Abstract
Advances in genetic technology challenge couples to make complex life and death decisions about their fetus that have far-reaching practical and emotional consequences. When genetic defects lead to fetal loss, whether by miscarriage, elective interruption, or still birth, it can be a devastating experience with ripple effects on couple and family development. This paper presents a systemic approach to coping and adaptation to fetal loss in the wake of genetic testing. Clinical vignettes illustrate common experiences and present interventions designed to help the individual grieving partners as well as the marriage. thereby strengthening the family fabric at a vulnerable transitional stage.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bernstein, J. (June 1997). Healing Rituals after a miscarriage. SELF, 130, 139–140.
Blumberg, B., Golbus, M., & Hanson, K. (1975). Prenatal diagnosis: The experience of families who have children. American Journal of Medical Genetics, 9, 29–39.
Borg, S., & Lasker, J. (1981). When pregnancy fails: Families coping with miscarriage, stillbirth, and infant death. Boston: Beacon Press.
Bowen, M. (1978). Family therapy in clinical practice. New York: Jason Aronson.
Burns, L.H. (1999). Genetics and infertility: Psychosocial issues in reproductive counseling. Families, Systems, and Health, 17, 87–110.
Cain, A., & Cain, B. (1964). “On replacing a child. ” Journal of American Academy of Child Psychiatry, 3, 443–455.
Cardin, N. B. (1999). Tears of sorrow, seeds of hope: A Jewish spiritual companion for infertility and pregnancy loss. Woodstock, VT: Jewish Lights Publishing.
DeFrain, J. (1991). Learning about grief from normal families: SIDS, stillbirth, and miscarriage. Journal of Marital and Family Therapy, 17, 215–232.
DeFrain, J., Millspaugh, E., & Xiaolin, X. (1996). The psychosocial effects of miscarriage: implications for health care professionals. Families, Systems, and Health, 14, 331–347.
Eunpu, D.L. (1997). Systemically-based psychotherapeutic techniques in genetic counseling. Journal of Genetic Counseling, 6, 1–20.
Friedman, E.G. (1985). From generation to generation: Family process in church and synagogue. New York: Guilford Press.
Gawer, K.L., & Marchese, S.G. (1986). Genetic counseling for clinicians. Chicago: Year Book Medical Publishers.
Ginzberg, L. (1955). The legends of the Jews. Philadelphia: The Jewish Publication Society of America.
Helmrath, T., & Steinitz, E. (1978). Death of an infant: Perinatal grieving and the failure of social support. Journal of Family Practice, 6, 785–790.
Herz, F. (1980). The impact of death and serious illness in the family life cycle. In E. Carter & M. McGoldrick (Eds.), The family life cycle: A framework for family therapy (pp. 223–240). New York: Gardner Press.
Imber-Black, E. (1991). Rituals in the healing process. In F. Walsh & M. McGoldrick (Eds.), Living beyond loss (pp. 207–213). New York: Norton.
Johnson, A.M., Schild Wilkinson, D., & Taylor Brown, S. (1999). Genetic testing: Policy implications for individuals and their families. Families, Systems, and Health, 17, 49–61.
Kelly, P. T. (1977). Dealing with dilemma: A manual for genetic counselors. New York: Springer Verlag.
Kirkley-Best, E., & Kellner, K. (1982). The forgotten grief: a review of the psychology of stillbirth. American Journal of Orthopsychiatry, 52, 420–429.
Kluger-Bell, K. (1998). Unspeakable losses: Healing from miscarriage, abortion, and other pregnancy loss. New York: Quill.
Leon, I. G. (1995). Pregnancy termination due to fetal anomaly: Clinical considerations. Journal of Infant Mental Health, 16, 112-126.
Levinson, J. I. (1999). A New Model of Bereavement. The first annual Irvin B. Levinson memorial lecture on death, dying, and bereavement. July 9, 1999.
Mason, M. (1993). Shame: Reservoir for family secrets. In E. Imber Black (Ed.), Secrets in families and family therapy (pp. 29–46). New York: Norton.
McDaniel, S.H., Hepworth, J., & Doherty, W.J. (1992). Pregnancy loss, infertility, and reproductive technology. In S. H. McDaniel, J. Hepworth, & W. J. Doherty (Eds.), Medical family therapy: A biopsychosocial approach to families with health problems (pp. 152–183). New York: Basic Books, Harper Collins.
McGoldrick, M. (1980). The joining of families through marriage: the new couple. In E. Carter & M. McGoldrick (Eds.), The family life cycle: A framework for family therapy (pp. 93–119). New York: Gardner Press.
McGoldrick, M., Almeida, R., Hines, P.M., Rosen, E., Garcia-Preto, N., & Lee, E. (1991). Mourning in different cultures. In F. Walsh & M. McGoldrick (Eds.), Living beyond loss: Death in the family (pp. 176–206). New York: Norton.
McGoldrick M., & Walsh, F. (1991). A time to mourn: Death and the family life cycle. In F. Walsh, & M. McGoldrick (Eds.), Living beyond loss: Death in the family (pp. 30–49). New York: Norton.
Meyers, M., Diamond, R., Kezur, D., Scharf, C., Weinshel, M., & Rait, D.S. (1995). An Infertility primer for family therapists: I. medical, social, and psychological dimensions. Family Process, 34, 219-229.
Meyers, M., Weinshel, M., Scharf, C., Kazur, D., Diamond, R., & Rait, D. S. (1995). An infertility primer for family therapists: II. Working with couples who struggle with infertility. Family Process, 34, 231–240.
Meyerstein, I. (1994). Reflections on “being there” and “doing” in family therapy: A story of chronic illness. Family Systems Medicine, 12, 21–29.
Meyerstein, I. (2000). A spiritual appproach to health care. Working together: The collaborative family health care association newsletter. 5(2), p. 4.
Minnick, M. A., Delp, K. J., & Ciotti, M. C. (1999). A time to decide, A time to heal: For parents making difficult decisions about babies they love (4th ed.). St. Johns, MI: Pineapple Press.
Montalvo, B. (2001). Personal communication. January 18, 2001.
Oakley, A., McPherson, A., & Roberts, H. (1984). Miscarriage. Glasgow: Williams Gelins & Sons, Ltd.
Paul, N., & Grosser, G. (1965). Operational mourning and its role in conjoint family therapy. Community Mental Health Journal, 1(4), 339–345.
Paul, N., & Paul, B. (1989). A marital puzzle. Boston: Allyn & Bacon.
Peppers, L., & Knapp, R. (1980). Motherhood and mourning. New York: Praeger.
Peters, J.A., Djividjinovic. L., & Baker, D. (1999). The genetic self: The human genome project, Genetic counseling, and family therapy. Families, Systems, and Health, 17(1), 5–25.
Rolland, J. S. (1999). Commentary: Families and genetic fate: A millennial change. Families, Systems, and Health, 17, 123-132.
Rosen, E. J. (1990). Families facing death: Family dynamics of terminal illness. New York: Lexington.
Shapiro, E. R. (1994). Grief as a family process: A developmental approach to clinical practice. New York: Guilford Press.
Statistical Abstract of the United States: (1996) (116th ed.) no. 109, Pregnancies, Number, and Outcome: 1976-92. Washington DC: U.S. Bureau of the Census.
Street, E., & Soldan, J. (1998). A conceptual framework for the psychosocial issues faced by families with genetic conditions. Families, Systems, and Health, 16, 217–232.
Taner-Leff, P. (1987). Here I am, Ma: The emotional impact of pregnancy loss on parents and health care professionals. Family Systems Medicine, 5, 105–114.
Taylor-Brown, S., & Johnson, A.M. (February 1998). Social work's role in genetics services. NASW Social Work Practice Update, 1–8.
U.S. Office of Technology Assessment. (1988). Infertility: medical and social choices. (Publication No. OTA BA-358). Washington, DC: U.S. Congress.
Weil, J. (2000). Psychosocial genetic counseling. New York: Oxford University Press.
Weinshel, M. (1990). Practice sketch: Treating an infertile couple. Family Systems Medicine, 8, 303–312.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Meyerstein, I. A Systemic Approach to Fetal Loss Following Genetic Testing. Contemporary Family Therapy 23, 385–402 (2001). https://doi.org/10.1023/A:1013096811134
Issue Date:
DOI: https://doi.org/10.1023/A:1013096811134