Men’s grief following pregnancy loss and neonatal loss: A systematic review and emerging theoretical model

Abstract Background Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men’s grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men’s grief, this systematic review sought to summarise and appraise the literature focusing on men’s experiences of grief following pregnancy loss and neonatal loss.Methods Systematic searches were completed across four databases (PsycINFO, PubMed, Embase and CINAHL), guided by two research questions: 1) what are men’s experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men’s grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men’s grief, published between 1998 and October 2018. Eligibility for loss type included any definition of miscarriage or stillbirth, and neonatal death up to 28 days after a live birth.Results A final sample of 46 articles were identified, of which 26 were qualitative, 19 quantitative, and one mixed methods. Findings indicate that men’s grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent support needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience.Conclusion To refine an emerging socio-ecological model of men’s grief, cohort studies are needed among varied groups of bereaved men to confirm grief-predictor relationships. There remains a need to promote genuine and consistent involvement of fathers as equal partners throughout pregnancy and childbirth. Likewise, engaging men early in the grief process is essential to providing recognition and validation to their experience, and improving awareness of available support services.