Beyond the Silence: Empowering Mothers through Effective Bereavement Care

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CONTENT WARNING: Mentions of pregnancy loss and miscarriage

The journey of motherhood is often marked by profound joy and anticipation, but for some, it takes an unexpected turn. Miscarriage, a heartbreaking and common occurrence, brings a unique set of challenges that can leave mothers grappling with grief and uncertainty. Khadijat Adeleye, a Ph.D. candidate in the Elaine Marieb College of Nursing, is a strong advocate for maternal grief care and is conducting research on improving grief counseling for bereaved mothers after pregnancy loss. 

Adeleye grew up and attended school in Nigeria, where she earned her bachelor’s and master’s degrees in nursing. Throughout her schooling and in clinical practice working at a hospital in Igbobi, Nigeria, she witnessed first-hand the stark reality of child mortality and maternal grief. Of the many interactions she had, one stuck with her the most: 

A happy couple, excited to soon welcome their new baby into the world, came to the hospital because the woman was experiencing minor abdominal cramping. After performing an ultrasound, it was evident that the women had experienced a miscarriage. The mother was shattered and distraught. Since the hospital was busy and understaffed, the couple was discharged without any further intervention or psychological care.  

Adeleye recalls the woman returning to the hospital after falling into a depression over the loss of her child. Adeleye explained, “Women who have experienced pregnancy loss often suffer from guilt, shame, inferiority complex, anxiety, and fear of the unknown. [The woman] asks so many questions: ‘Will I ever have this pregnancy again? Was it because of my mistakes?’”  

Sadly, this is not an isolated incident. In the United States, it is estimated that 10-20% of clinically-recognized pregnancies – meaning that the mother is aware that they are pregnant—end in miscarriage (Dugas & Slane, 2022). This statistic is even more harrowing for black women. The CDC suggests that Black mothers are more than twice as likely to experience stillbirth compared to Hispanic and white mothers. Adeleye expressed, “This could be my niece. This could be my cousin. That was when I knew I needed to be in maternal child health.” 

It is difficult to find healthcare systems that have programs in place to help mothers during this time of need and the US is no exception. To begin addressing these issues, Adeleye moved to the US to pursue a PhD under the mentorship of Dr. Favorite Iradukunda, studying maternal and child health.  

As she attended conferences, she encountered more and more women who shared their stories of grief following miscarriages. It became apparent to Adeleye that lack of adequate maternal care post-miscarriage was a widespread issue. This made her question why there weren’t measures in place to help these women.   

Adeleye pointed out that, “we have bereavement care that covers adult loss and end-of-life care. Those are things that we prepare for. Pregnancy loss is something that we cannot prepare for and yet we still don’t have adequate care for these mothers.” With this clear problem in mind, Adeleye decided to focus her research on creating an effective intervention for maternal care after child loss.  

Central to Adeleye’s research is that every woman's experience of miscarriage is unique. The required intervention strategies are not one-size-fits-all. Miscarriage is a deeply personal experience that carries distinct cultural and religious significance within different communities. Adeleye emphasizes that “we need interventions that are not only readily available, but also culturally adaptive.”  

For example, some African cultures have sex preference; sons are viewed as providers and heirs who will continue the family lineage and inherit property, while daughters are viewed as caretakers who will take care of her parents, especially in old age. When a mother loses a child, whose sex is known, it can have a different psychological impact depending on the cultural context. These factors need to be considered when providing bereavement care. 

Adeleye is still early in her graduate career, but she has recently been awarded a P.E.O. (Philanthropic Educational Organization) International Peace Scholarship to pursue her work. She began the third year of her PhD this fall and will coordinate with local pregnancy loss organizations and grief psychologists to speak with women who are willing to share their stories. She will be focusing on Black women because they have the highest incidence of pregnancy loss before and after 22 weeks gestation in the US.   

After a comprehensive literature review, Adeleye has decided to implement a mixed-method approach which uses both quantitative and qualitative measures to understand what loss means to these mothers. From there, she will design an intervention that can be readily implemented into hospitals and healthcare facilities. The intervention will be unique by providing personalized support that is tailored to the individual and honors their cultural identities and beliefs. Ultimately, the goal of her research is to help women navigate the complex journey of grief after miscarriage by providing culturally congruent psychological care.  

Adeleye's aims for her research to serve as a beacon of hope, illuminating paths toward improved maternal care after miscarriage. She is confident her dedication to enhancing support systems for grieving mothers has the potential to transform the landscape of post-miscarriage care. She hopes to translate her research findings into clinical practice starting locally. However, she emphasizes that these interventions would be applicable on a global scale and would allow countless mothers to find strength in a healthcare system that recognizes the depth of their experiences.   

When asked what she finds most rewarding about her research, Adeleye said, “To be able to help those women who are less privileged. To help women whose voices have not been heard. Women normally don’t talk about these things because of shame or guilt. I will be their voice and speak for them.” 

*If you or someone you know fit the study criteria and would like to reach out about being a part of this study, please contact Khadijat Adeleye via email (kadeleye [at] umass [dot] edu). A local organization that offers support groups for grieving parents is the Empty Arms Bereavement Organization (link: https://emptyarmsbereavement.org/) located in Northampton, MA. For online support, you can look into Quietly United in Loss Together on Facebook or Twitter.* 

Written by Briana Kubik, Department of Microbiology, as part of the Graduate School's Public Writing Fellows Program.