Reactions to perinatal loss: a qualitative analysis of the National Maternal and Infant Health Survey
Abstract
Women who had experienced an infant or fetal death responded to an open-ended question on the 1988 National Maternal and Infant Health Survey about their perinatal experience. A qualitative analysis of the 413 responses identified six major themes, including need for further information, problems with the mourning process, and unresolved questions about the cause of the death. Implications of the findings for health care practice are discussed.
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Parents reportedly experience avoidance or a lack of acknowledgment of their loss as providers, staff, and others focus on the living baby or babies.
“Parents reportedly experience avoidance or a lack of acknowledgment of their loss as providers, staff, and others focus on the living baby or babies.115”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [115]
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Perinatal Loss and Parental Grief: The Challenge of Ambiguity and Disenfranchised Grief
Lang, A., Fleiszer, A. R., Duhamel, F., Sword, W., Gilbert, K. R., & Corsini-Munt, S. (2011) · OMEGA - Journal of Death and Dying · doi:10.2190/om.63.2.e · Cited by 239 · see citing works
“…inappropriate or insensitive care following a perinatal death, even though there are well accepted standards of care that exists in the theoretical and research literature, as well as among professionals in the field (Covington & Theut, 1993; Joanna Briggs Institute, 2006; Lang et al., 2005).”
BackgroundNavigating care after a baby dies: a systematic review of parent experiences with health providers
Gold, K. J. (2007) · Journal of Perinatology · doi:10.1038/sj.jp.7211676 · Cited by 219 · see citing works
“…noted hospital staff were described as just the third most helpful part of bereavement care, preceded both by support groups and mourning rituals.28 Covington and Theut (1993) reported 2% of parents had only positive interactions with staff whereas 22% reported only negative reactions.29 Parents…”
BackgroundPregnancy After Perinatal Loss: The Relationship Between Anxiety and Prenatal Attachment
Armstrong, D., & Hutti, M. (1998) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.1998.tb02609.x · Cited by 178 · see citing works
Hospital Care for Parents After Perinatal Death
Gold, K. J., Dalton, V. K., & Schwenk, T. L. (2007) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000259317.55726.df · Cited by 139 · see citing works
Garstang, J. J., Griffiths, F. E., & Sidebotham, P. D. (2014) · BMC Pediatrics · doi:10.1186/1471-2431-14-269 · Cited by 90 · see citing works
“SN Covington and SK Theut [28] 1993 Reactions to perinatal loss: a qualitative analysis of the National Maternal and Infant Health Survey Mothers of infants dying perinatally Postal questionnaire survey 75%”
BackgroundResultInfluentialEnd-of-life experiences of nurses and physicians in the newborn intensive care unit
Epstein, E. G. (2008) · Journal of Perinatology · doi:10.1038/jp.2008.96 · Cited by 84 · see citing works
Perinatal death: bereavement interventions used by US and Spanish nurses and midwives
Steen, S. E. (2015) · International Journal of Palliative Nursing · doi:10.12968/ijpn.2015.21.2.79 · Cited by 53 · see citing works
Long-term impact of perinatal bereavement
Schaap, A. H. P., Wolf, H., Bruinse, H. W., Lande, S., & Treffers, P. E. (1997) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(97)00127-9 · Cited by 46 · see citing works
Mothers' Perceptions of Benefits of Perinatal Loss Support Offered at a Major University Hospital
Sanchez, N. A. (2001) · The Journal of Perinatal Education · doi:10.1624/105812401x88165 · Cited by 33 · see citing works
Health Care Provider Support and Grief after Perinatal Loss: A Qualitative Study
Ujda, R. M., & Bendiksen, R. (2000) · Illness, Crisis & Loss · doi:10.1177/105413730000800304 · Cited by 30 · see citing works
“In 1976, Klaus and Kennell wrote in Maternal-Infant Bonding that health care workers needed to realize that in some women, affectional ties will begin or accelerate on quickening, or feeling fetal movement. They claimed that the majority of those who initially rejected pregnancy accept their situation during the cours…”
BackgroundInfluentialRoberts, L. R., Nick, J. M., Sarpy, N. L., Peters, J., & Tamares, S. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00149 · Cited by 27 · see citing works
Meaning-Making After Neonatal Death: Narratives of Xhosa-Speaking Women in South Africa
Sturrock, C., & Louw, J. (2013) · Death Studies · doi:10.1080/07481187.2012.673534 · Cited by 20 · see citing works
“…feel they have been listened to, given as much information as possible, and been allowed to make their own choices, experience interaction with medical staff as supportive and helpful in dealing with their loss (Corbet-Owen & Kruger, 2001; Covington & Theut, 1993; Klier, Geller, & Ritsher, 2002).”
BackgroundCovington, S. N. (2001) · Cambridge University Press eBooks · doi:10.1017/cbo9780511547263.018 · Cited by 15 · see citing works
Self-citationEffects of Intentional Touch on Complicated Grief of Bereaved Mothers
Kempson, D. A. (2001) · OMEGA - Journal of Death and Dying · doi:10.2190/t1u8-jwau-3rxu-ly1l · Cited by 15 · see citing works
“…grieving process because bereaved mothers are at greater risk than bereaved fathers to experience the on-going effects of complicated grief from the death of a child (Covington & Theut, 1993; Dyregrov, 1990; Dyregrov & Matthiesen, 1991; Fish, 1986; Murphy-Mancini, 1988; Schatz, 1986; Schwab, 1996).”
BackgroundNetzer, D., & Arad, I. (1999) · Twin Research · doi:10.1375/136905299320565744 · Cited by 15 · see citing works
Communicating with Parents who Experience a Perinatal Loss
Kavanaugh, K. L., & Paton, J. B. (2001) · Illness Crisis & Loss · doi:10.1177/105413730100900404 · Cited by 11 · see citing works
Saöflund, K., Sjögren, B., & Wredling, R. (2000) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674820009075608 · Cited by 11 · see citing works
Do Couples Grieve Differently following Infant Loss?
Hunfeld, J. A. M., Mourik, M., Passchier, J., & Tibboel, D. (1996) · Psychological Reports · doi:10.2466/pr0.1996.79.2.407 · Cited by 10 · see citing works
“The majority of these studies only focus on the mothers' grief (1, 2, 3 , 6, 9).”
BackgroundNetzer, D., & Arad, I. (1999) · Twin Research · doi:10.1375/twin.2.4.258 · Cited by 10 · see citing works
de Tychey, C., & Dollander, M. (2006) · Rorschachiana Journal of the International Society for the Rorschach · doi:10.1027/1192-5604.28.1.16 · Cited by 7 · see citing works
Lang, A. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.1041715 · Cited by 6 · see citing works
Friedrichs, J. B., Daly, M., & Kavanaugh, K. L. (2000) · Illness Crisis & Loss · doi:10.1177/105413730000800306 · Cited by 6 · see citing works
“…because of the documented social isolation of the parents postdischarge (Kavanaugh 1999; Malacrida 1997; Rajan 1994) and the frequent accounts of parents’ lack of understanding of the events surrounding the loss (Covington and Theut 1993; Crowther 1995; Kavanaugh 1999; Radestad et al. 1998).”
BackgroundHow mothers experience personal growth after a perinatal loss
Thomadaki, O. O. (2012) · City Research Online (City University London) · Cited by 6 · see citing works
Äidin suru alle seitsenvuotiaan lapsen kuoleman jälkeen
Laakso, H. (2000) · Tampere University Institutional Repository (Tampere University) · Cited by 5 · see citing works
Covington, S. N., & Burns, L. H. (2001) · Cambridge University Press eBooks · doi:10.1017/cbo9780511547263.016 · Cited by 4 · see citing works
Self-citationCarrying Death: A Qualitative Study of Women’s Bodily Perceptions After Their Baby Died in Utero
Damm, M. F., Jørgensen, M. L., Eklund, M. V., Hvidtjørn, D., & Prinds, C. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231190544 · Cited by 3 · see citing works
“Several studies have suggested that this type of loss is a traumatic experience that differs from other types of loss (Burden et al., 2016; Covington & Theut, 1993; Huberty et al., 2014; Nuzum et al., 2018).”
Gandino, G., Diecidue, A., Sensi, A., Venera, E. M., Finzi, S., Civilotti, C., Veglia, F., & Fini, G. D. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1085944 · Cited by 3 · see citing works
“The lack of a clear explanation after long periods of time not only encouraged cause-seeking behavior, but in some cases led parents to feel that the reason for their baby’s death was withheld from them (Covington and Theut, 1993), which could jeopardize their already fragile mental health.”
BackgroundOlder Women and Grief: A New Direction for Research
McCandless, N. J., & Conner, F. P. (1997) · Journal of Women & Aging · doi:10.1300/j074v09n03_06 · Cited by 3 · see citing works
Visiting women after a termination
Young, N., & Bennett, R. (2002) · British Journal of Midwifery · doi:10.12968/bjom.2002.10.1.10048 · Cited by 1 · see citing works
Covington, S. N. (2009) · Postgraduate Obstetrics & Gynecology · doi:10.1097/01.pgo.0000348533.03993.0a · Cited by 1 · see citing works
Self-citationGrimshaw, J. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.1050040
Pregnancy After Perinatal Loss: The Relationship Between Anxiety and
Armstrong, D. S., & Hutti, M. H. (1998)
The emergence and effect of hospital protocols for perinatal loss in Canada
Davidson, D. E. (2020) · Bereavement Care · doi:10.1080/02682621.2020.1728081
“Next was a quantitative literature on grief, mourning, gender differences, and patient satisfaction (see Covington & Theut, 1993; Gilbert & Smart, 1992; Goldbach, Dunn, Toedter, & Lasker, 1991; Harper & Wisian, 1994; Moohan, Ashe, & Cecil, 1994; Theut, Zaslow, Rabinovich, Bartko, & Morihisa, 1990;…”
Parental Grief Responses to Perinatal Loss
Peacock, L. (1998) · ScholarWorks - GVSU (Grand Valley State University)
- Authors
- Covington, S. N., & Theut, S. K.
- Affiliations
- Georgetown University (US)
- Venue
- American Journal of Orthopsychiatry
- Published
- 1993
- Volume
- 63
- Issue
- 2
- Pages
- 215-222
- ISSN
- 0002-9432 (ISSN-L)
- 1939-0025
- OpenAlex
- W2155903806
- Cited by
- 33
- References
- 0
- Citations by year
- 2024: 1 · 2023: 2 · 2020: 1 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Orthopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- perinatal loss, infant death, fetal death, grief, mourning process, bereavement, maternal experience, information needs, maternal mental health, health care practices
- MeSH terms
- Adaptation, Psychological, Adult, Attitude of Health Personnel, Female, Fetal Death, Follow-Up Studies, Grief, Humans, Infant, Newborn, Pregnancy, Caregivers, Patient Satisfaction
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