The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study

Abstract

BackgroundPerinatal bereavement is an event that greatly impacts the emotional, psychological, and psychosocial aspects of those who want to have a child.ObjectivesSince there are few studies on the psychological impact of the COVID-19 pandemic on couples grieving for perinatal loss, this research aimed to survey this experience.ParticipantsBetween 2020 and 2021, in Italian provinces highly affected by the COVID-19 pandemic, 21 parents participated: 16 mothers (76%; mean age 36.2; SD: 3.1) and 5 fathers (24%; mean age 40.2; SD: 3.4), among which there were 4 couples.MethodsA mixed-method design was used through self-report questionnaires and in-depth interviews. Accompanied by a sociodemographic form, the following questionnaires were administered: Prolonged Grief-13, the Parental Assessment of Paternal Affectivity (PAPA) (to fathers), the Parental Assessment of Maternal Affectivity (PAMA) (to mothers), the Dyadic Adjustment Scale short version, the Daily Spiritual Experiences Scale, and the Impact of Event Scale-Revised. The texts obtained through the in-depth interviews underwent thematic analysis.ResultsFifty per cent of participants suffered from Post-Traumatic Stress Disorders (PTSD) symptoms and 20% suffered from relational dyadic stress. Four areas of thematic prevalence emerged: psychological complexity of bereavement, the impact of the COVID-19, disenfranchisement vs. support, and spirituality and contact with the lost child. Participants interpreted their distress as related to inadequate access to healthcare services, and perceiving the pandemic restrictions to be responsible for less support and lower quality of care. Furthermore, they needed psychological help, and most of them were unable to access this service. Spirituality/religiosity did not help, while contact with the fetus and burial did.ConclusionIt is important to implement psychological services in obstetrics departments to offer adequate support, even in pandemic situations.

Perinatal Loss and Parents’ Grief Amidst the COVID-19 Pandemic: A Mixed-Method Research

“…The baseline findings indicated that COVID-19 restrictions have adversely impacted the experience of spontaneous pregnancy loss in couples [5], with follow-up results confirming the lasting detrimental effects on the processing of traumatic loss. These restrictions have strained relationships between healthcare providers and parents, limiting interactions with the family and friends network.…”

“…The number of participants, mothers and fathers, who filled out the questionnaire in the follow-up was 20 out of 45 of total participants at the baseline ( [5], see also Table 2). For 61.5% (50% of the mothers and 20% of the fathers) this was their first pregnancy, and 46% (37.5% of the mother and 60% of the fathers) had previous experience with miscarriage.…”

“…A mixed-methods design was adopted through the use of a self-report protocol [38] and the implementation of a semi-structured interview [39]. The longitudinal-type research was divided into a base-line phase [5,38] and a follow-up phase six months after the first one (as the Criterion A for Prolonged Grief Disorders requires a 12-month temporal line, a follow-up after six months was considered a pertinent temporal evaluation). The mixedmethod design involves the parallel analysis of quantitative and qualitative data.…”

“…The loss of a child is an intensely dramatic event that disrupts the natural course of life [1][2][3][4][5]. It deeply affects mothers, fathers, and the entire family system, potentially leading to intense and enduring grief that persists for several years [6].…”

“…In particular, the aim was to investigate the impact of COVID-19 on the experience of the parental couple six months after the baseline phase of the study by comparing the narratives of mothers and fathers (for preliminary results on the baseline phase cfr. [5]). Changes over time in the grieving process were assessed at the baseline and the follow-up in order to check for the evolution or development of the grief reaction and experience.…”