Attachment and quality of life in women’s grieving after perinatal loss

Introduction: Perinatal grief is the loss of an infant that occurred during pregnancy or during the child's first year of life. Perinatal loss may be associated with intense distress as manifested by sadness, hopelessness, fear, guilt, and anger and longing for the lost child. Even though grief is a distinctive, nonpathological reaction, persistent grief disorder (PGD) may develop when symptoms are more distressing, pervasive, or persistent. The process of grief may be affected by various factors, among them, the individual’s attachment style may be an influential variable. Attachment theory certainly offers a useful perspective to understand the response to loss. In particular, anxiously attached people seem to show more intense grief symptoms following the loss of a significant attachment figure, whereas avoidantly attached individuals display fewer externalized expressions of grief but higher levels of somatization. During pregnancy, the developing attachment to the unborn child goes together with by the formation of a parent-child bond. Therefore, it is critical to consider how attachment is linked to the prolonged grief response after perinatal loss and the woman's perceived quality of life. The objective of the present study was to study the perinatal grief symptoms and the quality of life in a sample of 137 Italian women (mean age 36.9 ±6.88 years) in relation to the two dimensions of parental attachment: parental care and parental control. Methods: Recruited women filled online the Parental Bonding Instrument, the Perinatal Grief Scale, and the Psychosocial General Well-Being Index. Results: All subjects presented intense grief and severe grief reactions to loss. In addition, women who reported higher maternal care disclosed higher quality of life in comparison with women who experienced lower maternal care. Moreover, optimal maternal attachment was associated with a positive healing process and a higher quality of life than women with a loveless control profile. Conclusions: Perinatal loss has proved to be a frequent experience connected with an increased risk for impaired quality of life. In this context, an optimal maternal attachment showed to be a protective factor; hence, attachment-based tailored interventions for women who experience perinatal loss should be implemented to foster their general and psychological health.