Grief and depression after pregnancy loss in Sotho women

English: This study investigated whether a sample of 25 Sotho women presented with depression and grief reactions after a spontaneous abortion. A spontaneous abortion is defined as follows: "The expulsion of a foetus without signs of viability before 28 weeks of pregnancy" (Stabile, Gruzinskas & Chard, 1992: p.1). It is also important to note that the terms spontaneous abortion, miscarriage and stillbirth are often used interchangeably. This study furthermore aimed to investigate the influence of certain factors on the intensity and severity of the depressive and grief reactions following such a loss. A literature study indicated that while a number of studies had focused on grief and depression after pregnancy loss, few of these studies were conducted within a multi-cultural, South African context. A need was therefore identified for research in this area that focused primarily on the emotional reactions of non-western women. Previous studies have found that depression and grief reactions are common in women who have experienced a spontaneous abortion. Research also indicates that while a typical grief pattern can be identified in most women, a small percentage of women may develop debilitating depression and grief reactions after a miscarriage or stillbirth. A number of potential risk factors have been noted in the literature as negatively influencing postloss adjustment. These factors include the presence of other living children, length of gestation, maternal age, previous reproductive loss, attitude towards the pregnancy, previous mental health problems, cognitive processes, social support and cultural aspects. This study focused on the potentially moderating effects of five factors. These factors included length of gestation, the presence of other living children, attribution as to the cause of the loss, whether the miscarriage or stillbirth was unexpected or not and social support. The following research hypothesis was tested in this study: There are significant differences in the mean depression scores for length of gestation, blame for loss, presentation of the problem and social support. Participants completed the Zung Self-rating Depression Scale and the Perinatal Grief Scale. The mean scores of the participants indicated that the majority of women were suffering form mild/moderate depression and were experiencing a normal grief reaction as determined on the Perinatal Grief Scale. A small percentage of women did however measure to be suffering from severe depression. Of the five potential risk factors investigated in this study, two resulted in statistically significant differences of the mean grief scores of participants. Results indicated that women who did not have other children and who received poor social support form their partners experienced more severe grief reactions. The independent variables measured in this study did not appear to influence the onset and development of depression. The results obtained in this study therefore indicate that the majority of women who participated in this study experienced what may be regarded as a normal depressive and grief reaction after their pregnancy loss. Only a small number of women seemed to be experiencing greater difficulty in coping with their loss. These results may then also indicate a need for further research that may provide South African medical and mental health professionals with the necessary information to implement effective management of the emotional repercussions of pregnancy loss.