Grief and depression after pregnancy loss in Sotho women

[摘要] English: This study investigated whether a sample of 25 Sotho women presented withdepression and grief reactions after a spontaneous abortion. A spontaneousabortion is defined as follows: The expulsion of a foetus without signs of viabilitybefore 28 weeks of pregnancy (Stabile, Gruzinskas & Chard, 1992: p.1). It is alsoimportant to note that the terms spontaneous abortion, miscarriage and stillbirth areoften used interchangeably. This study furthermore aimed to investigate theinfluence of certain factors on the intensity and severity of the depressive and griefreactions following such a loss.A literature study indicated that while a number of studies had focused on grief anddepression after pregnancy loss, few of these studies were conducted within amulti-cultural, South African context. A need was therefore identified for research inthis area that focused primarily on the emotional reactions of non-western women.Previous studies have found that depression and grief reactions are common inwomen who have experienced a spontaneous abortion. Research also indicatesthat while a typical grief pattern can be identified in most women, a smallpercentage of women may develop debilitating depression and grief reactions aftera miscarriage or stillbirth. A number of potential risk factors have been noted in theliterature as negatively influencing postloss adjustment. These factors include thepresence of other living children, length of gestation, maternal age, previousreproductive loss, attitude towards the pregnancy, previous mental healthproblems, cognitive processes, social support and cultural aspects.This study focused on the potentially moderating effects of five factors. Thesefactors included length of gestation, the presence of other living children, attributionas to the cause of the loss, whether the miscarriage or stillbirth was unexpected ornot and social support.The following research hypothesis was tested in this study:There are significant differences in the mean depression scores for length ofgestation, blame for loss, presentation of the problem and social support.Participants completed the Zung Self-rating Depression Scale and the PerinatalGrief Scale. The mean scores of the participants indicated that the majority ofwomen were suffering form mild/moderate depression and were experiencing anormal grief reaction as determined on the Perinatal Grief Scale. A smallpercentage of women did however measure to be suffering from severedepression.Of the five potential risk factors investigated in this study, two resulted in statisticallysignificant differences of the mean grief scores of participants. Results indicatedthat women who did not have other children and who received poor social supportform their partners experienced more severe grief reactions. The independentvariables measured in this study did not appear to influence the onset anddevelopment of depression.The results obtained in this study therefore indicate that the majority of women whoparticipated in this study experienced what may be regarded as a normaldepressive and grief reaction after their pregnancy loss. Only a small number ofwomen seemed to be experiencing greater difficulty in coping with their loss. Theseresults may then also indicate a need for further research that may provide SouthAfrican medical and mental health professionals with the necessary information toimplement effective management of the emotional repercussions of pregnancy loss.

[发布机构] University of the Free State