The impact of bereavement intervention on levels of grief in pregnant women who experience pre-twenty-week loss
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One in six pregnancies is lost before the 20th week of gestation (Craven & Wise, 2002). Such losses can be devastating for the woman and her family. However, the psychological impacts of these losses are frequently not addressed by the health care establishment as attention is focused on the woman's immediate physiological needs. This study examined the impact of a secondary bereavement intervention on levels of grief in women who experienced pre-twenty week loss compared to women receiving the usual standard of care. The randomized control study selected forty low income women who had experienced complete abortions at the gestational age of 12 weeks to 19 weeks and 6 days(Iess than 500gms) and received care in a county hospital obstetrical emergency room. Each participant provided informed consent and was randomly assigned to either the treatment group or control group. The Medical Professional Guidelines for Health Care Professionals were used to construct and implement a perinatal grief intervention for participants in the experimental group. The control group received the usual standard of care. Demographic data forms and the Perinatal Grief Scale (PGS) were completed during a routine follow-up clinic visit. Analysis of the total PGS grief scores showed no significant difference between the two groups on overall levels of grieving (t= 2.518,p=.065). An examination of three subsets of the grieving process revealed no differences in the active grief processes or coping processes for two groups. This was attributed in part to the short two week period of time between the intervention and the measurement of grief. However, there were significant differences in the levels of despair between the two groups (t=4.80 p=.OOO). Despair is a complex form of grieving that is seen when coping mechanisms fail to ameliorate the grief reaction. The experimental group displayed significantly lower levels of despair. The study concluded that the bereavement intervention was effective in ameliorating the degree of the grief reaction as measured by levels of despair in low income women experiencing an early pregnancy loss.