Nursing interventions to facilitate the grieving process after perinatal death: a systematic review
Open accessAbstract
Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions.
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Psychological support provided by nurses and midwives can significantly reduce the emotional burden on parents and improve their psychological outcomes.
“Researchers have demonstrated that psychological support provided by nurses and midwives can significantly reduce the emotional burden on parents, improving their psychological outcomes (Fernández-Férez et al., 2021; Xie et al., 2024; Yıldız Karaahmet and Bilgiç, 2024).”
From Nurses' and midwives' experiences of supporting parents following perinatal bereavement: A qualitative systematic review (2026) · cites this paper as Fernández-Férez et al., 2021
The Results (§3.4) report significantly better outcomes in intervention groups, including reduced grief symptoms after counselling and better depression and post-traumatic stress scores. The Conclusions (§5) identify professional support as helpful after perinatal death, but note that the interventions studied focused mainly on women; the evidence does not establish the same outcomes for parents generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMany nurses and midwives report a lack of bereavement care experience, time, organizational support, and emotional support, which can prevent them from effectively supporting grieving parents.
“Many nurses and midwives report a lack of bereavement care experience, time, organizational support, and emotional support, which can prevent them from effectively supporting grieving parents (Fernández-Férez et al., 2021).”
From Nurses' and midwives' experiences of supporting parents following perinatal bereavement: A qualitative systematic review (2026) · cites this paper as Fernández-Férez et al., 2021
The Discussion (page unavailable) reports that nurses and midwives lack some grief-counselling skills and may not know how to create memories of the baby for parents. The Introduction (page unavailable) also says a lack of recognized strategies hampers their work. The paper does not report lack of time, organizational support, or emotional support for staff as barriers. (LLM, conf=0.87)
Experimental — accuracy not yet measuredCompassionate practices such as active listening, emotional support, and relational care, particularly in institutions with well-prepared multi-disciplinary teams, were perceived as facilitators in the grief process and demonstrate the transformative impact of woman-centered care.
“In contrast to reports of negligence, some studies highlighted compassionate practices such as active listening, emotional support, and relational care, particularly in institutions with well-prepared multi-disciplinary teams. These approaches were perceived as facilitators in the grief process and demonstrate the transformative impact of woman-centered care (52).”
From Experiences and long-term repercussions of perinatal grief in women after perinatal bereavement: a meta-ethnography (2025) · cites this paper as [52]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe bereavement care provided after perinatal loss is of the utmost importance to facilitate coping in order to prevent worse immediate and long-term mental health outcomes, with some indication that earlier bereavement care leads to better outcomes.
“The bereavement care provided after perinatal loss is of the utmost importance to facilitate coping in order to prevent worse immediate and long-term mental health outcomes, with some indication that earlier bereavement care leads to better outcomes.20,22,23”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [22]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredFifty-one reports identified an association between emotional and social support and mental health outcomes of coping, well-being, healing, PTSD, trauma symptoms, anxiety, depression, emotional distress, helplessness, anger, and loneliness.
“Fifty-one reports identified an association between emotional and social support, which was associated with mental health outcomes of coping, well-being, healing, PTSD, trauma symptoms, anxiety, depression, emotional distress, helplessness, anger, and loneliness.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [22]
The Results (sections 3.1 and 3.4; page unavailable) say the review included four studies, not fifty-one reports, and describe improvements in anxiety, post-traumatic stress, depression and grief. The Discussion (section 4; page unavailable) also links social support with coping and reduced anxiety. The paper does not report the full claimed list of outcomes, including healing, helplessness, anger and loneliness. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Parents who suffer perinatal loss face an increased risk of poor psychological outcomes including grief, depression, anxiety, and sleep disturbances.
“Parents who suffer from such a loss face an increased risk of developing poor psychological outcomes, including grief, depression, anxiety, and sleep disturbances (Burnett et al., 1997; Fernández‐Basanta et al., 2020; Fernández-Férez et al., 2021)”
From Nurses' and midwives' experiences of supporting parents following perinatal bereavement: A qualitative systematic review (2026) · cites this paper as Fernández-Férez et al., 2021
Shared decision-making is particularly important when there is no clear evidence to guide policies, such as with the inconsistent findings related to parents' seeing/holding the baby.
“Shared decision-making is particularly important when there is no clear evidence to guide policies, such as with the inconsistent findings related to parents’ seeing/holding the baby.22,205”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [22]
Experimental research to build evidence for best practices for important characteristics of bereavement care are lacking.
“Experimental research to build evidence for best practices for important characteristics of bereavement care are lacking.22”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [22]
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- Authors
- Fernández-Férez, A., Ventura-Miranda, M. I., Camacho-Ávila, M., Fernández-Caballero, A., Granero-Molina, J., Fernández-Medina, I. M., & Requena-Mullor, M. D. M.
- Affiliations
- Faculty of Health Sciences, University of Granada, Distrito Sanitario Almería, 04009 Almería, Spain
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain
- Obstetrics Service, Hospital La Inmaculada, 04600 Huércal-Overa, Spain
- Faculty of Nursing, Univesity of Cádiz, 11207 Algeciras, Spain
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2021-05-24
- Volume
- 18
- Issue
- 11
- Pages
- 5587
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC8197264
- OpenAlex
- W3164239444
- Cited by
- 40
- References
- 48
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 10 · 2023: 7 · 2022: 4
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Repositorio de Patentes de la Universidad de Almería (Universidad de Almería) (submittedVersion, cc-by-nc-nd)
- RODIN (Universidad de Cádiz) (submittedVersion, cc-by)
- 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 › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- perinatal death, perinatal grief, nursing interventions, parental bereavement, midwife support, depression, post-traumatic stress, social support, group sessions, family education, physical activity
- MeSH terms
- Emotions, Female, Grief, Humans, Pregnancy, Social Support, Parturition, Perinatal Death
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