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Perinatal grief following a termination of pregnancy for foetal abnormality: the impact of coping strategies.Pregnancy termination for foetal abnormality (TFA) can have significant psychological repercussions, but little is known about the coping strategies involved in dealing with TFA. This study examined the relationships between women's coping strategies and perinatal grief. A total of 166 women completed a survey online. Coping and perinatal grief were measured using the Brief COPE and Short Perinatal Grief Scales. Data were analysed through multiple regression analyses. Despite using mostly adaptive coping strategies, women's levels of grief were high and varied according to obstetric and termination variables. Grief was predicted by behavioural disengagement, venting, planning, religion, self‐blame, being recently bereaved, being childless at the time of TFA, not having had children/being pregnant since TFA and uncertainty about the decision to terminate the pregnancy. Acceptance and positive reframing negatively predicted grief. Identifying women vulnerable to poor psychological adjustment and promoting coping strategies associated with lower levels of grief may be beneficial. This could be addressed through information provision and interventions such as Cognitive Behavioural Therapy or Acceptance and Commitment Therapy.
The role of rumination in adjusting to termination of pregnancy for fetal abnormality: rumination as a predictor and mediator of posttraumatic growth.Objective: Rumination is important in adjusting to traumatic events. Evidence suggests that deliberate rumination predicts posttraumatic growth (PTG), and mediates the relationship between coping and PTG. This study examined the relationship between rumination and psychological adjustment following pregnancy termination for fetal abnormality (TFA). Method: A cross-sectional, online study was conducted with women who had undergone TFA. Women were recruited from a support organisation; 161 women completed the Brief COPE, the Perinatal Grief Scale, the Event-Related Rumination Inventory and the Posttraumatic Growth Inventory. Data were analysed using regression and mediation analyses. Results: The results show that women engaged in high levels of intrusive and deliberate rumination post-TFA and that intrusive rumination predicted grief. Intrusive and deliberate rumination predicted PTG, although intrusive rumination was a negative predictor of growth. Deliberate rumination mediated the relationship between grief and PTG. It also mediated the path between positive reframing and PTG, and religious coping and PTG, although the mediation effect depended upon the inclusion of the grief variable in the models. Conclusions: The results confirm the applicability of the PTG model to TFA and support the relevance of rumination to the PTG experience. The results also have clinical implications. Given the positive relationship between deliberate rumination and PTG, promoting interventions that encourage reflective thinking and narrative construction would benefit women post-TFA, particularly those experiencing high levels of distress and/or at risk of complicated grief.