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Psychological impact of stillbirth on fathers in the subsequent pregnancy and puerperium

Published online by Cambridge University Press:  02 January 2018

Penelope Turton ,
William Badenhorst ,
Patricia Hughes ,
Julia Ward ,
Samantha Riches  and
Sarah White
Penelope Turton*
Affiliation:
Division of Mental Health, St George's University of London, London, UK
William Badenhorst
Affiliation:
Division of Mental Health, St George's University of London, London, UK
Patricia Hughes
Affiliation:
Division of Mental Health, St George's University of London, London, UK
Julia Ward
Affiliation:
Division of Mental Health, St George's University of London, London, UK
Samantha Riches
Affiliation:
Division of Mental Health, St George's University of London, London, UK
Sarah White
Affiliation:
Division of Mental Health, St George's University of London, London, UK
*
Dr Penelope Turton, Division of Mental Health, St George's University of London, London SW17 0RE, UK. E-mail: pturton@sgul.ac.uk
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Abstract

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Background

Approximately 1 in 200 UK pregnancies ends in stillbirth. Although serious psychological effects of stillbirth on mothers are well established, much less is known about the impact of such loss on fathers.

Aims

To assess the psychological morbidity of fathers in the pregnancy and post-partum year subsequentto a stillbirth, to test within-couple effects and to identify risk factors.

Method

This was a community-based cohort study of 38 pregnant couples whose previous pregnancy had ended in stillbirth, and 38 pair-matched controls. Psychological assessments took place antenatally and at 6 weeks, 6 months and 1 year postnatally.

Results

Fathers in the index group experienced significant levels of anxiety and post-traumatic stress disorder antenatally, but all of their symptoms remitted postnatally (after the birth of a live baby). Fathers' symptom levels were lower than those of mothers at all time points. In contrast to mothers, fathers experienced greater anxiety when a subsequent pregnancy (following stillbirth) was delayed.

Conclusions

The vulnerability of fathers to psychological distress during the pregnancy after a stillbirth needs to be recognised.

Type
Papers
Information
The British Journal of Psychiatry , Volume 188 , Issue 2 , February 2006 , pp. 165 - 172
Copyright
Copyright © 2006 The Royal College of Psychiatrists 

Footnotes

Declaration of Interest

None.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
CACI (2003) Wealth of the Nation Survey Report. London: CACI.Google Scholar
Cox, J. L., Holden, J. M. & Sagovsky, R. (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.Google Scholar
DeFrain, J., Martens, L., Stork, J., et al (1991) The psychological effects of a stillbirth on surviving family members. Journal of Death and Dying, 22, 81–108.Google Scholar
de Montigny, F., Beaudet, R. N. & Dumas, L. (1999) A baby has died: the impact of perinatal loss on family social networks. Journal of Obstetric, Gynecologic and Neonatal Nursing, 28, 151–156.Google Scholar
Dyregrov, A. & Matthiesen, S. B. (1987) Anxiety and vulnerability in parents following the death of an infant. Scandinavian Journal of Psychology, 28, 16–25.Google Scholar
Foulds, G. A. & Bedford, A. (1978) Delusions-Symptoms-States Inventory of Anxiety and Depression. Windsor: National Foundation of Educational Research.Google Scholar
Helmrath, T. & Steinitz, E. M. (1978) Death of an infant: parental grieving and the failure of social support. Journal of Family Practice, 6, 785—790.Google Scholar
Hughes, C. B. & Page-Lieberman, J. (1989) Fathers experiencing a perinatal loss. Death Studies, 13, 537–556.Google Scholar
Hughes, P., Turton, P. & Evans, C. D. H. (1999) Stillbirth as a risk factor for anxiety and depression in the next pregnancy: does time since loss make a difference? BMJ, 318, 1721–1724.Google Scholar
Hughes, P., Turton, P., Hopper, E., et al (2001) Disorganised attachment behaviour among infants born subsequent to stillbirth. Journal of Child Psychology and Psychiatry, 42, 791–801.Google Scholar
Hughes, P., Turton, P., Hopper, E., et al (2002) Assessment of good practice guidelines in the psychosocial care of mothers after stillbirth: a cohort study. Lancet, 360, 114–118.CrossRefGoogle ScholarPubMed
Hughes, P., Turton, P., Hopper, E., et al (2004) Factors associated with the unresolved classification of the adult attachment interview in the pregnancy following a stillbirth. Development and Psychopathology, 16, 215–230.Google Scholar
Janssen, H. J. E. M., Cuisinier, M. C. J., de Graauw, K. P., et al (1997) A prospective study of risk factors predicting grief intensity following pregnancy loss. Archives of General Psychiatry, 54, 56–61.Google Scholar
Keane, T. M., Malloy, P. F. & Fairbank, J. A. (1984) Empirical development of an MMPI subscale for the assessment of combat-related post-traumatic stress disorder. Journal of Consulting and Clinical Psychology, 52, 888–891.CrossRefGoogle Scholar
Kennell, J. H., Slyter, H. & Klaus, M. H. (1970) The mourning response of parents to the death of a newborn infant. New England Journal of Medicine, 283, 344–349.Google Scholar
Kimble, D. L. (1991) Neonatal death: a descriptive study of fathers’ experiences. Neonatal Network – Journal of Neonatal Nursing, 9, 45—50.Google Scholar
Lewis, R. J., Winstead, B. & Derlega, V. J. (1989) Gender differences in volunteering for friendship research. Journal of Social Behaviour and Personality, 4, 623–632.Google Scholar
Melcalfe, M. & Goldman, E. (1965) Validation of an inventory for measuring depression. British Journal of Psychiatry, 111, 240–242.Google Scholar
Murray, D. & Cox, J. (1990) Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale (EPDS). Journal of Reproductive and Infant Psychology, 8, 99–107.Google Scholar
Najman, J. M., Vance, J. C., Boyle, F., et al (1993) The impact of a child death on marital adjustment. Social Science and Medicine, 37, 1005–1010.Google Scholar
Peppers, L. G. & Knapp, R. J. (1980) Maternal reactions to involuntary fetal/infant death. Psychiatry: Journal for the Study of Interpersonal Processes, 43, 155–159.Google Scholar
Rich, D. E. (2000) The impact of post pregnancy loss services on grief outcome: integrating research and practice in the design of perinatal bereavement programs. Illness, Crisis and Loss, 8, 244–264.Google Scholar
Rust, J., Bennun, I., Crowe, M., et al (1988) The Golombok Rust Inventory of Marital Satisfaction (GRIMS). Windsor: NFER–Nelson.Google Scholar
Samuelsson, M., Radestad, I. & Segesten, K. (2001) A waste of life: fathers’ experience of losing a child before birth. Birth, 28, 124–130.Google Scholar
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. (1970) Test for the State–Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Stinson, K. M., Lasker, J., Lohmann, J., et al (1992) Parents’ grief following pregnancy loss: a comparison of mothers and fathers. Family Relations, 41, 218–223.CrossRefGoogle Scholar
Theut, S. K., Pedersen, F. A. & Zaslow, M. J. (1988) Pregnancy subsequent to perinatal loss: parental anxiety and depression. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 289–292.CrossRefGoogle ScholarPubMed
Theut, S. K., Pedersen, F. A., Zaslow, M. J., et al (1989) Perinatal loss and parental bereavement. American Journal of Psychiatry, 146, 635–639.Google ScholarPubMed
Theut, S. K., Zaslow, M. J., Rabinovich, B. A., et al (1990) Resolution of parental bereavement after a perinatal loss. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 521–525.Google Scholar
Toedter, L. J., Lasker, J. N. & Janssen, H. J. E. M. (2001) International comparison of studies using the Perinatal Grief Scale: a decade of research on pregnancy loss. Death Studies, 25, 205–228.Google Scholar
Turton, P., Hughes, P., Evans, C. D. H., et al (2001) The incidence and significance of post-traumatic stress disorder in the pregnancy after stillbirth. British Journal of Psychiatry, 178, 556–560.CrossRefGoogle Scholar
Vance, J. C., Foster, W. J., Najman, J. M., et al (1991) Early parental responses to sudden infant death, stillbirth or neonatal death. Medical Journal of Australia, 155, 292–297.CrossRefGoogle ScholarPubMed
Vance, J. C., Najman, J. M., Boyle, F. M., et al (1994) Alcohol and drug usage in parents soon after stillbirth, neonatal death or SIDS. Journal of Paediatrics and Child Health, 30, 269–272.Google Scholar
Vance, J. C., Najman, J. M., Thearle, M. J., et al (1995a) 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, 96, 933–938.Google Scholar
Vance, J. C., Boyle, F. M., Najman, J. M., et al (1995b) Gender differences in parental psychological distress following perinatal death or sudden infant death syndrome. British Journal of Psychiatry, 167, 806–811.Google Scholar
Watson, C. G., Juba, M. P., Manifold, V., et al (1991) The PTSD Interview: rationale, description, reliability and concurrent validity of a DSM –III-based technique. Journal of Clinical Psychology, 47, 179–188.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Worth, N. J. (1997) Becoming a father to a stillborn child. Clinical Nursing Research, 6, 71–89.Google Scholar
Zeanah, C. H., Danis, B., Hirshberg, L., et al (1995) Initial adaptation in mothers and fathers following perinatal loss. Infant Mental Health Journal, 16, 80–93.Google Scholar
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