The Impact of Postpregnancy Loss Services on Grief Outcome: Integrating Research and Practice in the Design of Perinatal Bereavement Programs
Abstract
A national sample of 249 bereaved mothers and 114 of their male partners was investigated retrospectively, using a mailed questionnaire and the Perinatal Grief Scale, to determine the impact of postpregnancy loss services on grief outcome. Participants ranged in age from eighteen to forty-seven and experienced from one to twelve pregnancy losses with gestational age of two to forty-two weeks. A three-stage multiple regression analysis determined that predictors differed by gender and that services contributed to the prediction of grief outcome above and beyond demographic variables. Significant predictors for mothers were months since loss, attending counseling, and attending support group; significant predictors for fathers were length of pregnancy, talking with friends, and timing of talking with family. A large-scale longitudinal study that controls for service variables could inform the development of future perinatal bereavement programming in addressing the unique needs of bereaved mothers and fathers.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Ten included studies did not state whether institutional ethical approval had been sought or obtained.
“However, 10 studies did not state whether institutional ethical approval had been sought or obtained [25, 46, 79, 82, 83, 86, 87, 91, 93, 94].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
Of the 12 quantitative studies that provided raw grief scores for men, outcomes varied considerably both between studies and within them.
“Of the 12 quantitative studies that provided raw grief scores for men, outcomes varied considerably both between studies and within them [23, 25, 67, 76, 84, 87, 88, 91, 93–96].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
The majority of average total PGS scores across remaining studies were between 73 and 83, with SDs ranging between values of 16 and 22.
“However, the majority of average total PGS scores across remaining studies were between 73 and 83, with SDs ranging between values of 16 and 22 [25, 87, 88, 91, 93].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
The difference between men's and women's grief scores was approximately 20 points on the PGS and IES, and 3 points on the RIMS.
“This was indicated by approximately 20 points of difference on the PGS and IES [88, 91, 93], and 3 points of difference on the RIMS [23, 76].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
Average total grief scores for men in studies using the PGS varied from 36 to 133.19 from a possible range of 33 to 165.
“Average total grief scores for men in studies using the PGS varied from 36 [93] to 133.19 [95] from a possible range of 33 to 165.”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
In five quantitative studies, increasing gestational age was associated with higher grief scores.
“In five quantitative studies, increasing gestational age was associated with higher grief scores [23–25, 67, 93].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
The remaining quantitative studies including age as a predictor did not find a significant association, and qualitative studies did not specifically explore or discuss the impact of age on grief.
“The remaining quantitative studies including age as a predictor did not find a significant association [24, 93, 95], and qualitative studies did not specifically explore or discuss the impact of age on grief.”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
In one quantitative study, 'talking with friends' was associated with increased grief scores, along with 'timing of talking to family'.
“In the one quantitative study that looked at family and friend support as variables, ‘talking with friends’ was associated with increased grief scores, along with ‘timing of talking to family’.”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
In some quantitative studies, men's grief was less intense compared to women's.
“Although men’s grief was less intense compared to women’s in some quantitative studies [23, 67, 76, 88, 91, 93, 94, 96], qualitative studies identified the significant impact of loss on men.”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [93]
Cites
Social Support, Life Events, and Depression During Pregnancy and the Puerperium
O’Hara, M. W. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800060063008 · Cited by 573 · see citing works
Social support for the bereaved: Recipients' and providers' perspectives on what is helpful.
Lehman, D. R., Ellard, J. H. T., & Wortman, C. B. (1986) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.54.4.438 · Cited by 528 · see citing works
Miscarriage as a traumatic event: A review of the literature and new implications for intervention
Lee, C. W., & Slade, P. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00579-x · Cited by 253 · see citing works
Measuring grief: A short version of the perinatal grief scale
Potvin, L., Lasker, J., & Toedter, L. (1989) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/bf00962697 · Cited by 227 · see citing works
Radestad, I., Steineck, G., Nordin, C., & Sjogren, B. (1996) · BMJ · doi:10.1136/bmj.312.7045.1505 · Cited by 204 · see citing works
Lee, C. W., Slade, P., & Lygo, V. (1996) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1996.tb01849.x · Cited by 204 · see citing works
Major Depressive Disorder in the 6 Months After Miscarriage
Neugebauer, R. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540290035029 · Cited by 202 · see citing works
The Psychological Sequelae of Miscarriage: A Critical Review of the Literature
Frost, M., & Condon, J. T. (1996) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679609076072 · Cited by 174 · see citing works
Controlled prospective study on the mental health of women following pregnancy loss
(1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.2.226 · Cited by 165 · see citing works
Depressive symptoms in women in the six months after miscarriage
Neugebauer, R., Kline, J., O’Connor, P., Shrout, P., Johnson, J., Skodol, A., Wicks, J., & Susser, M. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(92)91839-3 · Cited by 158 · see citing works
Beutel, M., Willner, H., Deckardt, R., Von Rad, M., & Weiner, H. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00520-x · Cited by 141 · see citing works
Grief and Depression After Miscarriage: Their Separation, Antecedents, and Course
Beutel, M., Deckardt, R., von Rad, M., & Weiner, H. (1995) · Psychosomatic Medicine · doi:10.1097/00006842-199511000-00003 · Cited by 140 · cited 1× · see citing works
“Parents who experience pregnancy loss are at increased risk of suffering serious psychological disturbance, which may take the form of a variety of psychological symptoms and is likely to impair daily living skills functioning (Beutel et al. 1995, 1996; Garel et al. 1994).”
BackgroundDeterminants of depressive symptoms in the early weeks after miscarriage.
Neugebauer, R., Kline, J. K., O’Connor, P. A., Shrout, P. E., Johnson, J. O., Skodol, A. E., Wicks, J., & Susser, M. W. (1992) · American Journal of Public Health · doi:10.2105/ajph.82.10.1332 · Cited by 139 · see citing works
The forgotten grief: A review of the psychology of stillbirth.
Kirkley‐Best, E., & Kellner, K. R. (1982) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1982.tb01428.x · Cited by 137 · see citing works
Acute versus chronic grief: The case of pregnancy loss.
Lasker, J. N., & Toedter, L. J. (1991) · American Journal of Orthopsychiatry · doi:10.1037/h0079288 · Cited by 134 · cited 17× · see citing works
“The PGS short form, a thirty-three-item self-report covering thoughts and feelings of the bereaved parent, served as the measurement instrument.”
BackgroundResultInfluentialCoping with the death of a child: A study over time.
Videka-Sherman, L. (1982) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1982.tb01458.x · Cited by 130 · see citing works
Human grief: A model for prediction and intervention.
Bugen, L. A. (1977) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1977.tb00975.x · Cited by 127 · see citing works
Vance, J. C., Boyle, F. M., Najman, J. M., & Thearle, M. J. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.167.6.806 · Cited by 113 · see citing works
Satisfaction with hospital care and interventions after pregnancy loss
Lasker, J. N., & Toedter, L. J. (1994) · Death Studies · doi:10.1080/07481189408252642 · Cited by 105 · see citing works
Pregnancy following miscarriage: course of grief and some determining factors
Cuisinier, M., Janssen, H., de Graauw, C., Bakker, S., & Hoogduin, C. (1996) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674829609025678 · Cited by 105 · see citing works
Caring in the instance of unexpected early pregnancy loss.
Swanson‐Kauffman, K. M. (1986) · PubMed · Cited by 99 · see citing works
Patterns of grief reaction after pregnancy loss.
Lin, S. X., & Lasker, J. N. (1996) · American Journal of Orthopsychiatry · doi:10.1037/h0080177 · Cited by 96 · see citing works
Miscarriage and stillbirth: time since the loss, grief intensity and satisfaction with care
Cuisinier, M. C. J., Kuijpers, J. C., Hoogduin, C. A. L., de Graauw, C. P. H. M., & Janssen, H. J. E. M. (1993) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0028-2243(93)90066-l · Cited by 95 · see citing works
The grief response in the partners of women who miscarry
Johnson, M. P., & Puddifoot, J. E. (1996) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1996.tb01875.x · Cited by 89 · see citing works
The effects of gestational age and gender on grief after pregnancy loss.
Goldbach, K. R. C., Dunn, D. S., Toedter, L. J., & Lasker, J. N. (1991) · American Journal of Orthopsychiatry · doi:10.1037/h0079261 · Cited by 84 · see citing works
Psychological reactions in women followed for 1 year after miscarriage
Robinson, G. E., Stirtzinger, R. M., Stewart, D. E., & Ralevski, E. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408865 · Cited by 66 · see citing works
Evaluation of mental health and depression during pregnancy: position paper.
Hendrick, V. C., Altshuler, L. L., Cohen, L., & Stowe, Z. N. (1998) · PubMed · Cited by 63 · see citing works
Resolution of Parental Bereavement after a Perinatal Loss
THEUT, S. K., ZASLOW, M. J., RABINOVICH, B. A., BARTKO, J. J., & MORIHISA, J. M. (1990) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199007000-00003 · Cited by 62 · see citing works
The miscarriage clinic: an audit of the first year
Turner, M. J., Flannelly, G., Wingfield, M. B., Rasmussen, M., Ryan, R., Cullen, S., Maguire, R., & STRONGE, J. M. (1991) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1991.tb13398.x · Cited by 60 · see citing works
Thearle, M. J., Vance, J. C., Najman, J. M., Embelton, G., & Foster, W. J. (1995) · OMEGA - Journal of Death and Dying · doi:10.2190/baxy-48au-petw-4mq3 · Cited by 46 · see citing works
Stillborn: The Invisible Death
DeFrain, J. (1986) · Medical Entomology and Zoology · Cited by 41 · see citing works
Miscarriage experience and the role of support systems: A pilot study
Conway, K. (1995) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1995.tb01833.x · Cited by 38 · see citing works
A Critical Review of the Concept of Pathological Grief following Pregnancy Loss
Janssen, H. J. E. M., Cuisinier, M. C. J., & Hoogduin, K. A. L. (1996) · OMEGA - Journal of Death and Dying · doi:10.2190/yll0-mwv4-wg7h-kbr3 · Cited by 36 · see citing works
Long-Term Effects of Perinatal Loss
ROSENBLATT, P. G., & Burns, L. H. (1986) · Journal of Family Issues · doi:10.1177/019251386007003002 · Cited by 35 · see citing works
Long-term consequences of miscarriage: the depressive disorders and the following pregnancy
Garel, M., Blondel, B., Lelong, N., Bonenfant, S., & Kaminski, M. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408409086 · Cited by 30 · see citing works
Explaining Pregnancy Loss: Parents' and Physicians' Attributions
Dunn, D. S., Goldbach, K. R. C., Lasker, J. N., & Toedter, L. J. (1991) · OMEGA - Journal of Death and Dying · doi:10.2190/a27n-vdk5-pnr7-mfaq · Cited by 30 · see citing works
When a Baby Dies: Psychotherapy for Pregnancy and Newborn Loss
Craig, J. M. (1990) · JAMA · doi:10.1001/jama.1990.03450230110042 · Cited by 29 · see citing works
Short-term psychotherapy for perinatal loss.
Leon, I. G. (1987) · Psychotherapy · doi:10.1037/h0085703 · Cited by 29 · see citing works
The Comparison Group Problem in Bereavement Studies and the Retrospective Pretest
Toedter, L. J., Lasker, J. N., & Campbell, D. T. (1990) · Evaluation Review · doi:10.1177/0193841x9001400105 · Cited by 27 · see citing works
Reproductive Losses and Grieving
Conway, P. G., & Valentine, D. P. (1988) · Journal of Social Work & Human Sexuality · doi:10.1300/j291v06n01_05 · Cited by 27 · see citing works
Reliability and validity of the Perinatal Grief Scale for women who experienced late pregnancy loss
Hunfeld, J. A. M., Wladimiroff, J. W., Passchier, J., Uden, M. U. V., Frets, P. G., & Verhagexy, F. (1993) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1993.tb01753.x · Cited by 27 · see citing works
When a Baby Dies: A Handbook for Healing and Helping
NM (1987) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/00005721-198709000-00010 · Cited by 25 · see citing works
Perinatal mortality counseling program for families who experience a stillbirth
Kellner, K. R., Best, E. K., Chesborough, S., Donnelly, W. H., & Green, M. (1981) · Death Education · doi:10.1080/07481188108252075 · Cited by 23 · see citing works
Simpson, K. (1989) · PubMed · Cited by 19 · see citing works
Fathers and grieving: coping with infant death.
Cordell, A. S., & Thomas, N. (1990) · PubMed · Cited by 17 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Obst, K. L., Due, C., Oxlad, M., & Middleton, P. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2677-9 · Cited by 222 · see citing works
REPORT ON BEREAVEMENT AND GRIEF RESEARCH
Genevro, J., Marshall, T., & Miller, T. (2004) · Death Studies · doi:10.1080/07481180490461188 · Cited by 189 · 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
Büchi, S., Mörgeli, H., Schnyder, U., Jenewein, J., Hepp, U., Jina, E., Neuhaus, R., Fauchère, J., Bucher, H. U., & Sensky, T. (2007) · Psychotherapy and Psychosomatics · doi:10.1159/000097969 · Cited by 127 · see citing works
Psychological aspects of perinatal loss
Hughes, P., & Riches, S. (2003) · Current Opinion in Obstetrics and Gynecology · doi:10.1097/00001703-200304000-00004 · Cited by 112 · see citing works
Jones, K., Robb, M., Murphy, S., & Davies, A. (2019) · Midwifery · doi:10.1016/j.midw.2019.102531 · Cited by 105 · see citing works
Psychological impact of stillbirth on fathers in the subsequent pregnancy and puerperium
Turton, P., Badenhorst, W., Hughes, P., Ward, J., Riches, S., & White, S. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.188.2.165 · Cited by 98 · see citing works
Obst, K. L., Oxlad, M., Due, C., & Middleton, P. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-03514-6 · Cited by 61 · see citing works
“For example, quantitative studies comparing heterosexual couples’ experiences following pregnancy loss and neonatal death suggest that men typically experience less intense and enduring levels of grief than women [18-23].”
BackgroundMergl, R., Quaatz, S. M., Edeler, L.-M., & Allgaier, A. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2108578 · Cited by 53 · see citing works
Helping men with the trauma of miscarriage.
Rinehart, M. S., & Kiselica, M. S. (2010) · Psychotherapy: Theory, Research, Practice, Training · doi:10.1037/a0021160 · Cited by 37 · see citing works
Toward a Theoretical Framework for Perinatal Bereavement
Brownlee, K. (2004) · The British Journal of Social Work · doi:10.1093/bjsw/bch063 · Cited by 33 · see citing works
Tsartsara, E., & Johnson, M. P. (2002) · Clinical Effectiveness in Nursing · doi:10.1016/s1361-9004(02)00028-6 · Cited by 21 · see citing works
Carlson, R., Lammert, C., & O’Leary, J. M. (2012) · Illness Crisis & Loss · doi:10.2190/il.20.3.e · Cited by 20 · see citing works
Conry, J., & Prinsloo, C. (2008) · Health SA Gesondheid · doi:10.4102/hsag.v13i2.276 · Cited by 18 · see citing works
Women and Reproductive Loss: Client-Worker Dialogues Designed to Break the Silence
Price, S. K. (2008) · Social Work · doi:10.1093/sw/53.4.367 · Cited by 13 · see citing works
Bakhbakhi, D., Siassakos, D. M., Davies, A. K., Merriel, A., Barnard, K., Stead, E., Shakespeare, C., Duffy, J. M., Hinton, L., McDowell, K., et al. (2023) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17390 · Cited by 12 · see citing works
Balle, S. R., Nothelfer, C., Mergl, R., Quaatz, S. M., Hoffmann, S., Hoffmann, H., Allgaier, A., & Eichhorn, K. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2386827 · Cited by 6 · see citing works
Martin, C. J. H., & Martin, C. R. (2016) · Springer eBooks · doi:10.1007/978-3-319-08359-9_44 · Cited by 4 · see citing works
Death and Factors of Adjustment Among Bereaved Parents
Al-Nasa’h, M., & Asner‐Self, K. K. (2019) · Advances in Science, Technology & Innovation/Advances in science, technology & innovation · doi:10.1007/978-3-030-01662-3_11 · Cited by 1 · see citing works
Conry, J. R. (2007) · UpSpace Institutional Repository (University of Pretoria)
Martin, C. J. H., & Martin, C. R. (2015) · Springer eBooks · doi:10.1007/978-3-319-08613-2_44-1
Tarmey, L., Iles, J. E., & Poole, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1867729
- Authors
- Rich, D. E.
- Affiliations
- Fairview Health Services (US)
- Corresponding author
- Rich, Deborah E.
- Venue
- Illness, Crisis & Loss
- Publisher
- SAGE Publications
- Published
- 2000-07
- Volume
- 8
- Issue
- 3
- Pages
- 244-264
- ISSN
- 1054-1373 (ISSN-L)
- 1552-6968
- OpenAlex
- W2311425549
- Cited by
- 22
- References
- 46
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2016: 1 · 2015: 1 · 2012: 1
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Illness Crisis & Loss (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- perinatal bereavement, miscarriage, bereavement services, support groups, counseling, gender differences, Perinatal Grief Scale
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
