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Grief following miscarriage: a comprehensive review of the literature.

OBJECTIVE
The literature exploring the relationship between miscarriage and grief is sparse. This paper summarizes the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators.


METHODS
An electronic search of the Medline and Psych Info databases was conducted. Studies were selected for inclusion if they related to early miscarriage, used a standardized measure to assess perinatal grief, and specified the assessment intervals employed. Qualitative studies were included when helpful to develop hypotheses.


RESULTS
Descriptions of grief following miscarriage are highly variable but tend to match descriptions of grief used to characterize other types of significant losses. A sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief unclear. Suggestively, grief, when present, seems to be similar in intensity to grief after other types of major losses and is significantly less intense by about 6 months. Few conclusions can be drawn in regard to potential moderators of grief following a miscarriage.


CONCLUSIONS
Although additional research is clearly needed, guidelines for coping with grief following miscarriage can be based on the data available on coping with other significant types of losses. Given the range of potential meanings for this primarily prospective and symbolic loss, practitioners need to encourage patients to articulate the specific nature of their loss and assist in helping them concretize the experience.