This research explores the influence of pregnancy loss and coping strategies employed while connecting to the fetus in a subsequent pregnancy following a late term loss. Nine participants were interviewed using a qualitative, phenomenological methodology to determine participant's experience. Four themes emerged within the data: (1) support network – participants acknowledged who was there for them and who was not, (2) emotional ups and downs – participants reported the emotional ups and downs from loss to the subsequent pregnancy to delivery and after birth, and how they connected during this process (3) coping – participants describe coping strategies used throughout their experience, and (4) moving forward – participants reported their process of finding their new normal and how this event changed their perspective on life. Limitations, future research and clinical implications were all identified and discussed. / Master of Science

Perinatal loss is a tragic event in a woman's life and is a time filled with much aguish and · grief. The care a women and her family receive during a perinatal loss experience can have an incredible impact on future subsequent pregnancies. Subsequent pregnancies have shown to be filled with apprehension and anxiety that can potentially lead to complications such as preterm labor or another loss. Depressive symptoms and decreased prenatal attachment are additional factors that play a role in the experience of a subsequent pregnancy. The purpose of this thesis was to complete a comprehensive review of research studies concerning the experiences of women and subsequent pregnancies after suffering a perinatal loss and develop strategies that can be used to promote effective coping in this population. A review of the literature was conducted using Cumulative Index of Nursing and Allied Health Literature Plus with Full Text, PubMed, and Medline databases. Results found higher pregnancy anxiety, more depressive symptoms, and decreased prenatal attachment in couples with a history of perinatal loss, a lack of bereavement education for nurses and midwives, and emphasized the need for support for both families and health care providers. Coping strategies for women and their families were identified and specific nursing implications for practice were established in order to facilitate coping in women and families.

The purpose of this research is to evaluate the coping strategies of families and childbearing women after intrauterine fetal demise and early infant death. The secondary purpose is to examine the effect of grieving strategies after intrauterine fetal demise compared to early infant death on time until subsequent pregnancy in women of childbearing age. A literature review exploring parental grief and coping strategies to cope with loss and its effect on the subsequent pregnancy was conducted from various online databases. All reviewed articles in the analysis indicated that coping strategies consist of a diverse number of mechanisms during the bereavement process. Results show that positive mechanism such as talking about the experience of fetal and infant death was beneficial in the grieving journey and showed a positive correlation to a shorter time to subsequent pregnancy. Identification of strategies to improve mental health in women after fetal demise and early infant death are of value to pregnancy counseling following demise and improving time to conception outcomes after emotional trauma caused by perinatal loss. There is great value in understanding the connection between conception after the early death of an infant and intrauterine fetal demise in helping healthcare providers support family planning goals.

The present study explored how emotional cushioning (EC) buffered the relationship between grief intensity of perinatal loss and relationship satisfaction among women who have experienced pregnancy after loss. It was hypothesized that higher levels of grief intensity would be negatively associated with relationship satisfaction among women. Additionally, it was hypothesized that higher levels of EC would lessen the negative relationship between grief intensity of perinatal loss and relationship satisfaction among women. Through the use of a hierarchical linear regression, it was determined that grief intensity was not significantly associated with relationship satisfaction and that EC did not serve as a buffer between grief intensity and relationship satisfaction. However, a significant correlation was found between EC and relationship satisfaction. The results of this study can help contribute to the literature by providing more discussion about utilizing systemic approaches for clients who have experienced perinatal loss and pregnancy-related anxiety.