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.
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Perinatal grief is a complex phenomenon requiring HCPs to provide special care for parents' psychosocial needs, as research shows parents' initial coping after perinatal loss may influence later mental health outcomes.
“Perinatal grief is a complex phenomenon requiring HCPs to provide special care for parents’ psychosocial needs, as research shows parents’ initial coping after perinatal loss may influence later mental health outcomes.17,18”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [18]
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Counselor Competency to Work With Clients Following Reproductive Trauma: An Exploratory Study
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Women’s Reproductive Mental Health in India
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- Authors
- Davoudian, T., Gibbins, K., & Cirino, N. H.
- Affiliations
- Oregon Health & Science University (US)
- Corresponding author
- Davoudian, Teni
- Cirino, Nicole H.
- Venue
- Obstetrical & Gynecological Survey
- Published
- 2021-04
- Volume
- 76
- Issue
- 4
- Pages
- 223-233
- ISSN
- 0029-7828 (ISSN-L)
- 1533-9866
- OpenAlex
- W3154303831
- Cited by
- 51
- References
- 71
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 13 · 2023: 12 · 2022: 8 · 2021: 3
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrical & Gynecological Survey (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- perinatal loss, maternal mental health, grief, major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, interpregnancy interval, psychotherapy, psychopharmacology, brief psychological intervention, screening, social support, childlessness
- MeSH terms
- Abortion, Spontaneous, Mental Disorders, Female, Humans, Maternal Health Services, Postnatal Care, Pregnancy, Psychotherapy, Puerperal Disorders
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