[Bereavement evolution in mothers and families after perinatal death]

Semi-structured interviews were conducted with 33 mothers one to 9 years after the death of a child in the perinatal period: 15/33 mothers (45.5%) are dissatisfied with care givers attitudes, 8/33 (24.2%) showed pathological grief reactions, 11/29 (37.9%) had established a pathological relationship with at least one of their living children, 5/29 (17.2%) were in disagreement with the child's father. Univariable analysis of interviews and obstetrical data showed that some factors where significantly correlated with pathological evolution. The relative risk (RR) of mothers' dissatisfaction was significantly decreased by positive attitudes: support by their obstetrician (RR 0.22, p < 0.01), by midwives and nurses (RR 0.24, p < 0.05), showing the dead baby (RR 0.39, p < 0.05), and increased by caregivers negative altitudes RR 13.18 p < 0.01) as well as by a concurrent bereavement (RR 2.29, p < 0.05). Pathological grief was more frequent amongst foreign culture mothers (RR 5.25, p < 0.01). Pathological mother-child relationships were increased by negative attitudes (RR 8.13, p < 0.05), by dissatisfaction (RR 4.82, p 0.01), by another bereavement (RR 2.86, p < 0.05) and decreased by seeing the dead baby (RR 0.35, p < 0.05) and understanding the cause of the death (RR 0.35, p < 0.05).