Impact of Cognitive Behavioral-Based Counseling on Grief Symptoms Severity in Mothers After Stillbirth

Abstract

Background: An active intervention is necessary for the care and support of women who have experienced stillbirth. Objectives: The aim of the present study was to determine the impact of psychological counseling on the severity of grief symptoms in mothers after stillbirth. Methods: We conducted a semi-experimental study on 100 women who had experienced stillbirth in their most recent delivery in a Central Maternity Hospital affiliated to the University of Medical Sciences, Zahedan, Iran. Participants were randomly assigned to two groups: intervention (n = 50) and control (n = 50). The intervention group received four sessions of small-group psychological counseling over 2 weeks and the control group received the routine postnatal care. We evaluated the severity of grief symptoms in both the groups before the first counseling session as well as at the end of the fourth week following the final session (and at equivalent times in the control group) using the Perinatal Grief Scale. Data were analyzed using independent and paired t-tests, chi-square test, and analysis of covariance. Results: The mean total grief symptom score and three subscale scores (active grief, difficulty coping, and despair) were significantly lower in the participants who received psychological counseling than in those who received the routine care (P < 0.05). Conclusions: Counseling significantly reduces grief symptoms, allowing for faster transition from grieving and preventing complicated grief. It is, therefore, necessary to integrate psychological interventions into the care system for mothers.

Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review

“…Navidian et al [ 27 ] determined the effect of behavior-based cognitive counselling on the severity of bereavement symptoms in mothers after fetal death. They conducted a quasi-experimental study with a sample of 100 pregnant women.…”

“…This is the case of one of the studies that conducted five interviews with the experimental group and two with the control group [ 30 ]. Another study carried out the intervention over a 6-week period and then did follow ups for 15 to 20 min by telephone or WeChat (platform created) 2 weeks after the birth [ 29 ], and the other two studies reviewed carried out the intervention in 60 min sessions over two weeks [ 27 , 28 ].…”

“…The interventions were carried out by nurses in one of the studies [ 30 ], and in another, by a multidisciplinary team (a psychologist, two obstetric doctors, a researcher and two nurses) [ 29 ]. The other two remaining studies did not specify who performed the interventions [ 27 , 28 ].…”

“…The participants were pregnant women with a gestational age of more than 20 weeks [ 30 ], women who had experienced still birth (at least 7–10 days after loss) and a gestational age of more than 22 weeks [ 27 , 28 ], and women with a history of fetal death (1 to 3 perinatal losses) with a gestational age between 28–29 weeks and full term (28), and were at least 18 years old [ 27 , 28 , 29 , 30 ].…”

“…In all four studies, the results were significantly more positive in the intervention group; however, in one, the psychological, self-concept and role functions, as well as mutual commitment improved significantly in the experimental group except in terms of anxiety and nausea and vomiting [ 30 ]. In two of the studies, counselling given to mothers reduced grief symptoms [ 27 , 28 ]. In another study, family APGAR scores and depression and post-traumatic stress scores were significantly better in the intervention group [ 29 ].…”