Electronic Theses and Dissertations



Document Type


Degree Name

Doctor of Philosophy



Committee Chair

Melanie Burgess

Committee Member

Eli Jones

Committee Member

Pamela Cogdal

Committee Member

Eraina Schauss


Abstract One in five mothers experience a perinatal mood or anxiety disorder (PMAD), and parents who have suffered infant loss are more at risk of experiencing mental health symptoms than other new parents. There are numerous risk factors for perinatal women developing a mood or anxiety disorder, including a history of depression, lack of support, and negative childhood experiences. This study followed more than 1,000 mothers who participated in an integrated behavioral health perinatal bereavement family support program in the Southeast region of the United States from 2015–2023. Mothers who have suffered from infant loss were found to have a statistically significant relationship with a large effect size between certain risk factors, including depression, anger, and guilt, and PMAD symptoms on the Edinburgh Postnatal Depression Scale (EPDS) at the one-month mark after the loss. Moderate to high risk levels were also statistically significant with a medium effect size with higher EPDS scores. Lastly, certain risk factors indicated a greater or less likelihood to participate in therapy after infant loss. Those with depression were four times more likely to participate in therapy. Mothers with anxiety and guilt were twice as likely to engage in therapy services, and those with anger were almost twice as likely to participate in therapy. While those with addiction were three times less likely to get therapeutic support following a miscarriage or infant loss. Those who did not have depression were also less likely to participate in therapy. This bereavement family support program better sets parents up for healthy grieving, recovery, and resilience building after the profound loss of an infant. Through providing training on grief and trauma informed bereavement care, proper screening and identification of risk factors for mental illness and complicated grief, and providing timely treatment, healthcare providers can positively impact parents and their whole families, including any surviving loved ones that are impacted by the loss. This study seeks to bring awareness, promote education, and encourage advocacy for bereaved perinatal parents integrated behavioral health screening and treatment needs to implement a universal standard of care in hospitals and healthcare settings that treat these families.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest


Open Access