Bute, J. J., Brann, M., Buskmiller, C., & Fredenburg, M. (2023). "There's no time limit on grief:" Women's perspectives on a novel reproductive grief screening tool. PEC Innovation, 3, 100244. https://doi.org/10.1016/j.pecinn.2023.100244
Bute JJ, Brann M, Buskmiller C, Fredenburg M. "There's no time limit on grief:" Women's perspectives on a novel reproductive grief screening tool. PEC Innov. 2023;3:100244. doi:10.1016/j.pecinn.2023.100244
Bute, Jennifer J., et al. ""There's no time limit on grief:" Women's perspectives on a novel reproductive grief screening tool." PEC Innovation, vol. 3, 2023, pp. 100244.
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Author affiliations
4 institutions
Communication, Indiana University-Purdue University Indianapolis (IUPUI), Indianpolis, USA.
Department of Obstetrics, Gynecology, and Women’s Health, St. Louis University, St. Louis, MO, USA01p7jjy08
Institute of Reproductive Grief Care, San Diego, USA.02pttbw34
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RRM Academy Synopsis
Women with pregnancy loss viewed a brief grief screen favorably
In a mixed-methods study of 27 interviewed and 282 surveyed U.S. women with pregnancy loss, participants viewed a five-item Reproductive Grief Screen favorably and found it validating. About 7 out of 10 surveyed women believed a provider check-in about coping would help. Most preferred completing the screen online before an appointment.
Key Findings
The study included 27 women in online interviews (23 in focus groups, 4 in individual interviews) and 282 survey respondents; 153 (54.3%) of the survey respondents had a miscarriage.
Of 282 survey respondents, 208 (73.8%) said their current provider knew about their loss; 18.1% said the provider did not know and 7.8% were unsure.
In the survey, 72% believed a provider check-in about coping after pregnancy loss would be helpful. For screening frequency, 35.1% recommended monthly in the first year and 47.5% annually afterward.
Electronic completion was preferred before arriving at the facility (57.4%) or during the exam (21.3%); 30.1% chose a patient portal and 27.3% a text message link.
Preferred completion method varied with age (χ2(30, N = 277) = 93.61, p < .001) and with time since loss (p < .05).
Interpretation
This mixed-methods study combined online focus groups, individual interviews, and a national survey to learn how women wanted a reproductive grief screen used in their care. Recruitment ran through reproductive loss support websites and social media. The authors note that their sample skewed White (77.3% of survey respondents). The findings support larger, more diverse studies of this screening approach.
RRM Context
Restorative reproductive medicine looks for the cause of a loss in both partners, and the emotional history belongs in that picture. Survey respondents reported gaps: 25.9% said their provider did not know of the loss or they were unsure. Women in the study thought the five-item screen could promote communication about grief between women and their providers.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
Women who have experienced reproductive loss (i.e., miscarriage, stillbirth, abortion) evaluated the usefulness of a novel screening tool, Reproductive Grief Screen (RGS), to identify patients struggling with ongoing, complicated grief.
Methods
This mixed-methods study involved U.S. women who had experienced reproductive loss. Online data collection resulted in 27 interviews and 282 surveys completed. Perceptions of and preferences about RGS were thematically analyzed. Chi square analyses assessed relationships between demographics and tool preferences.
Results
RGS validated women's experiences with grief after reproductive loss. Women noted their providers may be unaware of their loss(es). Participants requested periodic screening using RGS beginning shortly after a loss (or during new patient intake) and occurring regularly (e.g., annually). Overall, women preferred completing RGS online before an appointment, though preferences varied by demographics (i.e., age, time since loss). Participants want providers to compassionately discuss RGS results with them and offer appropriate resources.
Conclusion
The RGS can help identify largely ignored grief after reproductive loss.
Innovation
Findings from group and individual interviews and a survey of women who have coped with reproductive loss suggest that use of a brief RGS tool could reshape clinical practice to aid women who might be facing complicated grief. Moreover, women expressed clear preferences for how to implement use of the RGS in clinical contexts.
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