Bereaved Mothers Research Articles

From mourning to memorialising - A lasting connection through remembrance: The role of memory making in preserving the identity of parenthood amongst women who have suffered a perinatal bereavement.

From mourning to memorialising - A lasting connection through remembrance: The role of memory making in preserving the identity of parenthood amongst women who have suffered a perinatal bereavement.

Milk Donation Following Perinatal Loss: Insights from a Survey across Italian Human Milk Banks

Background/Objectives: Milk donation after perinatal loss has been increasingly recognised as a potential healing practice for bereaved mothers. However, lactation support offered to bereaved mothers within hospital settings is still limited. The study aimed to explore the experiences and current practices of Italian Human Milk Banks (HMBs) regarding milk donation after perinatal loss, and to identify barriers and facilitators towards the implementation of this practice, in order to inform future quality improvement initiatives. Methods: An online survey was distributed to Italian HMBs between June and September 2023. Close-ended questions were reported as frequencies. Open-ended responses were analyzed through a comparative analysis. Results: forty-three Italian HMBs were contacted, and 34 replied (response rate 79%). Milk donation was offered as a possible option to manage lactation to bereaved mothers in 22 out of 34 Italian HMBs (65%). The lactation counselling was conducted by the HMB personnel in 18 out of 34 centers, by neonatologists in 17 centers, by neonatal nurses in 12 centers, by obstetricians in 4 centers. Twenty-two HMBs (65%) reported to have received from the mothers themselves the request to donate milk after losing their baby. Interviewees reported as main barriers towards implementation of this practice: lack of psychological preparation of the HMBs staff to handle the proposal of milk donation after a loss, to support the mother in processing the death through a gift to life and lack of adequate communication skills. Conclusion: in order to offer bereaved mothers adequate lactation counselling, specific training should be delivered to the healthcare workers involved, focusing on psychological, communication, and sociocultural aspects.

Factors Associated with Perinatal Bereavement Among Mothers in Bolivia: A Qualitative Study.

Background/Objectives: The objective of this research was to analyze the experiences and factors associated with perinatal grief in mothers in the urban context of Santa Cruz de la Sierra, Bolivia. Methods: The sample consisted of seven mothers who experienced a loss during pregnancy up to the second month after the baby's birth, occurring between 2015 and 2020 in the city of Santa Cruz de la Sierra. The mean age of the mothers was 34.86 years (SD = 3.13), and they belonged to middle or upper-middle socioeconomic levels. Data were collected through semi-structured interviews and analyzed using descriptive qualitative analysis. Results: The identified characteristics of perinatal grief were sadness, anger, guilt, emotional numbness, social isolation, and anxiety. Factors contributing to grief processing included support from the partner and family, when they accommodated and respected the mother's needs. Factors hindering the grieving process included social and cultural environments that often silence and minimize the loss, a history of previous losses, the desire to be pregnant, and the mother's life expectations and projects focused on motherhood. Conclusions: In conclusion, this research suggests that perinatal losses in the Bolivian context may be influenced by factors such as knowledge of the cause of death, previous loss experiences, and their emotional effects. The limitations of the study include the lack of diversity in participants' educational and socioeconomic backgrounds and the restriction of the sample to an urban area in Bolivia. Emotional interventions to support these bereaved mothers in those complex moments should be integrated in the Bolivian healthcare system.

Grief in fars and turkmen women experiencing perinatal loss

IntroductionPerinatal grief is one of the most stressful events in women’s lives and can be influenced by various factors, such as cultural and ethnic background. Gorgan City in Golestan province is populated by two main ethnic groups, Fars and Turkmen, with differences in various dimensions such as language, clothing, and customs. The study aimed to compare grief among Fars and Turkmen women who experienced perinatal loss in Gorgan − 2020–2021.Materials and methodsThe present cross-sectional study was conducted among 860 Fars and Turkmen mothers with a history of PL. A convenience sampling method was used. Participants with inclusion criteria completed the questionnaire, including demographic information and the Persian version of the Perinatal Grief Scale. A chi-square test, univariate and multiple logistic regressions were used via SPSS 16.ResultsFars women experienced severe grief more than Turkmen women (26% vs. 18.4%, p = 0.009). The univariate logistic regression showed that the variables of ethnicity, women’s education level, and number of living children were significantly associated with the intensity of grief. After controlling for the covariates, multiple logistic regression showed that only the number of live children had a significant effect on the intensity of perinatal grief. In other words, the risk of severe grief was 79%, 77%, and 76% lower in women with one, two, and three or more children than women with no children, respectively.ConclusionThe frequency of severe grief was higher in Fars women than in Turkmen. The severe grief was also associated with childlessness. It is suggested that the above differences be taken into account in providing care services to bereaved mothers.

Hindi translation and validation of perinatal grief scale (short version): Assessing grief following stillbirth in bereaved mothers

Background: Perinatal grief is the experience or emotions of parents following the loss of an infant by miscarriage, stillbirth, neonatal loss, or elective termination for fetal anomalies. Aim: We aimed to translate and adapt the Perinatal Grief Scale (PGS) into Hindi and evaluate its psychometric properties in a sample of women who had recently experienced a stillbirth. Method: The PGS was translated and adapted into Hindi following the process of translation and adaptation recommended by the World Health Organization. Internal consistency reliability was assessed by calculating Cronbach’s alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to assess discriminant validity and composite reliability. Additionally, the participants were assessed on four other questionnaires (State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire) to test the convergent validity. Results: The mean age of the participants was 27.57 years (SD = 4.42), and 7% of the mothers were of advanced age. The Cronbach’s alpha of the three subscales of PGS was more than 0.85, which confirms the reliability of PGS-H. A significant positive correlation was found between PGS-H and scores of STAI, EPDS, GAD7, and PHQ9 (P < 0.05). EFA identified three domains of PGS. In CFA, the goodness of model fit was confirmed with a root mean square error of approximation of 0.06, a comparative fit index of 0.915, and a goodness of fit index of 0.812. Conclusion: The PGS-H has been demonstrated to be a reliable and valid instrument for assessing grief in women following pregnancy loss.

Cultural differences on baby loss experiences: A comparison of the US and New Zealand

Prior research has shown that the death of a baby (whether it be through miscarriage, stillbirth, or infant loss) can have profound effects on the parents involved. However, research has yet to adequately understand how these effects differ cross-culturally. Our research addresses these issues through a qualitative study of 47 bereaved mothers in the United States and New Zealand—cultures that have differing perspectives on death. Findings reveal that bereaved mothers in each country do not process grief the same but do have an equal end desire to find meaning and give back. In terms of processing grief, bereaved mothers in New Zealand rely more on spending time with the deceased, utilizing spirituality for comfort and connection, and prioritizing self-care. In contrast, bereaved mothers in the United States rely more on easy access to qualified counselors, utilizing religion for comfort and connection, and continuing parenting actions in the long-term.

A Phenomenological Study of Clinical Stillbirth Management for Grieving Mothers

For any expectant mother, the worst possible outcome of pregnancy is for the baby to die. The experience can lead to various forms of physical and psychosocial morbidity. The purpose of this study was to gain in-depth understanding of the experiences of mothers who suffered stillbirth with a view to improving the clinical management of stillbirth. Semi-structured qualitative interviews were conducted with ten women who had experienced stillbirths within one year prior to the interview. The interviews were recorded and transcribed verbatim. The data were analyzed using Smith’s interpretative phenomenological analysis (IPA) model and ATLAS.ti 8 software. Healthcare professionals identified three main themes: clinical management for stillbirth and bereaved mothers across various roles; public hospitals; and the Jordanian Ministry of Health Policies and Guidelines. The study findings underscore the devastating impact of insensitive and poor-quality care on bereaved mothers, highlighting how it exacerbates their grief and sorrow. These findings emphasize the need for training healthcare providers in perinatal loss and bereavement care, as well as the importance of adopting new policies and guidelines to improve the quality of care provided to bereaved mothers.

Mother's Milk Donation to a Human Milk Bank During Bereavement: Circumstances Associated with Completing the Donation Process.

Background: Bereaved mothers describe positive experiences donating breast milk and negative experiences when not informed of opportunities to donate. Predictors of whether mothers donate milk are unknown, impairing efforts to optimize support in completing donation. Objective: To define circumstances associated with completing mother's milk (MM) donation during bereavement. Methods: A retrospective cohort study included dyads of bereaved mothers and their deceased children if a child's death occurred on-site at a quaternary care children's hospital during 2016-2020, the child had documentation of MM availability, and age at death <24 months. The primary outcome was the completion of MM donation to the milk bank. Multivariate logistic regression measured associations between clinical variables and odds of completion. Results: Of 124 deceased children with documented MM exposure, 34 mothers (28%) of 35 of those children completed MM donation, donating a mean of 13.7 liters (SD 16.8). The child's race/ethnicity documented in the medical record was White for 25 (71%), Black/African American (AA) for 1 (3%), Asian for 1 (3%), and Hispanic/Latino for 8 (23%). Referenced to mothers of White children, being a mother of an AA [OR 0.05 (95% CI: 0.01-0.43)] or Asian [0.08 (0.01-0.75)] child was associated with lower odds of donation. Referenced to mothers delivering full term (≥37 weeks'), mothers delivering <34 weeks showed higher odds [5.0 (1.5-17.5)] of donation. Conclusion: Relatively few bereaved mothers of children with indicators of MM exposure completed donation. The results suggest an opportunity to ensure bereaved mothers are uniformly informed and supported in donating.

Intergenerational Clustering of Under-Five Mortality: A Cohort Perspective in Low- and Middle-Income Countries

A burgeoning demographic literature documents the exceedingly high rates at which contemporary cohorts of women across the Global South experience the death of their children—even amid historic declines in child mortality. Yet, the patterning of maternal bereavement remains underinvestigated, as does the extent to which it replicates across generations of the same family. To that end, we ask: Are the surviving daughters of bereaved mothers more likely to eventually experience maternal bereavement? How does the intergenerational clustering of maternal bereavement vary across countries and cohorts? To answer these questions, we make use of Demographic and Health Survey Program data from 50 low- and middle-income countries, encompassing data on 1.05 million women and their mothers spanning three decadal birth cohorts. Descriptive results demonstrate that maternal bereavement is increasingly patterned intergenerationally across cohorts, with most women experiencing the same fate as their mothers. Multivariable hazard models further show that, on average, women whose mothers were maternally bereaved have significantly increased odds of losing a child themselves. In most countries, the association is stable across cohorts; however, in select countries, the risk associated with having a bereaved mother is shrinking among more recent birth cohorts.

Healthcare professionals' needs when providing perinatal bereavement care: A qualitative study.

Caring for and supporting bereaved parents with fetal loss requires preparation, training, and attention to a set of needs of health workers to provide optimal services. This is although it has been less addressed in the educational curriculum and in-service training. This study aims to investigate the experiences of Iranian healthcare professionals regarding the needs related to the care of bereaved parents with perinatal loss. This research was a qualitative study conducted in Shahroud City, Iran, to explore healthcare professionals' needs from June 2021 to December 2022. Semi-structured in-depth interviews on purposive sample of 14 participants were conducted. The participants were care providers who worked in OB-GYN ward, general midwifery clinics, and a private office. The interviews were recorded verbatim, transcribed, and analyzed using an inductive content analysis. MAXQDA software version 10 was used for data analysis. Granheim and Lundman's approach was used to analyze the data. Two major themes, four categories, and nine subcategories emerged. The themes included the "existence of protective laws and policies" and "skill and training needs." Protective laws and policies included "Government Rules and guidelines" and "organizational Rules protecting the individual." Skills and training needs consisted of two categories: "communication skills" and "Self-Care needs." Educational policies, development of guidelines for the care of bereaved mothers based on culture, training programs for dealing with bereaved parents, providing self-care programs for employees, and improving the physical and emotional conditions of the workplace were among the needs expressed by the participants. Meeting the needs of healthcare professionals is effective in job satisfaction, feeling of value, and high quality of services for bereaved parents.

With Woman in Perinatal Loss

This paper explores how women experience perinatal loss, and how midwives can be supportive under these circumstances. It examines both the features of perinatal loss that unite women into a subculture of bereaved mothers, as well as some sociocultural issues, such as poverty, that can compound their grief. It also addresses the limited professional training that midwives receive in this area, and offers suggestions for how to better prepare them.

Rituals of Separation in the Face of the Death of a Child

Objective: To describe the separation rituals developed by bereaved mothers in the face of the death of their children. Methodology: Descriptive field research, with a qualitative approach, carried out in a municipality in the interior of Paraíba, with ten members of the “Mothers of Pieta” group, consisting of mothers who lost children of natural or tragic death and share their experiences with other mothers in the process. mourning. Data collection took place over two months, using the focus group technique through individual interviews. Results: Interpretations were obtained about the maternal experiences of loss produced from conceptual maps in the light of the rituals of "Before death" - the rite of anointing the sick or the hospital experience, "Before the burial" - rite of the funeral and " After the burial” – celebration of the mass in faithful memory of the deceased. Conclusion: It was found that each ritual has its relevance in the face of the displeasure caused in a situation of loss, which shows the loss can have a better understanding when symbols (rites) are adopted that help in the elaboration of this experience.

“We are in the Battlefield”: "Bereaved Mothers and Widows: Navigating Multigenerational Conflicts.

Although the loss of a close family member affects the family relationship, most studies have focused on the coping of individuals with the loss and only a minority have examined the family system and the mutual influence of family members on their adjustment to loss. Less is known about the intergenerational relations in the context of loss. The aim of this article is to discusses conflicts in the relationships between Israeli widows and bereaved mothers after the death of their husband and son. Methods: Semi-structured in-depth interviews were conducted with two groups of participants: ten bereaved mothers and ten widows (from different bereaved families) whose sons or spouses died while serving in the Israeli military, the police, or the security forces. The data were analyzed using thematic analysis. Results: The following conflictual issues were identified: (1) Fighting over the memory of the deceased; (2) Tensions around the relationship with the children/grandchildren; and (3) Offensive communication patterns. Discussion: These conflicts are discussed in the Israeli context. The grieving rituals and the honor bestowed upon soldiers and other members of the security forces and their families have paradoxically served to silence the issue. At the same time, the findings and the literature suggest an urgent need for professional intervention to help the families avoid disconnection, aggression and even violence in those vulnerable relationships and maintain them after the loss.

The Benefits and Burdens of Participation in Qualitative Research to Bereaved Mothers of Children Who Died of Cancer

The Benefits and Burdens of Participation in Qualitative Research to Bereaved Mothers of Children Who Died of Cancer

A midwife's reflective writing in lactation and grief

Midwifery is not just about life and joy; unfortunately, at times it also involves death, sorrow and grief. The death of a baby and subsequent grief is complex, and involves grieving the baby's life as well as the life that parents have imagined with their child, including their role as parents. Pregnancy and baby loss have devastating effects on women and their families; expecting life and meeting death leave a profound emptiness. Perinatal death can include miscarriage, stillbirth and neonatal death. Lactation in these circumstances has been described by bereaved mothers as a healing therapy, and although there is some published evidence on this topic, further research will be necessary. This article was written based on the author's personal and professional experience, combined with current evidence, following Gibbs' reflective cycle, which provides a structured approach to learning from experiences. The aim is to create awareness of the importance of giving women the opportunity to decide how to manage their lactation and to speak about a topic that, unfortunately, is still taboo.

Associations between parental depression, communication, and self-worth of siblings bereaved by cancer.

A child's death from cancer may increase the risk for poor self-worth in bereaved siblings. Furthermore, bereaved parents may experience depressive symptoms and communicate differently with their surviving children. However, limited research has examined family factors associated with self-worth in bereaved siblings. Thus, we examined: (a) differences in parental depressive symptoms, parent-child communication, and sibling self-worth between bereaved and nonbereaved families and (b) indirect effects of parental depressive symptoms and communication quality on the association between bereavement and sibling self-worth. Bereaved parents and siblings were recruited 3-12 months after a child's death from cancer. Bereaved (n = 72) and nonbereaved families of classmates (n = 58) completed home-based questionnaires upon enrollment (T1), and 48 bereaved and 45 nonbereaved families completed 1-year follow-up (T2). Relative to controls at T1 and T2, bereaved mothers, but not fathers, reported more depressive symptoms. Bereaved siblings reported poorer maternal and similar paternal communication, and similar levels of self-worth compared to controls. Both cross-sectional and longitudinal serial mediation models for mothers were significant. Bereaved mothers were at greater risk for depressive symptoms, which adversely affected sibling self-worth over time through disrupted mother-child communication. The father sample was limited, but the cross-sectional model was nonsignificant. Mothers and fathers may grieve differently and may require different therapeutic approaches. Family-centered interventions should target bereaved mothers' emotional adjustment and communication to enhance sibling self-worth. Additionally, clinicians should bolster other sources of support for bereaved siblings to promote adaptive outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An exploration of women’s lived experiences of care and support following perinatal death in South-Western Nigeria: A hermeneutic phenomenological study

BackgroundPerinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience. AimThis study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria. MethodsA qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen’s approach to hermeneutic phenomenology was used in data analysis. FindingsFour main themes were identified: “they did not tell me the baby died”, “response of health care professionals after the baby died”, “moving on from hospital”, and “support from family”. The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge. ConclusionThis study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death.

Psychological profile of mothers who lost children due to violence

Grief is an amalgamation of symptoms and reactions related to significant loss. When a mother loses a child also loses its forecasts, projections, and idealizations. This study aims to psychologically analyze a sample of mothers who have lost children through violent means. They participated in ten mothers a town in Paraíba, selected through non-probability sampling for convenience. We used a socio-demographic questionnaire for the characterization data of mothers and Beck scales (Inventory Beck Depression, the Beck Anxiety and Beck Hopelessness Scale) and factorial scale of emotional adjustment / neuroticism to measure characteristics anxiety, depression, hopelessness, and emotional maladjustment. The results indicated a significant association between the variables vulnerability, anxiety, depression, inadequacy, and loss of time. The mothers had a higher incidence of anxiety symptoms. This study may contribute to the planning of a better continuous counseling the bereaved mothers.

Continuing bonds of bereaved Muslims mothers with their young dead child

Based on continuing bonds theory, this research examined the experience and manifestations of continuing bonds of bereaved Muslim mothers with their children who died in home accidents. This qualitative phenomenological study is based on interviews with 15 bereaved mothers (aged 28–46 years) whose children (aged 1–6 years) died 2–7 years before the interviews. Analysis revealed three themes: efforts to continue the physical bonds, challenges in the continuing bonds in cases of traumatic death, and belief in afterlife as the main element of the continuing bonds. The traumatic circumstances of the death challenged the ability to maintain the bond based on positive memories without it being overwhelmed by the traumatic memories of the last moments of the child’s life. Religious beliefs played an important role in the characteristics of the bond. Maintaining the bond requires professionals to provide a therapeutic environment where bereaved mothers feel safe talking about it.

A Mother's Voice: The Construction of Maternal Identity Following Perinatal Loss.

Maternal identity, a mother's internalized view of self as mother, has not been studied in relation to perinatal loss. This study aimed to investigate how women construct a sense of maternal identity after the loss of a baby. We interviewed 10 mothers who had experienced perinatal loss. A Listening Guide framework for narrative analysis was used to identify patterns of giving voice to the mother's own story. We identified 12 overarching voices which fell within three distinct groupings: voices of motherhood, voices of grief, and voices of growth. Although bereaved mothers grappled with constructing their maternal identity, they also demonstrated how maternal identity is individually and intuitively created through an honouring and remembering of the child that was lost, resulting in significant growth. There is need for a broader definition of what constitutes motherhood to encapsulate diverse mothering experiences, including perinatal loss.