Special Article
Adaptation Following Perinatal Loss: A Critical Review

https://doi.org/10.1097/00004583-198907000-00001Get rights and content

Abstract

Parental adaptation following perinatal loss has received increasing attention in the past 20 years. From early anecdotal accounts to recent more rigorous investigations, it is clear that perinatal loss in the developed world is a significant psychological trauma for parents. Major immediate consequences are likely for virtually all affected families, and long-term sequelae are likely for some. Despite widespread attention to the experience of families who lose a stillborn or newborn infant, including major changes in hospital practices regarding management of these families, many important questions remain unanswered. We know little, for instance, about which parents are at greatest risk for disordered mourning or what additional measures might minimize their psychological morbidity. In fact, because of a tendency to focus exclusively on affective symptomatology following the loss, other important features of the process of mourning have been overlooked or examined unsystematically. Suggestions for specific and general directions for further research are discussed.

REFERENCES (92)

  • R.D. Beckey et al.

    Development of a perinatal grief checklist

    JOGNN

    (1985)
  • D.G. Benfield et al.

    Grief response of parents to neonatal death and parent participation in deciding care

    Pediatrics

    (1978)
  • P. Bourne

    The psychological effects of stillbirths on women and their doctors

    J. R. Coll. Gen. Pract.

    (1968)
  • P. Bourne

    The psychological effects of stillbirths on the doctor

    Proceedings of the Third International Congress on Psychosomatic Medicine in Obstetrics and Gyneacology

    (1972)
  • P. Bourne et al.

    Letter on “support after perinatal death: a study of support and counselling after perinatal bereavement.”

    Br. Med. J. [Clin. Res.]

    (1983)
  • J. Bowlby

    Loss

    (1980)
  • J.T. Brown et al.

    Normal and pathological grief

    JAMA

    (1983)
  • L.A. Bugen

    Human grief: a model for prediction and intervention

    Am. J. Orthopsychiatry

    (1977)
  • A.C. Cain et al.

    On replacing a child

    J. Am. Acad. Child Psychiatry

    (1964)
  • E.J. Callahan et al.

    Fetal loss and sudden infant death; grieving and adjustment for families

  • R. Clyman et al.

    Do parents utilize physician follow-up after the death of their newborn?

    Pediatrics

    (1979)
  • L. Cohen et al.

    Perinatal mortality: assisting parental affirmation

    Am. J. Orthopsychiatry

    (1978)
  • J.T. Condon

    Management of established pathological grief reaction after stillbirth

    Am. J. Psychiatry

    (1986)
  • J. Cornwall et al.

    Family response to loss of a child by sudden infant death syndrome

    Med. J. Aust.

    (1977)
  • J. Cullberg

    Mental reactions of women to perinatal death

    Proceedings of the Third International Congress on Psychosomatic Medicine in Obstetrics and Gyneacology

    (1972)
  • Davis, D. L., Stewart, M. & Harmon, R. J. (in press), Perinatal loss: providing emotional support for bereaved parents....
  • H. Deutsche

    The Psychology of Women: A Psychoanalytic Interpretation

    (1945)
  • B.A. Elliot et al.

    Neonatal death: reflections for physicians

    Pediatrics

    (1978)
  • P. Estok et al.

    Perinatal death: grief support for families

    Birth

    (1983)
  • G.C. Forrest et al.

    Support after perinatal death: a study of support and counselling after perinatal bereavement

    Br. Med. J. [Clin. Res.]

    (1982)
  • A. Freud

    A Discussion of Dr. John Bowlby's paper “Grief and mourning in infancy and early childhood.”

    Psychoanal. Study Child

    (1960)
  • E. Furman

    The death of the newborn: care of the parents

    Birth and the Family Journal

    (1978)
  • S.L. Gardner et al.

    Perinatal grief and loss

    Neonatal Network

    (1986)
  • P.F.H. Giles

    Reactions of women to perinatal death

    Aust. N. Z. J. Obstet. Gynecol.

    (1970)
  • D.P. Goldberg

    The Detection of Psychiatric Illness by Questionnaire

    (1972)
  • S. Goldberg et al.

    Maternal behavior and attachment in low-birth-weight twins and singletons

    Child Dev.

    (1986)
  • M. Green et al.

    Reactions to the threatened loss of the child

    Pediatrics

    (1964)
  • C. Grubb

    Is the baby alive or dead? Psychological work of a woman with an intrauterine fetal death

    Matern. Child Nurs. J.

    (1976)
  • T.A. Helmrath et al.

    Death of an infant: parental grieving and the failure of social support

    Fam. Pract.

    (1978)
  • E. Herz

    Psychological repurcussions of pregnancy loss

    Psychiatric Annals

    (1984)
  • W.L. Hildebrand et al.

    Helping parents cope with perinatal death

    Am. Fam. Physician

    (1980)
  • M.J. Horowitz et al.

    Pathological grief and the activation of latent self-images

    Am. J. Psychiatry

    (1980)
  • D.G. Inwood

    Postpartum Psychiatric Disorders

    (1985)
  • J.S. Jensen et al.

    Depression in mothers who have lost a newborn

    Rocky Mountain Medical Journal

    (1972)
  • H. Jolly

    Family reactions to stillbirth

    Proc. R. Soc. Med.

    (1976)
  • K.R. Kellner et al.

    Perinatal mortality counseling program for families who experience a stillbirth

    Death Education

    (1981)
  • Cited by (0)

    Partial support during the preparation of this review was provided by NIH Biomedical Research Starter Grant 1S07RR05993–01.

    The author acknowledges the assistance of Dr. Marianne Goldsmith with this review.

    View full text