Walk with Me (WWM) for Perinatal Grief - Project Summary
The loss of a child during pregnancy and the early postpartum period causes significant psychological distress
for many women and their partners and may lead to long-lasting psychological impairment and disorder such
as posttraumatic stress, prolonged grief, and suicide. Approximately 24,000 babies in the United States are
stillborn each year and over 14,000 infants die within the first 30 days of life. About 15% of parents will
experience a miscarriage and more than 30% of women who experience a miscarriage meet the diagnostic
criteria for posttraumatic stress disorder. Currently, there are limited efficacious and accessible treatments to
attenuate the effects of trauma and intense grief that are common to perinatal loss. Prior research has found
online cognitive behavioral therapy (CBT) to be effective for reducing perinatal grief and post-traumatic stress
disorder symptoms. However, there is a need for programs that provide support beyond cognitive reappraisal
to offer concrete strategies to reduce distress and increase availability for attachment to subsequent
pregnancies including mindfulness practice and the inclusion of guiding principles for working with parents who
have experienced perinatal loss. Using guiding principles of grief and infusing practical strategies to reduce
distress for bereaved parents such as facilitating partner engagement and examples of grief rituals are be
important additions to components of cognitive behavioral therapy for this population. Additionally, bereaved
parents may experience damaging communication from health care professionals (HCPs) who lack sufficient
training. There are no readily available tools that blend HCP training with direct support for bereaved parents.
The goal of this phase I project is to create a prototype of a mobile application that demonstrates promise of
effectiveness for reducing parent distress (traumatic stress and intensity of grief) following a perinatal loss. We
will accomplish this goal by accomplishing our three specific aims: Specific Aim 1: Use an iterative formative
development process to develop training and modules for grief processing and healing activities leveraging
cognitive behavioral therapy and guiding principles for working with parents who have experienced perinatal
loss. Specific Aim 2: Develop prototype featuring core components of the application. Specifically, HCP
training and four key modules for bereaved parents including two on normalization of grief, one on mindfulness
to facilitate coping with trauma and distress symptoms and one using CBT strategies to manage negative
thoughts. Specific Aim 3: Evaluate the acceptability, usability, and effectiveness of Walk with Me by
conducting a mixed-methods program evaluation with HCPs and bereaved parents to optimize the successful
use of Walk with Me.
