reproductive loss. Patients with perinatal loss can benefit from psychological and possibly pharmacologic treatments. Recommended interpregnancy interval after perinatal loss should be customized by gestational age and cause of loss. Conclusions and Relevance Patients with perinatal loss emotionally benefit from their reproductive health care providers acknowledging the psychological aspects of reproductive loss, inquiring about their emotional needs, and providing information regarding grief and mental health referrals. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After completing this activity, the learner should be better able to define the range of psychological reactions associated with perinatal loss; differentiate between grief and major depressive disorder; list psychotherapeutic and psychopharmacologic treatments effective in treating emotional sequelae of reproductive loss; and describe recommendations for interpregnancy interval after perinatal loss and identify brief, psychological interventions that can be implemented by maternal health providers.

[Retracted] Application of Color Ultrasound in the Diagnosis of Gynecological Endocrine Disorders and Study of Ultrasonic Image Characteristics

“…Too high or too low may affect human health and even lead to diseases. In terms of the clinical significance of testing female sex hormones, the research of domestic scholars mainly discussed from three aspects: first, the significance of testing estrogen (E2) [ 11 ]. It is considered that the determination of E2 can judge the periodic change of estrogen secretion, which is also supported by empirical analysis after the study.…”

Tasked for Compassion: Initiating Reproductive Grief Care in the Neonatal Intensive Care Unit

“…Misconceptions about how the grief experience can impact physical or mental well-being are evidenced in inadvertent yet hurtful language patterns that frequently accompany reproductive loss and include comments like "it's common" or "you can just have another one". [62][63][64][65] Since the perinatal bereavement experience is outside of western cultural and societal norms, healthcare providers often report feeling awkward or uncomfortable acknowledging and addressing grief. 36,44,66,67 However, helpful interventions, which may initially seem too simplistic to be efficacious, can prove to be a challenge for care providers to utilize and assimilate into practice.…”

Family‐building and parenting considerations for people with cystic fibrosis

“…Infertility or pregnancy loss may result in stress, anxiety, and depression for both men and women. 76 , 77 , 78 , 79 , 80 Considering parenthood through ART, adoption, or fostering can also raise complex issues, including grief and loss, impact on relationships, and disclosure to children and others. 81 , 82 , 83 The American Society for Reproductive Medicine/Society for ART recommends psychoeducational consultation for people undergoing ART procedures, with referral for mental health evaluation and treatment as needed.…”