Factors contributing to men’s grief following pregnancy loss and neonatal death: further development of an emerging model in an Australian sample

Abstract

Background: Historically, men’s experiences of grief following pregnancy loss and neonatal death have been under-explored in comparison to women. However, investigating men’s perspectives is important, given potential gendered differences concerning grief styles, help-seeking and service access. Few studies have comprehensively examined the various individual, interpersonal, community and system/policy-level factors which may contribute to the intensity of grief in bereaved parents, particularly for men. Methods: Men (N = 228) aged at least 18 years whose partner had experienced an ectopic pregnancy, miscarriage, stillbirth, termination of pregnancy for foetal anomaly, or neonatal death within the last 20 years responded to an online survey exploring their experiences of grief. Multiple linear regression analyses were used to examine the factors associated with men’s grief intensity and style. Results: Men experienced significant grief across all loss types, with the average score sitting above the minimum cut-off considered to be a high degree of grief. Men’s total grief scores were associated with loss history, marital satisfaction, availability of social support, acknowledgement of their grief from family/friends, time spent bonding with the baby during pregnancy, and feeling as though their role of ‘supporter’ conflicted with their ability to process grief. Factors contributing to grief also differed depending on grief style. Intuitive (emotion-focused) grief was associated with support received from healthcare professionals. Instrumental (activity-focused) grief was associated with time and quality of attachment to the baby during pregnancy, availability of social support, acknowledgement of men’s grief from their female partner, supporter role interfering with their grief, and tendencies toward self-reliance.Conclusions: Following pregnancy loss and neonatal death, men can experience high levels of grief, requiring acknowledgement and validation from all healthcare professionals, family/friends, community networks and workplaces. Addressing male-specific needs, such as balancing a desire to both support and be supported, requires tailored information and support. Strategies to support men should consider grief styles and draw upon father-inclusive practice recommendations. Further research is required to explore the underlying causal mechanisms of associations found.Trial registration: N/A

Women’s experiences of a pregnancy whilst attending a specialist antenatal service for pregnancies after stillbirth or neonatal death: a qualitative interview study

“…However, Meredith et al also noted the important effects on the wider family unit which were not assessed here [7]. Given that (male) partners experience 12 different challenges after a baby dies [16,17], further research is needed to investigate whether a specialist antenatal service for pregnancy after loss improves partner's and other family member's experience of subsequent pregnancies as well as the having a positive impact on the parental relationship . Likewise, more work is needed to understand the emotional and psychological experiences of both parents following birth of a live baby.…”

Factors influencing parental posttraumatic stress disorder in cases of fetal abnormality requiring pregnancy termination in China

“…Similar to previous studies, in this study, the prevalence of PTSD in mothers who experienced TOPFA was 21.3%, and 62.7% of mothers were at clinical risk of PTSD (Cao et al, 2016). The effects of TOPFA on mothers have been extensively studied, but the effects on fathers are understudied (Christiansen, 2017; Obst et al, 2021). Studies have shown that fathers have similar levels of PTSD to those of mothers, with a prevalence of 15.6% being reported (Turton et al, 2006).…”

“…On the other hand, couples experiencing PTSD are less able to provide emotional support to each other, which is not conducive to alleviating psychological stress. Therefore, to promote the psychological adjustment of couples, healthcare providers should provide psychological guidance and interventions for both mothers and fathers, and reduce negative psychological interactions between them (Nguyen et al, 2019; Obst et al, 2021).…”

“…This implies that a negative psychological reaction in either the father or the mother affects the other spouse. This can be interpreted as implying that various PTS symptoms, such as Obst et al, 2021).…”

“…Therefore, TOPFA may not only bring physical trauma to pregnant women but also cause depression, PTSD, and other negative psychological feelings, as stated above (Zhou et al, 2019). Moreover, husbands often play the role of supporters, and their experience of negative emotions such as repressed sadness, anxiety, and stress is often ignored (Jones et al, 2019; Obst et al, 2021). However, differing reactions to fetal abnormality between members of couples, such as incongruent grief, can lead to misunderstandings and conflicts that may even result in the breakdown of the relationship (Burden et al, 2016), thereby further increasing psychological stress.…”