Mothers' and fathers' experiences of perinatal bereavement

Mothers' and fathers' experiences of perinatal bereavement were examined by interviewing 15 women and 13 men (representing 15 couples) who had experienced the death of a baby through third trimester stillbirth or neonatal death. The interviews were conducted between 3 and 14 months postbereavement. Eleven informants were reinterviewed approximately 3 months after the first interview. Content analysis of transcriptions of interviews was concurrent with further data collection. FACES III was used as an indirect measure of marital satisfaction and was administered prior to all interviews. All parents experienced movement through Devastating Numbness, Intense Hurtfulness, and Empty Sadness before being able to put the experience to rest with Peaceful, Precious Memories. The variety and intensity of feelings varied from parent to parent as did the rate at which movement through the passages occurred. Men whose wives were sedated and/or separated from the dying baby tended to move more quickly through Intense Hurtfulness than their wives. Women used more coping strategies than men. Expressive Behaviors, Seeking Spiritual Consolation, and Gathering Signs/Creating Symbols were important strategies used by women. Escape/Avoidance Behaviors and Physical Activity were important strategies used by men; only 54% of men acknowledged Expressive Behaviors as being an important way of coping. Coping strategies recognized as highly important by both men and women were Parenting the Baby and Seeking Understanding. Couples who were doing well at the time of interview used very similar styles of coping, were able to talk openly with one another, perceived themselves as experiencing similar feelings, were congruent in their attachment to the baby, did not have to make major decisions regarding the baby's life, were stable in terms of finances and employment, were not having to deal with a pile-up of stressors, and exercised regularly. The most helpful expressions of caring recognized by parents were those which provided direct emotional support. From nurses and physicians, parents desired care that meshed both Taking Care Of and Caring For/About. Findings support the need for development and testing of interventions directed to meet special needs of bereaved parents and families.