Advertisement

Post-Traumatic Stress Disorder (PTSD) and Its Relationship with Perinatal Bereavement: Definitions, Reactions, Adjustments, and Grief

  • Caroline J. Hollins Martin
  • Colin R. Martin
Reference work entry

Abstract

A small percentage of women present with diagnosed PTSD post childbirth; however, though this an area of increasing research and clinical interest generally, little is known about PTSD in relation to perinatal bereavement. Health professionals must however be aware of the mechanisms and models of loss following perinatal bereavement in order to identify potential mental health phenomena which may be implicated in the development of PTSD symptomology. Understanding the predictive factors which may give early warning signs is an important component of the clinical evidence base. This chapter discusses mechanisms, models, and risk factors in relation to perinatal bereavement and the development of PTSD.

Keywords

Bereavement Grief Loss Perinatal bereavement Trauma Psychology 

References

  1. Alipour Z, Lamyian M, Hajizadeh E. Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women Birth. 2012;25(3):e37–43.PubMedCrossRefGoogle Scholar
  2. Allen NB, Lewinsohn PM, Seeley JR. Prenatal and perinatal influences on risk for psychopathology in childhood and adolescence. Dev Psychopathol. 1998;10:513–29.PubMedCrossRefGoogle Scholar
  3. Bartellas E, Van Aerde J. Bereavement support for women and their families after stillbirth. J Obstet Gynaecol Can. 2003;25(2):131–8.PubMedCrossRefGoogle Scholar
  4. Beaumont E, Hollins Martin CJ. Compassion-focused eye movement desensitisation and reprocessing (EMDR): a case study of healing the wounds of trauma, shame and repressed grief. J EMDR Pract Res. 2013;7(4):186–98.CrossRefGoogle Scholar
  5. Beck CT. A meta-analysis of predictors of postpartum depression. Nurs Res. 1996;45(5):297–303.PubMedCrossRefGoogle Scholar
  6. Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001;50(5):275–85.PubMedCrossRefGoogle Scholar
  7. Bender H. On the outside looking in: sibling perceptions, dreams and fantasies of the premature infant. International Journal of Prenatal and Perinatal Studies. 1990;2:144–143.Google Scholar
  8. Blackburn C, Copley R. One precious moment: what you can offer when a newborn infant dies. Nursing. 1989;19:52–4.PubMedGoogle Scholar
  9. Bonanno GA, Wortman CB, Lehman DR. Resilience to loss and chronic grief: a prospective study from pre-loss to 18-months post-loss. J Pers Soc Psychol. 2002;83:1150–64.PubMedCrossRefGoogle Scholar
  10. Bowlby J. Processes of mourning. Int J Psychoanal. 1961;44:317.Google Scholar
  11. Bowlby J. Attachment and loss: loss: sadness and depression. London: Hogarth Press; 1980.Google Scholar
  12. Bowlby J. Attachment and loss. 1st ed. New York: Basic Books; 1981.Google Scholar
  13. Bowlby J. The making and breaking of affectionate bonds. London: Routledge; 1990.Google Scholar
  14. Brost L, Kenney J. Pregnancy after perinatal loss: parental reactions and nursing interventions. J Obstet Gynecol Neonatal Nurs. 1992;21:457–63.PubMedCrossRefGoogle Scholar
  15. Buist A. Childhood abuse, postpartum depression and parenting difficulties: a literature review of associations. Aust N Z J Psychiatry. 1998;32(3):370–8.PubMedCrossRefGoogle Scholar
  16. Buist A, Gotman N, Yonkers KA. Generalized anxiety disorder: course and risk factors in pregnancy. J Affect Disord. 2011;131(1):277–83.PubMedPubMedCentralCrossRefGoogle Scholar
  17. Caelli K, Downie J, Letendre A. Parent’s experiences of midwife-managed care following the loss of a baby in a previous pregnancy. J Adv Nurs. 2002;39(2):127–36.PubMedCrossRefGoogle Scholar
  18. Cain AC, Fast I, Erikson M. Children’s disturbed reactions to their mother’s miscarriage. Psychosom Med. 1964;26:58–66.PubMedCrossRefGoogle Scholar
  19. Centre for Maternal And Child Enquiries (CMACE). Saving mothers lives: reviewing maternal deaths to make motherhood safer (2006–08). The eighth report on confidential enquiries into maternal deaths in the United Kingdom. BJOG Int J Obstet Gynaecol. 2011;118:1–203.Google Scholar
  20. Chambers HM, Chan FY. Support for women/families after perinatal death. Cochrane Database Syst Rev. 2000;2, CD000452.PubMedGoogle Scholar
  21. Chiu YW, Huang CT, Yin SM, Huang YC, Chien CH, Chuang HY. Determinants of complicated grief in caregivers who cared for terminal cancer patients. Support Care Cancer. 2010;18:1321–7.PubMedCrossRefGoogle Scholar
  22. Christiansen DM. Infant death and bereaved parents with PTSD. In: Martin CR, Preedy VR, Patel VB, editors. Comprehensive guide to post-traumatic stress disorder. New York: Springer; 2005.Google Scholar
  23. Christiansen DM, Elklit A. Risk factors predict posttraumatic stress disorder differently in men and women. Annals of General Psychiatry. 2008;7:24. doi: 10.1186/1744-859X-7-24.Google Scholar
  24. Church NF, Brechman-Toussaint ML, Hine DW. Do dysfunctional cognitions mediate the relationship between risk factors and postnatal depression symptomatology? J Affect Disord. 2005;87(1):65–72.PubMedCrossRefGoogle Scholar
  25. Condon JT. Management of established pathological grief reaction after stillbirth. Am J Psychiatry. 1986;143:987–92.PubMedCrossRefGoogle Scholar
  26. Cuisinier MC, Kuijpers JC, Hoogduin CA. Miscarriage and stillbirth: time since the loss, grief intensity and satisfaction with care. Eur J Obstetric Gynecol Reprod Biol. 1993;52:163–8.CrossRefGoogle Scholar
  27. Defey D. Helping health care staff deal with perinatal loss. Infant Ment Health J. 1995;16:102–11.CrossRefGoogle Scholar
  28. DeFrain J, Martens L, Stork J. The psychological effects of a stillbirth on surviving family members. OMEGA J Death Dying. 1990;22:81–108.CrossRefGoogle Scholar
  29. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000;38:319–45.PubMedCrossRefGoogle Scholar
  30. Engler AJ, Lasker JN. Predictors of maternal grief in the year after a newborn death. Illn Crisis Loss. 2000;8:227–43.CrossRefGoogle Scholar
  31. Engler AJ, Cusson RM, Brockett RT. Neonatal staff and advanced practice nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. Am J Crit Care. 2004;13:489–98.PubMedGoogle Scholar
  32. Forrest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. Br Med J. 1982;285:1475–9.CrossRefGoogle Scholar
  33. Fraley RC, Shaver PR. Loss and bereavement: attachment theory and recent controversies concerning ‘grief work’ and the nature of detachment. In: Cassidy J, Shaver PR, editors. The handbook of attachment. New York: Guildford; 1999. p. 735–59.Google Scholar
  34. Gardner JM. Perinatal death: uncovering the needs of midwives and nurses and exploring helpful interventions in the United States, England, and Japan. J Transcult Nurs. 1999;10:120–30.PubMedCrossRefGoogle Scholar
  35. Gavin AR, Melville JL, Rue T, Guo Y, Dina KT, Katon WJ. Racial differences in the prevalence of antenatal depression. Gen Hosp Psychiatry. 2011;33(2):87–93.PubMedCrossRefGoogle Scholar
  36. Gensch BK, Midland D. When a baby dies: a standard of care. Illn Crisis Loss. 2000;8:286–95.CrossRefGoogle Scholar
  37. Gilson GJ. Care of the family who has lost a newborn. Postgrad Med. 1976;60:67–70.PubMedGoogle Scholar
  38. Green M, Solnit AA. Reactions to the threatened loss of a child: a vulnerable child syndrome. Pediatrics. 1964;34:58–66.PubMedGoogle Scholar
  39. Grey N, Young K, Holmes E. Cognitive restructuring within reliving: a treatment for peri-traumatic emotional ‘hotspots’ in posttraumatic stress disorder. Behav Cogn Psychother. 2002;30:37–56.CrossRefGoogle Scholar
  40. Hardison HG, Neimeyer RA, Lichstein KL. Insomnia and complicated grief symptoms in bereaved college students. Behav Sleep Med. 2005;3:99–111.PubMedCrossRefGoogle Scholar
  41. Heller SS, Zeanah C. Attachment disturbances in infants born subsequent to perinatal loss: a pilot study. Infant Ment Health J. 1999;20:188–99.CrossRefGoogle Scholar
  42. Heron J, O’Connor TG, Evans J, Golding J, Glover V. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004;80(1):65–73. doi: 10.1016/j.jad.2003.08.004.Google Scholar
  43. Hewitt CE, Gilbody SM, Brealey S, Paulden M, Palmer S, Mann R. Methods to identify postnatal depression in primary care: an integrated evidence synthesis and value of information analysis. Executive summary: health technology assessment. Perth: Prepress Projects Ltd; 2009.Google Scholar
  44. Hollins Martin CJ, Forrest E. Bereavement care for childbearing women and their families: an interactive workbook. Abingdon: Routledge; 2013.Google Scholar
  45. Hollins Martin CJ, Forrest E, Wylie L, Martin CR. The Understanding Bereavement Evaluation Tool (UBET) for midwives: factor structure and clinical research applications. Nurse Educ Today. 2013;33:1153–9.PubMedCrossRefGoogle Scholar
  46. Hollins Martin CJ, Forrest E, Wylie L, Martin CR. An evaluative survey to assess the effectiveness of using an interactive workbook to deliver bereavement education to undergraduate student midwives. Midwifery. 2014;30:942–8.PubMedCrossRefGoogle Scholar
  47. Honey KL, Bennett P, Morgan M. Predicting postnatal depression. J Affect Disord. 2003;76(1):201–10.PubMedCrossRefGoogle Scholar
  48. Howard LM, Flach C, Mehay A, Sharp D, Tylee A. The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy Childbirth. 2011;11(1):57.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Hughes PM, Turton P, Evans CD. Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study. Br Med J. 1999;318:1721–4.CrossRefGoogle Scholar
  50. Hughes P, Turton P, Hopper E. Disorganised attachment behaviour among infants born subsequent to stillbirth. J Child Psychol Psychiatry. 2001;42:791–801.PubMedCrossRefGoogle Scholar
  51. Hughes P, Turton P, Hopper E. Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. Lancet. 2002;360:114–8.PubMedCrossRefGoogle Scholar
  52. Ito M. Complicated grief among general Japanese population: validity and reliability of brief grief questionnaire. Presentation World Congress of Behavioral and Cognitive Therapies. Boston; 2010.Google Scholar
  53. Janssen HJ, Cuisinier MC, de Graauw KP. A prospective study of risk factors predicting grief intensity following pregnancy loss. Arch Gen Psychiatry. 1997;54:56–61.PubMedCrossRefGoogle Scholar
  54. Johnson JG, Zhang B, Greer JA, Prigerson HG. Parental control, partner dependency, and complicated grief among widowed adults in the community. J Nerv Ment Dis. 2007;195:26–30.PubMedCrossRefGoogle Scholar
  55. Keesee NJ, Currier JM, Neimeyer RA. Predictors of grief following the death of one’s child: the contribution of finding meaning. J Clin Psychol. 2008;64:1145–63.PubMedCrossRefGoogle Scholar
  56. Kelly E. Marking short lives: constructing and sharing rituals following pregnancy loss. Oxford: Peter Lang; 2007.Google Scholar
  57. Klass D, Silverman P, Nickman S. Continuing bonds: new understandings of grief. Washington: Taylor and Francis; 1996.Google Scholar
  58. Kubler-Ross E. On death and dying. New York: Macmillan; 1969.Google Scholar
  59. Kubler-Ross E, Kessler D. On grief and grieving: finding the meaning of grief through the five stages of loss. New York: Scribner; 2005.Google Scholar
  60. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol. 2010;202(1):5–14.PubMedPubMedCentralCrossRefGoogle Scholar
  61. Lasker JN, Toedter LJ. Acute versus chronic grief: the case of pregnancy loss. Am J Orthopsychiatry. 1991;61:510–22.PubMedCrossRefGoogle Scholar
  62. Lewis E. Mourning by the family after a stillbirth or neonatal death. Arch Dis Child. 1979;54:303–6.PubMedPubMedCentralCrossRefGoogle Scholar
  63. Lin SX, Lasker JN. Patterns of grief reaction after pregnancy loss. Am J Orthopsychiatry. 1996;66:262–71.PubMedCrossRefGoogle Scholar
  64. Lok I, Neugebauer R. Psychological morbidity following miscarriage. Best Pract Res Clin Obstetrics Gynaecol. 2007;21(2):229–47.CrossRefGoogle Scholar
  65. Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1):147–57.PubMedCrossRefGoogle Scholar
  66. Morina N, Rudari V, Bleichhardt G, Prigerson HG. Prolonged grief disorder, depression, and posttraumatic stress disorder among bereaved kosovar civilian war survivors: a preliminary investigation. Int J Soc Psychiatry. 2010;56:288–97.PubMedCrossRefGoogle Scholar
  67. National Institute for Clinical Excellence (NICE). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. 2011; http://publications.nice.org.uk/post-traumatic-stress-disorder-ptsd-cg26
  68. National Institute of Clinical Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance. 2007; http://www.nice.org.uk/CG45)
  69. National Institute of Clinical Excellence (NICE). Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care (No.26: 7): early interventions for PTSD in adults. 2005; http://www.ncbi.nlm.nih.gov/books/NBK56498/
  70. O’Connor MF, Irwin MR, Wellisch DK. When grief heats up: pro-inflammatory cytokines predict regional brain activation. Neuroimage. 2009;47:891–6.PubMedPubMedCentralCrossRefGoogle Scholar
  71. O’Hara MW, Swain AM. Rates and risk of postpartum depression-a meta-analysis. Int Rev Psychiatry. 1996;8(1):37–54.CrossRefGoogle Scholar
  72. O’Hara MW, Wisner KL, Asher N, Asher H. Perinatal mental illness: definitions, description and aetiology. Best Pract Res Clin Obstetrics Gynaecol. 2014;28:3–12.CrossRefGoogle Scholar
  73. Office For National Statistics. Statistical bulletin: births in England and Wales by characteristics of birth 2. 2012; http://www.ons.gov.uk/ons/rel/vsob1/characteristics-of-birth-2–england-and-wales/2012/sb-characteristics-of-birth-2.html.Google Scholar
  74. Ott CH. The impact of complicated grief on mental and physical health at various points in the bereavement process. Death Stud. 2003;27:249–72.PubMedCrossRefGoogle Scholar
  75. Pasternak RE, Reynolds CF, Schlernitzauer M. Acute open-trial nortriptyline therapy of bereavement-related depression in late life. J Clin Psychiatry. 1991;52:307–10.PubMedGoogle Scholar
  76. Patel V, Rodriques M, DeSouza N. Gender, poverty, and postnatal depression: a study of mothers in Goa (India). Am J Psychiatry. 2002;159(1):43–7.PubMedCrossRefGoogle Scholar
  77. Pope S. Postnatal depression: a systematic review of published scientific literature to 1999: an information paper. Canberra (Australia); National Health and Medical Research Council (NHMRC), Canberra (Australia); 2000.Google Scholar
  78. Poznanski EO. The replacement child: a saga of unresolved parental grief. J Pediatr. 1972;81:1190–3.PubMedCrossRefGoogle Scholar
  79. Prigerson H, Ahmed I, Silverman GK. Rates and risks of complicated grief among psychiatric clinic patients in karachi, pakistan. Death Stud. 2002;26:781–92.PubMedCrossRefGoogle Scholar
  80. Radestad I. Stillbirth: care and long-term psychological effects. Br J Midwifery. 2001;9:474–80.CrossRefGoogle Scholar
  81. Radestad I, Steineck G, Nordin C. Psychological complications after stillbirth-influence of memories and immediate management: population based study. Br Med J. 1996;312:1505–8.CrossRefGoogle Scholar
  82. Rich DE. The impact of post-pregnancy loss services on grief outcome: integrating research and practice in the design of perinatal bereavement programs. Illn Crisis Loss. 2000;8:244–64.CrossRefGoogle Scholar
  83. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26(4):289–95.PubMedCrossRefGoogle Scholar
  84. Robinson T, Marwit SJ. An investigation of the relationship of personality, coping, and grief intensity among bereaved mothers. Death Stud. 2006;30:677–96.PubMedCrossRefGoogle Scholar
  85. Rubertsson C, Wickberg B, Gustavsson P, Rådestad I. Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health. 2005;8(2):97–104.PubMedCrossRefGoogle Scholar
  86. Séjourné N, Callahan S, Chabrol H. Support following miscarriage: what women want. J Reprod Infant Psychol. 2010;28(4):403–11.CrossRefGoogle Scholar
  87. Shear K, Frank E, Houck PR. Treatment of complicated grief: a randomized controlled trial. J Am Med Assoc. 2005;293(21):2601–8.CrossRefGoogle Scholar
  88. Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, Reynolds C. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011;28(2):103–17.PubMedPubMedCentralCrossRefGoogle Scholar
  89. Siegel MD, Hayes E, Vanderwerker LC. Psychiatric illness in the next of kin of patients who die in the intensive care unit. Crit Care Med. 2008;36:1722–8.PubMedCrossRefGoogle Scholar
  90. Smith P, Perrin S, Yule W, Clark D. Post traumatic stress disorder: cognitive therapy with children and young people. London: Routledge, 2010.Google Scholar
  91. Sockol LE, Epperson CN, Barber JP. Preventing postpartum depression: a meta-analytic review. Clin Psychol Rev. 2013;33:1205–2017.PubMedPubMedCentralCrossRefGoogle Scholar
  92. Stroebe M, Schut H. The dual process model of coping with bereavement: rational and description. Death Stud. 1995;23(3):197–224.Google Scholar
  93. Stroebe W, Stroebe MS, Domittner G. Individual and situational differences in recovery from bereavement: a risk group identified. J Soc Issues. 1988;44:158.Google Scholar
  94. Tammentie T, Tarkka MT, Åstedt-Kurki P, Paavilainen E. Sociodemographic factors of families related to postnatal depressive symptoms of mothers. Int J Nurs Pract. 2002;8(5):240–6.PubMedCrossRefGoogle Scholar
  95. Thearle M, Vance J, Najman J. Church attendance, religious affiliation and parental responses to sudden infant death, neonatal death and stillbirth. OMEGA J Death Dying. 1995;31:51–8.CrossRefGoogle Scholar
  96. Tomarken A, Holland J, Schachter S. Factors of complicated grief pre-death in caregivers of cancer patients. Psychooncology. 2008;17:105–11.PubMedPubMedCentralCrossRefGoogle Scholar
  97. Tudehope DI, Iredell J, Rodgers D. Neonatal death: grieving families. Med J Aust. 1986;144:290–2.PubMedGoogle Scholar
  98. Turton P, Hughes P, Evans CDH. The incidence and significance of post traumatic stress disorder in the pregnancy after stillbirth. Br J Psychiatry. 2001;178:556–60.PubMedCrossRefGoogle Scholar
  99. Vance JC, Najman JM, Thearle MJ. Psychological changes in parents eight months after the loss of an infant from stillbirth, neonatal death, or sudden infant death syndrome: a longitudinal study. Pediatrics. 1995;96:933–8.PubMedGoogle Scholar
  100. Vanderwerker LC, Jacobs SC, Parkes CM, Prigerson HG. An exploration of associations between separation anxiety in childhood and complicated grief in later life. J Nerv Ment Dis. 2006;194:121–3.PubMedCrossRefGoogle Scholar
  101. Vessier-Batchen M, Douglas D. Coping and complicated grief in survivors of homicide and suicide decedents. J Forensic Nurs. 2006;2:25–32.PubMedCrossRefGoogle Scholar
  102. Worden JW. Grief counseling and grief therapy. 1st ed. London: Tavistock; 1983.CrossRefGoogle Scholar
  103. Wortman CB, Silver RC. The myths of coping with loss. J Consult Clin Psych.1989;57:349–357.Google Scholar
  104. Zauderer CR. PTSD after childbirth: early detection and treatment. Nurse Pract. 2014;39(3):36–41.PubMedCrossRefGoogle Scholar
  105. Zeanah CH. Perinatal loss and infant mental health: an introduction. Infant Ment Health J. 1995;16:76–9.CrossRefGoogle Scholar
  106. Zeanah CH, Danis B, Hirshberg L. Initial adaptation in mothers and fathers following perinatal loss. Infant Ment Health J. 1995;16:80–93.CrossRefGoogle Scholar
  107. Zuckoff A, Shear K, Frank E. Treating complicated grief and substance use disorders: a pilot study. J Subst Abuse Treat. 2006;30:205–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Caroline J. Hollins Martin
    • 1
    • 2
  • Colin R. Martin
    • 3
  1. 1.School of Nursing, Midwifery and Social Care, Edinburgh Napier University (Sighthill Campus)MidlothianUK
  2. 2.School of Nursing, Midwifery, Social Work & Social Sciences, College of Health and Social CareUniversity of SalfordSalfordUK
  3. 3.Faculty of Society and HealthBuckinghamshire New UniversityMiddlesexUK

Personalised recommendations