Hong Kong Study: Couples' Grief After Pregnancy Loss

The impact of miscarriage on women is widely acknowledged, yet its effects on couples are less examined. To gain a better understanding of a couple's interdependence in grief and coping mechanisms following a miscarriage, an online study titled "Couple's Interdependence in Grief and Coping After Pregnancy Loss in Hong Kong" was conducted from September to October 2024.

Data from 246 couples, sampled through community networks and social media platforms, were analysed in this survey. The median age of the respondents was 37. The majority were married (90%) with one or more children (61%). Most were employed (77%) and had a university education or higher (69%). Among the women, most experienced a miscarriage (82%) for the first time (79%), which had occurred within the past year (83%).

Research findings on couples after pregnancy loss

Prof. Celia Chan said, "Following pregnancy loss, couples often experience depressive symptoms and complicated grief, highlighting the need for attention from the public health sector."

A significant portion (54%) of couples (with either or both partners) experienced complicated grief after pregnancy loss, necessitating referral to psychological support:

• 69% of couples (with either or both partners) experienced complicated grief.
• Within a year of pregnancy loss, the majority (86%) of couples (with either or both partners) experienced complicated grief.
• Over a year later, more than half (65%) of couples (with either or both partners) were still experiencing complicated grief.

Common reactions included:

• Difficulty accepting the loss of a child.
• Emotional reactions interfering with daily life.
• Persistent images of losing the child or reminders of the loss.
• Avoidance of activities previously enjoyed before the loss.
• Difficulty connecting with others, including family and friends.

Nearly a quarter (23%) of respondents experienced moderate to severe depressive symptoms:

• 34% of couples (with either or both partners) experienced moderate to severe depressive symptoms.
• Within a year, over 47% of couples (with either or both partners) experienced moderate to severe depressive symptoms.
• Over a year later, 31% of couples or individuals were still experiencing depressive symptoms.

Dyadic coping is crucial for couples managing adversities. For those with low levels of dyadic coping, the impact on their emotional well-being was significant:

• Experiencing moderate or severe depressive symptoms: couples (16%), wives (21%), husbands (7%).
• Experiencing clinical levels of complicated grief: couples (41%), wives (24%), husbands (12%).

Recommendations from the Supporting Community:

Prof. Paul Wong suggested, "Clinicians should include grief and reproductive history as part of routine assessments. Couples are encouraged to share their loss openly, and the public should support the sharing of their loss."

• Incorporate grief and reproductive history into daily intake assessments.
• Encourage couples who have experienced pregnancy loss to share their loss openly, accept differences in grieving, and seek support when needed.
• The public is encouraged to support bereaved parents in sharing their loss.

Concluding the Project and Way Forward

Over the past three years, the project's online platform has engaged more than 74,000 bereaved parents, their families, and friends in psycho-education related to miscarriage. Additionally, the project has garnered over 560,000 views on social media. The online learning materials for helping professionals have also received over 1,500 views.

Feedback from service users has been positive:

• 82% of bereaved parents reported an improvement in emotional distress related to miscarriage after browsing the website content.
• 100% of helping professionals indicated that the learning platform enhanced their confidence in supporting bereaved parents.

Messages to the Public

• After pregnancy loss, 10% of couples experienced moderate depressive symptoms, and over half suffered from complicated grief, which deserves attention from the public health sector.
• Depressive symptoms should not be the only indicator for psychological assessment; grief levels in couples might be more relevant.
• Couples affected by pregnancy loss are encouraged to share their loss together with openness to vulnerability and acceptance of differences in grieving.
• Families and friends can help by allowing couples to share their experiences, which can aid in their grieving process.
• The Jockey Club Perinatal Bereavement Care Project is concluding with encouraging feedback. Public awareness and support for pregnancy loss, along with enhancing community capacity for perinatal bereavement care, are essential to sustaining the project's impact.

Please click here for more details on the survey findings.