Men's grief following pregnancy loss and neonatal death
Every year, millions of families worldwide experience the loss of their baby before or shortly after birth. In Australia, one in four pregnancies ends in miscarriage, six babies per day are stillborn and up to 1000 babies lose their fight for life in the Neonatal Intensive Care Unit (NICU) each year.
Although care and support services for grieving parents and families have improved in the last few decades, fathers frequently report feeling as though they are the “forgotten mourners” following the loss of a baby, and carry the responsibility to support their female partner and family. In Australia, there is limited research into men’s experiences of grief following a loss and their subsequent supports needs. Our research aims to improve the understanding of men’s grief and bereavement following pregnancy loss and neonatal death to inform bereavement care guidelines and support services for fathers.
- Qualitative study on men's experiences of grief and support following termination of pregnancy for life-limiting foetal anomalies, published in the Journal of Clinical Nursing.
- Quantitative study on the factors contributing to men's grief following pregnancy loss and neonatal death, published in BMC Pregnancy and Childbirth.
- Research note on men’s experiences of returning to work following pregnancy loss and neonatal death, published in Community, Work and Family.
- A Systematic review on men’s grief following pregnancy loss and neonatal death, published in BMC Pregnancy and Childbirth.
- Interviews with men and service providers following miscarriage and stillbirth, published in Midwifery and Death Studies.
- Featured in the Autumn Edition of the Australian Fatherhood Research Bulletin
- Article for Westpac Wire
- Blog post for the BMC Series
- Podcast interview for Two Shrinks Pod
Members of our research team are currently writing up the results of two student projects for publication.
The first involved follow-up interviews with Australian fathers from our nationwide survey who had experienced neonatal death, to explore their experiences of grief and support in more depth. The second study investigated the grief and support experiences of gay men who have experienced pregnancy loss.
We are also in the planning stages of a new student project, which aims to explore the grief experiences of culturally and linguistically diverse men after perinatal death. This project will interview men, service providers and community leaders about their experiences to gain evidence to inform future support services. For more information on this project, or to express interest in participating, please contact Tom Pearson or Dr Clemence Due.
More about our completed studies
Factors contributing to men's grief following pregnancy loss and neonatal death
In late 2019, we surveyed over 250 Australian men on their experiences of grief following pregnancy loss and neonatal death to further explore men’s experience of grief and the factors that contribute to grief.
Men’s grief scores in our study were substantially high across loss types, with the average grief score sitting above the minimum cut-off considered to be a high degree of grief.
Higher total grief scores were associated with having a history of previous losses, lower marital satisfaction, less availability of social support, little acknowledgement of grief from family/friends, more time spent bonding with the baby during pregnancy, and feeling as though a role of being a ‘supporter’ conflicted with the ability to process grief.
Factors related to grief also differed depending on grief style. Higher levels of intuitive (emotion-focused) grief were associated with less support received from healthcare professionals. In contrast, higher levels of instrumental (activity-focused) grief were associated with more time and higher quality of attachment to the baby during pregnancy, less availability of social support and acknowledgement of men’s grief from their female partner, the ‘supporter’ role interfering with grief, and tendencies toward self-reliance.
These findings indicate that men can experience high levels of grief regardless of the baby’s gestational age, requiring acknowledgement and validation from all healthcare professionals, family/friends, community networks and workplaces. Tailored information and support are also needed to help address male-specific needs, such as balancing a desire to support and be supported. Strategies to support men should consider grief styles and draw upon existing father-inclusive practice recommendations.
Men’s experiences of grief and support following termination of pregnancy for life-threatening foetal anomalies
In 2019/20, we completed follow-up interviews with ten men who completed our nationwide survey and experienced a termination of pregnancy for foetal anomaly (TOPFA). This group of bereaved parents have been particularly under-represented in the research literature to date.
Findings indicated that TOPFA is an extremely difficult experience for men, characterised by emotional reactions of shock and grief, challenges in decision-making, and perceived stigma surrounding termination of pregnancy.
Because men were not admitted to the hospital as a patient in the same way as their partner, they described feeling overlooked by current healthcare services, particularly in relation to providing support and assessing men’s needs. They expressed a need for specific support services tailored for men and follow-up services directed to men following TOPFA.
These findings provide further support for a need to broaden the focus of healthcare systems toward family-centred and father-inclusive views of pregnancy and childbirth to acknowledge fathers’ central role and support them in addressing their grief following TOPFA.
Men’s experiences of workplace leave
In September 2019, the Australian Government announced new policy which will provide parents with up to 12 months of unpaid leave following a stillbirth. In our national survey, we asked men questions about their experiences of leave provisions and support upon their return to work after a loss.
We found that returning to work too soon took an emotional toll on men across loss types. Although some men had supportive employers, others experienced little recognition or understanding for their grief. Only 17% of men were offered parental leave; others relied on various forms of bereavement or compassionate leave, sick/carers or annual leave, and leave without pay. 35% of men were offered additional supports, including counselling, Employee Assistance Programs, or flexible work arrangements. Although not all men wished to take extended (or any) paid leave following pregnancy loss or neonatal death, they believed leave should be available.
This research recommended a national, standardised approach to leave provision and additional support to ensure men’s grief is recognised and adequate support is provided upon return to work.
To develop a comprehensive understanding of men’s grief, we have reviewed the literature on men’s experiences of grief following pregnancy/neonatal loss published in the last 20 years, looking at two research questions:
- What are men’s experiences of grief following pregnancy loss or neonatal loss?
- What are the predictors of men’s grief following loss?
The findings were presented at the Perinatal Society of Australia and New Zealand (PSANZ) 2019 Congress on the Gold Coast, and the 2019 International Stillbirth Alliance Conference in Madrid, Spain.
Interviews with men
An Australian-first interview study on men’s experiences of support following pregnancy loss (including miscarriage and stillbirth). Our results suggested that men have highly individualised experiences of grief and varied support needs. Many of the participants experienced a lack of social recognition from family, friends and community in relation to their grief, which complicated their experience and recovery. Counselling and support groups were helpful to some men, however, others reported preferring more informal options such as catching up with another male who understood their experience or participating in fundraising events. Importantly, this research identified a need for further research on men’s grief following pregnancy loss to inform the development of future support services.
You can listen to Kate Obst talk about the research in an interview by Dr Hunter Mulcare for "Two Shrinks Pod".
Interviews with service providers
As part of the study on men’s experiences of pregnancy loss, we also interviewed service providers (including nurses, midwives, grief counsellors and social workers) on their experiences of supporting men following pregnancy loss. Although men’s grief is highly individualised, participants in this study highlighted a need to recognise and address the additional expectations and responsibilities that may compound men’s experience. To better support men, participants also described the need for creative strategies and use of inclusive language that promotes engagement of men throughout the pregnancy and loss experience.
Australian Stillbirth Senate Inquiry
In 2018, the Senate established an inquiry into stillbirth in Australia and highlighted the need for future investment in stillbirth research and education. We contributed our research on men to advocate for the needs of bereaved fathers following stillbirth. The final report and recommendations were tabled in December 2018. Our findings were included in chapter six on improving the quality of bereavement care and recommendation nine acknowledged the need for bereavement support to address the specific needs of bereaved fathers along with siblings, grandparents and other family members.
Contact the researchers
For more information on this program of research, or questions on how to get involved, please contact the researchers:
Kate Obst email@example.com or (08) 8313 6972
Dr Clemence Due firstname.lastname@example.org or (08) 8313 6096
Dr Melissa Oxlad email@example.com
Associate Professor Philippa Middleton firstname.lastname@example.org
Further support and information
If you require support or wish to speak to someone about your loss, please contact the following pregnancy/neonatal loss support services:
SANDS (Stillborn and Neonatal Death Support) support lines
Bears of Hope Grief Support
Red Nose Grief and Loss Support
SIDS and Kids SA
Free professional counselling and bereavement support to South Australian families who have experienced a loss during pregnancy, stillbirth and neonatal loss, as well as any sudden death up to 7 years of age.
Crisis Line available 24/7: 1300 799 656
Pillars of Strength
The Compassionate Friends Australia
For information on stillbirth awareness and research:
We thank the following organisations for their support:
Ms Obst is receiving funding for this research from an Australian Government Research Training Program Scholarship and a Westpac Scholars Trust 2018 Future Leaders Scholarship.