Proof of life: a protocol for pregnant women who experience pre-20-week perinatal loss

Abstract

One in 6 pregnancies is lost before the 20th week of gestation and the psychological impacts of this loss are frequently unaddressed while attention is focused on immediate physiological needs. To improve the comprehensive care provided to women experiencing pre-20-week loss, an evidence-based intervention protocol was developed to provide emotional support to these women in the immediate aftermath of the loss. The protocol was tested using a sample of 40 women who experienced a pre-20-week perinatal loss and were being treated in a large county emergency center. Twenty randomly selected women received the intervention protocol while another 20 women received the usual standard of care. Both groups completed the Perinatal Grief Scale during a routine 2-week follow-up visit. The results indicated that the intervention was effective in ameliorating the degree of despair in women experiencing an early pregnancy loss. Women receiving the protocol expressed feelings of being supported and cared for by the staff. Secondary benefits were an increased collaboration among health care professionals, development of an environment of empathy, and a change in the culture of belief that these women needed only physical care. Results indicate a need for a support protocol for all women experiencing loss regardless of gestational age.