The Use of Rituals in Grieving for a Miscarriage or Stillbirth

Abstract

Preparation for their changing roles in family and society, as well as readying their intimate space for the arrival of an infant, totally engage expectant parents. Miscarriage or stillbirth may bring on a grief storm that strips away many tender roots and branches of new life in the community that the parents have been nurturing. Creation and participation in a grief ritual can bring the grieving parents to a healing resolution. This article describes the healing efficacy of ritual, its elements, and how a compassionate therapist can create one in collaboration with grieving clients.     

No Fault Couples Therapy

A conceptual framework for treating couples who come into therapy desirous of changing the behavior of their partner. A case history is cited wherein sensitivity towards equality of input, power and responsibility for the couples' plight is continuously emphasized for each member of the pair. The histories of both partners are described in order to stress the no fault nature of the couples' conditions.     

Search for meaning,finding meaning and adjustment in women following miscarriage: A longitudinal study

Objective: The purpose of this study was to explore the associations between meaning making and psychological adjustment in 127 women who experienced a miscarriage.

Design: A longitudinal and controlled study design was employed.

Main outcome measures: Meaning-making variables and distress outcomes were examined at four, seven and 16?weeks after miscarriage, in two groups of women, one who had medical investigations of the cause of their loss, and a control group receiving standard care.

Results: Search for meaning was very common and it declined with time after miscarriage. By seven weeks post-loss, more than half the women reported that they had found meaning/understood why the miscarriage happened. Providing information about the cause of the loss was associated with finding meaning. A decline in the search for meaning and finding meaning at seven weeks post-miscarriage, predicted levels of distress at 16?weeks, whilst controlling for the initial distress and for significant background factors.

Conclusions: This study provides support for the notion that search for meaning is very common following negative life events, such as miscarriage, and that finding meaning is important in many peoples’ process of adjustment. Providing information about the cause of the loss facilitates finding meaning.     

Genetic Evaluation and Counseling of Couples with Recurrent Miscarriage: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic evaluation and counseling of couples with recurrent miscarriage (RM). The recommendations are the opinions of the multidisciplinary Inherited Pregnancy Loss Working Group (IPLWG), with expertise in genetic counseling, medical genetics, maternal fetal medicine, internal medicine, infectious disease, cytogenetics, and coagulation disorders. The IPLWG defines RM as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (<24 weeks gestation). These recommendations are provided to assist genetic counselors and other health care providers in clinical decision-making, as well as to promote consistency of patient care, guide the allocation of medical resources, and increase awareness of the psychosocial and cultural issues experienced by couples with RM. The IPLWG was convened with support from the March of Dimes Western Washington State Chapter and the University of Washington Division of Medical Genetics. The recommendations are U.S. Preventive Task Force Class III, and are based on clinical experiences, review of pertinent English-language published articles, and reports of expert committees. This document reviews the suspected causes of RM, provides indications for genetic evaluation and testing, addresses psychosocial and cultural considerations, and provides professional and patient resources. These recommendations should not be construed as dictating an exclusive course of medical management, nor does the use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the circumstances of a specific case, should always supersede these recommendations.     

Between Cultures

Abstract

A hospital is an institution established to pursue one principal primary task: the care and treatment of the sick. In some hospitals, other important tasks - for example, training and research - must also be undertaken. There may at times be conflict about the relative importance of these tasks. Within the hospital, a large number of heterogeneous groups must coexist, communicate and co-operate to achieve the primary task. Each group is composed of individuals. Each individual has his own motivation for belonging to that group and for working within the hospital. The individual's roles within his own group, his relationship with other subgroups and his place within the hospital as a whole are to a considerable degree determined and driven by his unconscious impulses and needs. Within a gynaecological unit the levels of anxiety and other primitive emotions may be particularly high. Here, issues of life, death and sexuality are constantly being confronted. A strong defence system is therefore likely to operate at both an individual and a social level. This may either enhance or hamper the work effort.     

Counseling Women Who Have Experienced Pregnancy Loss: A Review of the Literature

The authors review pregnancy loss scholarly literature and discuss themes of silence, grief, psychological distress, role of social support, satisfaction with health care, and coping strategies from a counseling standpoint. Counseling needs of women who have experienced pregnancy loss are delineated, and recommendations for future research in this area are made.     

Miscarriage,Religious Participation,and Mental Health

Approximately 15–20 percent of pregnancies result in miscarriage, yet pregnancy loss remains a socially taboo topic and one that has received limited attention in the literature. Utilizing nationally representative longitudinal data from the NLSY97, this study examines the influence of miscarriage on mental health and whether this relationship is moderated by religious participation. Results from this study suggest that miscarriage is associated with lower mental health among women who also experience a live birth. Results also suggest that religious participation moderates the relationship between miscarriage and mental health; religion is more likely to lead to increases in mental health among women who experience a miscarriage than among women who do not experience a miscarriage. Overall, evidence suggests that religion may be an important coping mechanism for women who deal with pregnancy loss.     

Cultural Dimensions of Early Pregnancy Loss: Spiritual and Religious Issues

Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.