244992 Effect of prior perinatal loss on the maternal emotional response to labor and delivery of a healthy infant

Sunday, October 30, 2011

Cara Bicking, MS, RNC , School of Nursing, The Pennsylvania State University, University Park, PA
Kesha Baptiste-Roberts, PhD, MPH , School of Nursing, Penn State University, Hershey, PA
Junjia Zhu, PhD , Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA
Kristen Kjerulff, MA, PhD , Public Health Sciences, Penn State University College of Medicine, Hershey, PA
BACKGROUND: Previous research has shown that women pregnant after perinatal loss experience increased levels of depression, anxiety, stress, and uncertainty compared to women who have not experienced such loss. However, little is known about the emotional response to the actual childbirth experience in this subset of women. METHODS: A prospective analysis was completed with 3000 first time mothers aged 18 to 35 in Pennsylvania. Interviews were conducted between January 2009 and January 2011 during the third trimester and at one month postpartum. The relationship between prior perinatal loss and fear of an adverse neonatal birth outcome during delivery was analyzed. Additionally, self-reported emotional response to labor and delivery was analyzed using four sub-dimensions: emotional adaptation, physical discomfort, fulfillment and negative emotional experience. RESULTS: Approximately 15.9% of the women had a history of perinatal loss. There were no significant differences in the overall emotional response to the birth experience or the four sub-dimensions. However, women with a history of loss were 1.23 times more likely to report moderate to extreme fear that the baby may be hurt or die during delivery compared to women without a history of loss [Odds Ratio (OR)=1.24, 95% Confidence interval (CI) 1.01, 1.52]. This relationship remained after adjustment for race and education (OR=1.24, 95% CI 1.01, 1.53). CONCLUSION: Women with a history of perinatal loss were more likely to have moderate to extreme fear of an adverse neonatal birth outcome compared to women who had not experienced a prior loss.

Learning Areas:
Public health or related nursing

Learning Objectives:
1.Discuss the emotional alterations that may be experienced by pregnant women with a history of perinatal loss. 2.Compare the emotional response to childbirth in women with a history of perinatal loss to the response for women without a history of loss.

Keywords: Maternal Well-Being, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a doctoral student studying perinatal loss and have analyzed the data for this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.