Pregnancy following miscarriage: A study of attachment and unresolved grief

This study investigates the sequelae of pregnancy/perinatal loss on several relationships. Measures included the Adult Attachment Interviews (AAI), Pregnancy Interviews (PI), Brief Symptom Indexes (BSI) and Strange Situations for 51 primiparas in the last trimester of pregnancy. Subjects included an experimental group of 10 primiparas with a history of pregnancy/perinatal loss and a control group of 41 primiparas without such a history. Subjects' 14 months-old offspring were also included in this study.;The relationship between a history of pregnancy/perinatal loss and the unresolved category on the AAI was examined. It was found that women with such a history fell into the unresolved category on the AAI in significantly higher numbers.;Subsequent pregnancy was investigated in terms of how the prospective mother's attachment to her fetus was impacted upon by a maternal history of pregnancy/perinatal loss. This was assessed with the PI. No significant differences were found between groups in terms of attachment to the fetus. Fantasy elaboration of the fetus approached significance.;The effect of a maternal history of pregnancy/perinatal loss on the attachment relationship between mother and infant was examined with the Strange Situation. Offspring of mothers with a loss history were significantly more often insecure.;The relationship between pregnancy/perinatal loss and psychological symptomatology was investigated with the BSI. Women with a loss history were significantly higher on the symptom of somatization.;The pregnancy/perinatal loss group was examined in a series of descriptive analyses. The data suggested that those who were secure on the AAI were more likely to have resolved their respective pregnancy/perinatal loss than those who were insecure. Mothers who resolved their respective pregnancy/perinatal losses tended to have children who were secure more often than did mothers who failed to resolve such losses.;The results of this study support the hypothesis that a history of pregnancy/perinatal loss effects the way prior losses are perceived and impacts upon the maternal-infant attachment relationship. That such a history effects maternal-fetal attachment was not supported. The qualitative data supported the hypothesis that attachment representation is related to the capacity to resolve pregnancy/perinatal loss and that resolution around pregnancy/perinatal loss is related to infant security status.