The Impact of the COVID-19 Pandemic on Perinatal Loss Experienced by the Parental Couple: Protocol for a Mixed Methods Study

Background: At the beginning of 2020, mothers and fathers who experienced perinatal events (from conception to pregnancy
and postpartum period) found themselves facing problems related to the emergency caused by the COVID-19 pandemic and the
associated difficulties for health care centers in providing care. In the unexpected and negative event of perinatal loss (ie,
miscarriage, stillbirth, and neonatal death) more complications occurred. Perinatal loss is a painful and traumatic life experience
that causes grief and can cause affective disorders in the parental couple—the baby dies and the couple’s plans for a family are
abruptly interrupted. During the COVID-19 pandemic, limited access to perinatal bereavement care, due to the lockdown measures
imposed on medical health care centers and the social distancing rules to prevent contagion, was an additional risk factor for
parental mental health, such as facing a prolonged and complicated grief.
Objective: The main aims of this study are as follows: to investigate the impact of COVID-19 on mothers and fathers who
experienced perinatal loss during the pandemic, comparing their perceptions; to evaluate their change over time between the first
survey administration after bereavement and the second survey after 6 months; to examine the correlations between bereavement
and anxiety, depression, couple satisfaction, spirituality, and sociodemographic variables; to investigate which psychosocial
factors may negatively affect the mourning process; and to identify the potential predictors of the development of complicated
grief.
Methods: This longitudinal observational multicenter study is structured according to a mixed methods design, with a quantitative
and qualitative section. It will include a sample of parents (mothers and fathers) who experienced perinatal loss during the
COVID-19 pandemic from March 2020. There are two phases—a baseline and a follow-up after 6 months.
Results: This protocol was approved by the Ethics Committee of Psychological Research, University of Padova, and by the
Institutional Ethics Board of the Spedali Civili of Brescia, Italy. We expect to collect data from 34 or more couples, as determined
by our sample size calculation.
Conclusions: This study will contribute to the understanding of the psychological processes related to perinatal loss and
bereavement care during the COVID-19 pandemic. It will provide information useful to prevent the risk of complicated grief and
psychopathologies among bereaved parents and to promote perinatal mental health.
International Registered Report Identifier (IRRID): DERR1-10.2196/38866