Factors associated with an increased grief response following abortion for fetal or maternal indications
Awarded 2021
Complex Family Planning Fellowship Research
Isa Ryan, MD
Northwestern University

Little is known about patients’ experiences of grief after abortion for fetal indications or pregnancy complications in the second trimester. The typical grief response is a process of expected distress during the acute grief period with a transition to integrated grief marked by the development of healthy coping skills and acceptance of the loss. While the majority of women seem to transition from acute grief to integrated grief, some women develop maladaptive behaviors and have prolonged severe grief responses. Few studies characterize risk factors predisposing to complicated grief or describe the typical grief trajectory after an abortion for fetal or maternal indications. This study aims through a nested case-control design to identify risk factors that could identify patients at increased risk for complicated grief in order to improve counseling and proactive coordination of mental health care after second-trimester abortion. As a secondary objective, this study will additionally aim to describe the typical grief response. Patients aged 18-50 seeking termination from gestational ages 12w0d to 26w6d for maternal or fetal indications will be recruited for study participation. Participants will complete the Perinatal Grief Scale (PGS), a validated questionnaire, at baseline and serially for up to 6 months following the abortion. Participants with an abnormal PGS one month after the abortion will be compared to participants with a normal PGS. Additionally, this study aims to obtain data on the timeframe for the typical grief response and resolution for this population.