A national sample of 249 bereaved mothers and 114 of their male partners was investigated retrospectively, using a mailed questionnaire and the Perinatal Grief Scale, to determine the impact of postpregnancy loss services on grief outcome. Participants ranged in age from eighteen to forty-seven and experienced from one to twelve pregnancy losses with gestational age of two to forty-two weeks. A three-stage multiple regression analysis determined that predictors differed by gender and that services contributed to the prediction of grief outcome above and beyond demographic variables. Significant predictors for mothers were months since loss, attending counseling, and attending support group; significant predictors for fathers were length of pregnancy, talking with friends, and timing of talking with family. A large-scale longitudinal study that controls for service variables could inform the development of future perinatal bereavement programming in addressing the unique needs of bereaved mothers and fathers.

This study analyzes the relationship between patient gender and satisfaction with primary care visits, using 1999 survey data on 1691 women and 760 men making primary care visits at multiple sites affiliated with a large academic health system designated as a National Center of Excellence in Women's Health (COE). The main findings are that in multivariate analyses controlling for patient and visit characteristics, different aspects of the content of primary care visits are important to women and men. Women's overall satisfaction with visits is more dependent than men's on informational content, continuity of care, and multidisciplinarity. Men's overall satisfaction is more dependent on the personal interest shown in them by providers. No differences in satisfaction are found between those seen in sites affiliated with the COE and other primary care sites within the health system that are not core sites of the COE. We conclude that quality improvement and research in women's primary care could benefit from gender analysis of patient satisfaction data and from more gender-sensitive patient satisfaction measures.

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Three overlapping areas of study form the foundation of the psychological impact of pregnancy loss: (1) transition to parenthood and the development of attachment, (2) perinatal mental health disorders, and (3) complicated grief. This article integrates findings from prominent lineages of theory to offer the obstetric provider an evidence-based framework for patient care. Current consensus across fields of study is that preexisting depression and anxiety are the strongest predictors of psychological functioning after loss and through the subsequent pregnancy. Compassionate care, informational guidance and timed follow-up positively impact patient outcomes. The article concludes with recommendations for obstetric provider training and self-care.

I have specialized exclusively in reproductive health psychology for 16 of the 27 years I've been a licensed psychologist. I am also a community leader, teacher, and mentor. In preparation for writing this article, however, I take off my doctoral cape, so to speak, and write simply about my two daughters, Shoshana and Yael. I intend to explore the question, "How do I experience the lifelong parenting relationship to my stillborn baby?" My first pregnancy was with my daughter Shoshana, named after my two grandmothers. If she had been a boy, we would have named him Micah or Misha, after my father-in-law. Shoshana was born at 38+ weeks after only 2 hours of labor. My sister made it to the hospital in time to capture the entire event in photos. I was so overwhelmed by the pace of labor, that I needed my husband to put his face right up to mine to direct me how to breathe, "inhale . . . exhale." Three big pushes and she was out. "It's a girl!" Shoshana had a full head of thick black hair, sweet thin lips, perfect little hands and toes that overlapped just like in my baby pictures. She was exquisite.My second pregnancy was with my daughter Yael, named after my fatherin-law. We called her peanut in utero until we knew she was a girl. When I went into labor at 38+ weeks, we grabbed the suitcase and headed for the hospital. I was so worried about delivering in the car, that I made my husband give me a detailed travelogue of our route, as if that would give me control. Once again, my sister met us at the hospital and took beautiful photos of the birth. I registered just after midnight, and Yael was born at 1:50 am. "It's a girl!" She too had a thick head of black hair and sweet little lips. Her facial features were more petite than Shoshana's. She had skinny little fingers and her toes were not overlapping like mine; she had flat feet just like her dad. Yael reached her arms up and looked around as if to say, "Here I am!" 309