PMH-C Perinatal Loss & Grief 1 — Questions and Answers
Question 1: Which term best describes the death of a fetus at or after 20 weeks of gestation, prior to birth?
- Miscarriage
- Stillbirth (Correct answer)
- Neonatal death
- Perinatal loss
Correct answer: Stillbirth
Stillbirth is defined as fetal death occurring at or after 20 weeks of gestation, distinguishing it from miscarriage which occurs earlier.
Question 2: According to Kübler-Ross's grief model, which of the following is NOT one of the five stages of grief?
- Denial
- Bargaining
- Isolation (Correct answer)
- Acceptance
Correct answer: Isolation
Kübler-Ross's five stages are denial, anger, bargaining, depression, and acceptance; isolation is not one of the named stages.
Question 3: A patient who experienced a stillbirth 8 months ago continues to have persistent yearning, difficulty accepting the death, and bitterness that impairs daily functioning. This best describes:
- Major depressive disorder
- Prolonged grief disorder (Correct answer)
- Adjustment disorder
- Acute stress reaction
Correct answer: Prolonged grief disorder
Prolonged grief disorder is characterized by persistent yearning, difficulty accepting the loss, and functional impairment lasting beyond 6 months after bereavement.
Question 4: When supporting a family after a perinatal loss, which of the following practices is generally recommended by bereavement specialists?
- Discouraging the parents from seeing or holding the baby
- Offering parents the choice to see, hold, and name the baby (Correct answer)
- Removing the baby from the room immediately to minimize distress
- Advising parents to plan another pregnancy as soon as possible
Correct answer: Offering parents the choice to see, hold, and name the baby
Offering parents the opportunity to see, hold, and name their baby is a recognized bereavement support practice that can facilitate healthy grieving.
Question 5: A mother in the NICU whose premature infant dies after two weeks describes feeling guilty that she was unable to protect her baby. This reaction is:
- Abnormal and requires immediate psychiatric referral
- A common component of perinatal grief that warrants compassionate support (Correct answer)
- Evidence of underlying personality disorder
- Indicative of postpartum psychosis
Correct answer: A common component of perinatal grief that warrants compassionate support
Guilt is a common and expected component of perinatal grief; compassionate normalization and support are the appropriate clinical response.
Question 6: Which assessment tool is specifically designed to screen for complicated grief or prolonged grief disorder in bereaved individuals?
- Edinburgh Postnatal Depression Scale (EPDS)
- Inventory of Complicated Grief (ICG) (Correct answer)
- Beck Anxiety Inventory (BAI)
- Perinatal Grief Scale (PGS)
Correct answer: Inventory of Complicated Grief (ICG)
The Inventory of Complicated Grief (ICG) is a validated tool specifically developed to assess symptoms of complicated/prolonged grief.
Question 7: Which of the following is a key difference between grief and depression in the context of perinatal loss?
- Grief never includes feelings of sadness, while depression always does
- In grief, mood often fluctuates and positive emotions can coexist; depression tends to involve persistent pervasive low mood (Correct answer)
- Depression resolves spontaneously within six weeks; grief does not
- Grief responds to antidepressants while depression does not
Correct answer: In grief, mood often fluctuates and positive emotions can coexist; depression tends to involve persistent pervasive low mood
A hallmark distinction is that grief involves fluctuating mood with preserved capacity for positive emotion, whereas depression typically involves pervasive, sustained low mood.
PMH-C Perinatal Loss & Grief 1
Which term best describes the death of a fetus at or after 20 weeks of gestation, prior to birth?