The impact of a subsequent pregnancy on grief and emotional adjustment following a perinatal loss

Abstract

The present study examined the impact of a subsequent pregnancy on emotional adjustment associated with a previous perinatal loss and on the following components of parental grief—active grief, difficulty coping, despair. Participants included 25 women and 24 partners who were expecting a baby for the first time since their loss and 25 women and 18 partners who were not expecting and had not had a child or pregnancy after their loss. Depressive symptomatology, anxiety, marital adjustment, as well as active grief, despair, and difficulty coping were measured. Mothers who were not pregnant were experiencing significantly higher levels of despair and difficulty coping than pregnant mothers, independently from the effect of time elapsed since the loss. For the fathers, no significant group effect in emotional distress or intensity of grief was found. Women reported significantly higher levels of negative affectivity than men. A new pregnancy may be associated with a beneficial effect on the mourning process of women with a previous perinatal loss, primarily by decreasing their despair and difficulty coping. However, in our sample, grief intensity remained high, suggesting that the mourning process may not be hindered by a subsequent pregnancy.

The Influence of Prior Perinatal Loss on Parents' Psychological Distress After the Birth of a Subsequent Healthy Infant

“…Parents who have experienced a previous perinatal loss enter their subsequent pregnancies with much higher levels of psychological distress (Armstrong, 2002; Cote‐Arsenault, Donato, & Earl, 2006; Hughes, Turton, & Evans, 1999; Hughes, Turton, Hopper, McGauley, & Fonagy, 2001; Janssen, Cuisinier, Hoogduin, & de Graauw, 1996; Statham & Green, 1994) and pregnancy‐specific anxiety (Armstrong, 2002, 2004, Armstrong & Hutti, 1998; Cote‐Arsenault & Marshall, 2000; Franche & Mikail, 1999), and may even develop symptoms of posttraumatic stress (PTS; Armstrong, 2002; O'Leary & Thornwick, 2006; Turton, Hughes, Evans, & Fainman, 2001). Several studies of mothers who have had a previous loss show that they experience higher levels of anxiety than do fathers (Armstrong, 2002, 2004; Franche & Bulow, 1999). Anxiety is pervasive in a subsequent pregnancy, resulting in exaggerated arousal, heightened awareness, never feeling safe, and a constant state of hypervigilance (Armstrong, 2001; Cote‐Arsenault, 2007; Cote‐Arsenault & Marshall).…”

National survey of obstetrician attitudes about timing the subsequent pregnancy after perinatal death

“…Obstetricians may appreciate the repeated finding that the next pregnancy can facilitate resolution of the prior loss, both by providing the wished-for baby as well as having a healthy pregnancy which restores maternal self-worth so often devastated by perinatal loss 15,20,30-35…”

Social and Professional Support Needs of Families After Perinatal Loss

“…Distress may carry over into later pregnancies. In pregnancy after a perinatal loss, parents have been found to have elevated levels of anxiety (Armstrong, 2002;Armstrong & Hutti, 1998;Cote-Arsenault, 2002;Franche & Bulow, 1999;Hughes, Turton, & Evans, 1999;Van & Meleis, 2002), symptoms of depression (Armstrong, 2002;Armstrong & Hutti, 1998;Franche & Bulow, 1999;Hughes, Turton, & Evans, 1999), disordered attachment to the subsequent baby (Bakermans-Kranenburg, Schuengel, & van Ijzendoorn, 1999;Heller & Zeanah, 1999;Hughes, Turton, Hopper, & McGauley, 2001), and increased health care utilization (Cote-Arsenault, 2002;Waterstone, Wolfe, Hooper, & Bewley, 2003).…”