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Posttraumatic growth after perinatal loss: A systematic review

2025-06-25T03:23:47Z

Title: Posttraumatic growth after perinatal loss: A systematic review Authors: Alvarez-Calle, María; Chaves, Covadonga Abstract: Perinatal loss is a potentially painful event for parents and a grief that is often not recognised socially. Research has widely shown that grief responses can coexist with posttraumatic growth responses. The aim of this systematic review was to assess the available evidence of studies investigating posttraumatic growth in people who have suffered a perinatal loss. A search was conducted in PROQUEST and Web of Science for articles published from 2011 to 2021. After reviewing 10 selected articles, it was found that the participants showed moderate levels of posttraumatic growth, mostly in the domains of personal strength, relationships with others, appreciation of life, and to a lesser extent in the perception of new possibilities and spiritual growth. Factors that facilitated the growth experience were finding meaning in the loss, changes in core beliefs, adaptive coping strategies, deliberate rumination, continued bonds with the deceased baby, and social support. It is expected that this systematic review will provide a basis for the design of future interventions aimed at promoting growth when facing perinatal loss.

Parents experiences of pregnancy following perinatal loss: An integrative review

2025-06-25T03:19:32Z

Title: Parents experiences of pregnancy following perinatal loss: An integrative review Authors: Donegan, Gemma; Noonan, Maria; Bradshaw, Carmel Abstract: Background: Pregnancy following perinatal loss has a profound effect on parents and may contribute to intense psychological distress including grief, post-traumatic stress disorder, anxiety and depression. The subsequent pregnancy may also be perceived as more stressful due to the fear of recurrent loss. Midwives and other health care professionals need to be sensitive and empathetic to the needs of these parents when providing care in a pregnancy subsequent to a loss. Methodology: The aim of this integrated literature review was to explore parents’ experiences of pregnancy following a previous perinatal loss using a systematic approach. This is presented in a five-stage process that includes problem identification, literature search, data extraction and evaluation, data analysis and presentation of results. A systematic search of seven electronic databases was conducted (Jan 2009 -Jan 2023) to identify relevant primary research which addressed parents’ experiences of pregnancy following a previous perinatal loss. Seven papers met the eligibility criteria and were assessed for quality using Crowe’s Critical Appraisal Tool (CCAT). Thematic analysis identified two themes. Findings: The key themes identified from the literature were; the psychosocial needs and challenges faced by previously bereaved parents in subsequent pregnancies; and the need for specialist care and support in a subsequent pregnancy. Psychological needs and challenges included continued grief, depression, anxiety, and disparities in the grief process between men and women. The importance of specialist care with an increased level of support from competent, confident and compassionate health care providers was highlighted. Conclusion: The experience of pregnancy following a perinatal loss can be a complex emotional experience for parents. The review identifies the need for post pregnancy loss debriefing and counselling and care pathways specific to caring for women and their partners in a pregnancy subsequent to a perinatal loss. Care in pregnancy subsequent to loss should be provided by empathetic, competent health care providers and include additional antenatal clinic appointments, pregnancy monitoring and psychological support in order to meet the needs of these expectant parents.

Interventions to improve enablers and/or overcome barriers to seeking care during pregnancy, birthing and postnatal period for women living with vulnerabilities in high-income countries: A systematic review and meta-analysis

2025-06-25T03:15:35Z

Title: Interventions to improve enablers and/or overcome barriers to seeking care during pregnancy, birthing and postnatal period for women living with vulnerabilities in high-income countries: A systematic review and meta-analysis Authors: Bowden, Emily R; Chang, Anne B; McCallum, Gabrielle B Abstract: Objective: To reduce maternal morbidity and mortality, World Health Organization recommendations include: commencing pregnancy care before 12-weeks’, at least eight antenatal and four postnatal visits, and attendance of skilled care at birthing. While lower adherence to the recommendation predominates in low- and middle-income countries, it also occurs in some settings in high-income countries. Globally, various strategies are used to optimise maternity care, in line with these recommendations. This systemic review aimed to determine if enhanced care improves maternal care-seeking, thus improving clinical outcomes for women and babies living with vulnerabilities, in high-income countries. Design, setting and participants: We searched the Cochrane Central Registers of Controlled Trials and Cochrane Pregnancy and Childbirth, MEDLINE, CINAHL, Proquest Dissertation and Thesis and reference lists of relevant articles. The latest search was performed June 20, 2022. Randomised controlled trials, non-randomised intervention trials and cohort studies comparing effects of interventions designed to increase utilisation of maternal health services with routine care, for women at increased risk of maternal mortality and severe maternal morbidity in high-income countries were included. Two authors selected, extracted, assessed and analysed data. Additional information was sought from study authors. This systematic review and meta-analysis was registered with PROSPERO(CRD42021256811). Findings: Nine studies with 5,729 participants were included. Interventions to enhance care significantly increased utilisation of health services, increasing attendance at antenatal classes (Odds Ratio[OR]=15·23, 95%Confidence Interval[CI] 10·73–21·61, p<0·0001) and postnatal visits by 6–8 weeks (OR=2·66, 95%CI 1·94–3·64, p<0·0001), compared to routine care. Infants in the intervention groups were significantly less likely to be: born preterm (OR=0·68, 95%CI 0·56–0·82, p<0·0001); low birthweight (OR=0·78, 95%CI 0·64–0·95, p = 0·01) or; require neonatal intensive care (OR=0·80, 95%CI 0·66–0·96, p = 0·02). Conclusions and Implications for practice: Among women living with vulnerabilities in high-income countries, interventions to enhance care increases utilisation of maternal health services and improves outcomes.

Experiences and information needs of women who become pregnant after bariatric surgery: An interpretive descriptive qualitative study

2025-06-25T02:45:14Z

Title: Experiences and information needs of women who become pregnant after bariatric surgery: An interpretive descriptive qualitative study Authors: Vasilevsk, Vidanka; Angel, Genevieve; Mathison, Amanda; Teale, Glyn; Sweet, Linda Abstract: Background: Obesity is known to negatively impact fertility and increase pregnancy related complications. Many women of childbearing age opt for bariatric surgery to lose weight in the preconception period. Physiological changes of bariatric surgery are associated with both benefits and risks for maternal and neonatal outcomes. How women understand these risks and experience pregnancy following bariatric surgery are largely unknown. Objective: To explore the information needs and experiences of Australian women who become pregnant following bariatric surgery. Design: An interpretive descriptive qualitative study of 11 Australian women with experiences of pregnancy following bariatric surgery participated in a private Facebook discussion group conducted in 2021. Women were recruited via targeted advertisements on social media. Results: Women identified several information gaps regarding the implications of having bariatric surgery for preconception, pregnancy, and postnatal periods. Family planning, pregnancy nutrition, and breastfeeding advice were key areas of information need. Women’s experiences of pregnancy following bariatric surgery included attitudes of judgement and lack of knowledge from their healthcare providers. Conclusions: Healthcare professionals caring for women who have had bariatric procedures need to ensure that all women are fully informed about the risks of becoming pregnant within the first 12-months post-surgery. They should also anticipate that despite recommendations, women will become pregnant earlier than advised, and can benefit from non-judgemental and supportive care to ensure risks of poor outcomes are minimised. The findings highlight that the provision of tailored resources and education for women and their healthcare teams are needed.