Religious beliefs affect grieving after pregnancy loss.

Religious beliefs and practices may aid in coping with bereavement and grief after pregnancy loss. Data from 103 women enrolled in the original Lehigh Valley Perinatal Loss Project, and who were followed-up for at least 1 year, were evaluated for the impact of initial religious practices and beliefs on the course and severity of grief. Religious practices corresponding to standard scales of religiosity and agreement with specific beliefs were rated by the women on a Likert scale of 1-5. Neither agreement with statements corresponding to extrinsic and intrinsic religiosity or to positive religious coping, nor frequency of religious service attendance was predictive of follow-up scores on the Perinatal Grief Scale. Religious struggle, agreement with statements classified as negative religious coping, and continued attachment to the baby were all associated with more severe grief.

International comparison of studies using the perinatal grief scale: a decade of research on pregnancy loss.

The Perinatal Grief Scale (PGS) has been used in many studies of loss in pregnancy, including miscarriage, stillbirth, induced abortion, neonatal death, and relinquishment for adoption. This article describes 22 studies from 4 countries that used the PGS with a total of 2485 participants. Studies that report Cronbach's alpha for their own samples give evidence of very high internal consistency reliability. Evidence for the validity of the PGS is also reviewed, such as convergent validity seen in its association with measures of mental health, social support, and marital satisfaction. The standard errors of the means for the total scale and for the subscales reveal fairly consistent scores, in spite of very different samples and types of loss; computation of means and standard deviations for the studies as a whole permits us to establish normal score ranges. Significantly higher scores were found in studies that recruited participants from support groups and self-selected populations rather than from medical sources, and from U.S. studies compared with those in Europe.

Patterns of grief reaction after pregnancy loss.

Analysis of three waves of Perinatal Grief Scale scores for 194 bereaved subjects over the course of two years revealed patterns of change different from those commonly noted in the literature. Less than half the sample matched the "normal" model; the rest exhibited non-normal patterns that did not fit the alternative psychological models. Demographic variables and pregnancy history, both before and after the loss, help explain some of the differences in direction of the grief response.

Community social change and mortality.

This paper first reviews the types of explanations that have been used in analyzing unequal distribution in coronary heart disease among different groups and changes in prevalence over time. The explanations have mostly focused on the individual: individual behaviors, personalities, stressors, or social ties. It is suggested here that a shift in focus to community-level characteristics may also aid in understanding changes in mortality. Data are presented from Roseto, PA--a town that became known in the 1960's for its strong Italian traditions and very low mortality from myocardial infarction and that subsequently experienced a sharp rise in mortality--and from the adjacent comparison town of Bangor. Data collected over several decades--in some cases as far back as 1925--on marriages, population composition, organizational memberships, voting patterns, and social class indicators suggest that important community changes that accelerated significantly in the 1960's coincided with and may help to explain Roseto's loss of protection from coronary heart disease deaths after 1965.

Satisfaction with hospital care and interventions after pregnancy loss.

Hospital practices after pregnancy loss have changed considerably over the past decade, yet they have not been well evaluated. In a longitudinal study of 194 women and men who experienced miscarriage, ectopic pregnancy, stillbirth, or newborn death, the recommended interventions at the time of loss are examined. In most cases, parents were more satisfied if they had experienced an intervention than if they had not, but having experienced more total interventions was not associated with lower grief or greater satisfaction with overall care; the latter was related more to the attentiveness and sensitivity of health care personnel. Three groups identified as in need of greater attention are clinic patients, who were significantly less satisfied and more grief-stricken than the patients of private physicians, those who had spontaneous abortions or ectopic pregnancies, and those who had early fetal losses.

Acute versus chronic grief: the case of pregnancy loss.

Conceptual and measurement problems in identifying those at risk of chronic grief are reviewed, and results are presented of a longitudinal study of people who have experienced pregnancy loss. Coping resources, particularly prior mental health and social support, were the best predictors of low scores on subscales of the Perinatal Grief Scale that indicate chronic grief reactions. Results also offer some evidence of delayed grief responses, especially among men and those who experienced early losses.

The effects of gestational age and gender on grief after pregnancy loss.

The roles of gestational age and gender in grief reactions following loss of pregnancy were explored. Parents with losses later in pregnancy reported more intense grief than did those whose losses were earlier. Women expressed higher levels of grief than did men six to eight weeks after the loss; however, this difference had decreased by one and two years after the loss.

The Perinatal Grief Scale: development and initial validation.

The theoretical strategy underlying development of the Perinatal Grief Scale is described. The instrument was completed by 194 subjects as part of a longitudinal study of factors affecting the resolution of grief following spontaneous abortion, fetal or neonatal death, or ectopic pregnancy. Variables found to be significant predictors of grief, as measured by this scale, were: overall physical health of mother, gestational age at time of loss, quality of the marital relationship, and pre-loss mental health symptomatology.