Long-term impact of perinatal bereavement. Comparison of grief reactions after intrauterine versus neonatal death

OBJECTIVE: To investigate possible differences in emotional impact on parents following either a deliberate intrauterine death or a neonatal death in extremely preterm growth retarded infants. DESIGN: Retrospectively matched study by audiotaped semi-structured interview, 3-9 years after the perinatal loss. RESULTS: Nineteen couples (ten in the intrauterine death group and nine in the neonatal death group) consented to participate. More than 50% of the intrauterine death group couples could not share or discuss their emotions. Most partners in this group did not feel the loss of their own child. Discongruent grieving between partners was more pronounced in the intrauterine death group and could be identified as a risk factor for prolonged and abnormal grief reactions. Four couples (three in the intrauterine death group and one in the neonatal death group) developed long-term emotional disturbance and psychosocial problems. Long-term follow-up in both groups was failing remarkably. CONCLUSION: Assimilating a non-intervention policy followed by fetal death requires different skills and is more complicated than grief support around an early neonatal death. Follow-up is essential to identify the couple 'at risk' and to mobilize extra support