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.

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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.

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.

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.