Autonomy and Social Norms in a Three Factor Grief Model Predicting Perinatal Grief in India

Abstract

Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.

Multicultural coping experiences of parents following perinatal loss: A meta‐ethnographic synthesis

“…In some cultures, social context and religion establish that femininity is synonymous with motherhood, which means that when childlessness occurs, a woman is deprived of her gender identity and some mothers may experience social isolation (Gerber‐Epstein, Leichtentritt, & Benyamini, ). However, religion can also have a protective effect for mothers, since it helps them make sense of the loss and cope with bereavement (Abdel‐Razeq & Al‐Gamal, ; Roberts & Lee, ). Our results show that when parents do not get answers that allow them to make sense of the loss, they may look to other resources, such as religion or superstition.…”

Barriers and enablers to reporting pregnancy and adverse pregnancy outcomes in population-based surveys: EN-INDEPTH study

“…The multiple negative psycho-social impacts of APOs on women who experience these adverse outcomes have been highlighted in this and other studies [44]. Effects include social withdrawal, depression, somatic symptoms, anger, exhaustion, self-blame and breakdown of relationships [6,[44][45][46]. A review of literature on grief after miscarriage reported that while extreme grief declines and almost ends in 6 months, mourning continues through different stages of grief [6].…”

Cross-Cultural Adaptation and Validation Evidence of the Perinatal Grief Scale

“…17 The sociodemographic and reproductive characteristics of women in studies covering grief due to fetal death should be included, and it has been observed that social norms according to each country can contribute to the high levels of grief. 12 The different means of the PGS score between the populations of this and other studies with perinatal (m=88±27), 10 and fetal losses (m=91±21), 9 prove that although loss may be a universal experience, its representation and influence on an individual's life are modified by their personality, culture, and society. 10 Among the limitations of the study we can include the study duration, as it influenced the num-ber of participants in the annual census of women with fetal death in a Brazilian municipality and of the Canadian women who participated in a referral center to support families, although the statistical tests showed robust results.…”

“…Its application has helped to better identify the suffering of bereaved/grieving mothers, 4,[9][10][11][12] enabling the nursing approach in investigating grief as a result of fetal death and increasing the quality of psychosocial care.…”

“…8 The most commonly used grief identification tool for women who have experienced abortion, fetal and neonatal deaths and the one which has been evidenced as being the most accurate is the short version of the Perinatal Grief Scale -PGS (in Portuguese Escala de Luto Perinatal -ELP). 4 The original scale in English was first applied to a population in Pennsylvania, the United States, 9 and has been used in several studies in different countries worldwide, most recently in the Czech Republic, 10 the United States, 11 India, 12 and Mexico. 4 Regarding the literature for understanding the grief process experienced by women after fetal death, this study aimed to perform the cross-cultural adaptation and evidence validation of the Perinatal Grief Scale for Brazilian Portuguese and Canadian French.…”