Effect of bereavement counseling on maternal grief after perinatal loss

Abstract

Abstract Background: Mother-child attachment is formed from early stages of pregnancy and peaks in the second trimester and continues until after childbirth. The fetal or neonatal death as a tragic event could lead to the grief experience among parents, especially mothers. The present study aimed to determine the effect of bereavement counseling on mothers’ grief following perinatal deaths. Materials and methods: This quasi-experimental study was performed on 56 women experienced perinatal death during the last 1-3 months, who were referred to the health centers of Tabriz, with score of Perinatal Grief Scale ≥ 91. Participants were randomly assigned into the intervention and control groups through stratified blocking on the basis of the stillbirth and neonatal death. The intervention group received individually bereavement counseling during three sessions, once a week for 45-60 minutes. Data collection tools included the demographic and obstetric characteristic questionnaire, Perinatal Grief Scale, Post-Traumatic Stress Disorder checklist for DSM-5 (PCL-5), and Edinburgh Postnatal Depression Scale. The data were analyzed using SPSS21. The groups were compared through t-test, and ANCOVA after adjusting the effect of baseline score. Results: After intervention, the mean of the grief total score in the intervention group was significantly lower than that in the control group after controlling the effect of baseline score [AMD: -18.7, 95% CI: - 26.7 to -10.7, p<0.001]. After intervention, the severity of the PTSD symptoms was not significantly different between the two groups [AMD: -1.5, 95% CI: -7.5 to 4.4, P=0.59]. The mean score of depression in the intervention group was significantly lower than that in the control group after intervention [AMD: -2, 95% CI: -3.2 to -0.8, P=0.001]. Conclusion: Conducting bereavement counseling, after experiencing perinatal deaths is effective in reducing the mothers’ grief reactions, and depression. But it could not reduce severity of PTSD symptoms. It is recommended to evaluate the effectiveness of other intervention approaches on PTSD after perinatal deaths in further studies. Keywords: Bereavement, Grief, Perinatal death, Stillbirth, Counseling, Post-traumatic stress disorder, Depression