Moderating Role of Sense of Coherence on the Relationship between Grief and Embitterment among Women's Experiences Fetal Demise/Spontaneous Abortion


  • Rizwana Samreen MS Scholar, Department of Psychology, University of Wah, Wah Cantt., Punjab, Pakistan.
  • Samina Rashid Assistant Professor, Department of Psychology, University of Wah, Wah Cantt., Punjab, Pakistan.
  • Babar Nadeem MS Scholar, Department of Management Sciences, Riphah International University, Islamabad, Pakistan.



Grief, Embitterment, Sense of Coherence (SOC), Fetal Demise, Spontaneous Abortion


A time of anticipation and support, bearing a child is an emotional journey defined by the promise and certainty of new life. However, some individuals and couples have a deep and often tragic experience in the middle of this joy and expectation: fetal demise/ spontaneous abortion. The intention of the current study is to examine the association between grief and embitterment for females who have undergone fetal demise/ spontaneous abortion. The study also aims to explore the buffering impact of a sense of coherence on the association between grief and embitterment. Data from 200 married women who experienced fetal demise/ spontaneous abortion was collected in person and online by using a purposive sampling technique. For data collection, three reliable scales were used, namely the Perinatal Grief Scale (PGS) for grief, the Traumatic Embitterment Disorder Self-Rating Scale (PTED) for embitterment, and the Sense of Coherence (SOC) scale for measuring sense of coherence. Results of the study suggest a positive relationship between grief and embitterment. As grief increases, embitterment also increases. Sense of Coherence helps to decrease the impact of embitterment. Sense of Coherence significantly moderates the association between grief and embitterment. The study implications were examined.


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Author Biography

  • Rizwana Samreen, MS Scholar, Department of Psychology, University of Wah, Wah Cantt., Punjab, Pakistan.


Antonovsky, A. (2002). Unraveling the mystery of health: How people manage stress and stay well. The Health Psychology Reader, 127-139.

Badenhorst, W., & Hughes, P. (2007). Psychological aspects of perinatal loss. Best Practice & Research Clinical Obstetrics & Gynaecology, 21(2), 249-259.

Brann, M., Bute, J. J., & Scott, S. F. (2019). Qualitative assessment of bad news delivery practices during miscarriage diagnosis. Qualitative Health Research, 30(2), 258-267.

Callander, G., Brown, G. P., Tata, P., & Regan, L. (2007). Counterfactual thinking and psychological distress following a recurrent miscarriage. Journal of Reproductive and Infant Psychology, 25(1), 51–65.

Çamaş, G., and Yalçin, I. (2021). The relationships between stigma toward psychological help-seeking, self-efficacy, family sense of coherence and social support. Kastamonu Eğitim Dergisi, 29(4), 233–245.

DeMontigny, F., Verdon, C., Meunier, S., Gervais, C., & Coté, I. (2020). Protective and risk factors for women’s mental health after a spontaneous abortion. Revista Latino-americana De Enfermagem, 28.

Donegan, G., Noonan, M., & Bradshaw, C. (2023). Parents experiences of pregnancy following perinatal loss: An integrative review. Midwifery, 121, 103673.

Downey, C., & Crummy, A. (2022). The impact of childhood trauma on children's wellbeing and adult behavior. European Journal of Trauma & Dissociation, 6(1), 100237.

Elzen, K. D., Breen, L. J., & Neimeyer, R. A. (2023). Rewriting grief following bereavement and non-death loss: a pilot writing-for-wellbeing study. British Journal of Guidance & Counselling, 51(3), 425–443.

Ernst, M., Niederer, D., Werner, A. M., Czaja, S. J., Mikton, C., Ong, A. D., Rosen, T., Brähler, E., & Beutel, M. E. (2022). Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.American Psychologist, 77(5), 660–677.

Finney, M. A. (2002). Fire growth using minimum travel time methods. Canadian Journal of Forest Research, 32(8), 1420–1424.

Galletta, M., Cherchi, M., Cocco, A., Lai, G., Manca, V., Pau, M., Tatti, F., Zambon, G., Deidda, S., Origa, P., Massa, E., Cossu, E., Boi, F., & Contu, P. (2019). Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component. BMJ Open, 9(9), e030001.

Gao, X., Louwers, Y. V., Laven, J. S. E., & Schoenmakers, S. (2024). Clinical Relevance of Vaginal and Endometrial Microbiome Investigation in Women with Repeated Implantation Failure and Recurrent Pregnancy Loss. International Journal of Molecular Sciences, 25(1), 622.

Gómez-Salgado, J., Domínguez-Salas, S., Romero-Martín, M., Ortega-Moreno, M., García-Iglesias, J. J., & Ruiz-Frutos, C. (2020). Sense of coherence and psychological distress among healthcare workers during the COVID-19 pandemic in Spain. Sustainability, 12(17), 6855.

Issanov, A., Aimagambetova, G., Terzic, S., Bapayeva, G., Ukybassova, T., Baikoshkarova, S., Utepova, G., Daribay, Z., Bekbossinova, G., Balykov, A., Aldiyarova, A., & Terzic, M. (2022). Impact of governmental support to the IVF clinical pregnancy rates: differences between public and private clinical settings in Kazakhstan—a prospective cohort study. BMJ Open, 12(2), e049388.

Javaid, Z.K. & Mahmood. K (2023). Efficacy Of Expressive Writing Therapy in Reducing Embitterment Among University Students. Pakistan Journal of Law, Analysis and Wisdom, 2(02), 136–145.

Kase, T., Ueno, Y., & Endo, S. (2023). Association of sense of coherence and resilience with distress and infection prevention behaviors during the coronavirus disease pandemic. Current Psychology.

Kerns, J. L., Mengesha, B., McNamara, B. C., Cassidy, A., Pearlson, G., & Kuppermann, M. (2018). Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications. Contraception, 97(6), 520–523.

Khalife, D., Ghazeeri, G., & Kutteh, W. (2019). Review of current guidelines for recurrent pregnancy loss: New strategies for optimal evaluation of women who may be superfertile. Seminars in Perinatology, 43(2), 105-115.

Lewis, R., & Frydenberg, E. (2004). Adolescents least able to cope: How do they respond to their stresses? British Journal of Guidance & Counselling, 32(1), 25-37.

Leyland, A., & Choucri, L. (2024). Student midwives’ lived experiences of caring for bereaved parents following perinatal loss using actor-based simulation: A phenomenological study. Midwifery, 130, 103913.

Linden, M., & Lieberei, B. (2023). Injustice and embitterment: crucial stressors in psychosomatic patients. Psychopathology, 57(1), 39–44.

Linden, M., Baumann, K., Lieberei, B., & Rotter, M. (2009). The post‐traumatic embitterment disorder Self‐Rating Scale (PTED Scale). Clinical Psychology & Psychotherapy/Clinical Psychology and Psychotherapy, 16(2), 139–147.

Martin, C. J. H., & Reid, K. (2022). A scoping review of therapies used to treat psychological trauma post perinatal bereavement. Journal of Reproductive and Infant Psychology, 41(5), 582–598.

Mitonga-Monga, J., & Mayer, C. (2020). Sense of coherence, burnout, and work engagement: the moderating effect of coping in the Democratic Republic of Congo. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 17(11), 4127.

Parkes, C. M., & Prigerson, H. G. (2010). Bereavement: Studies of Grief in Adult Life. Routledge

Quenby, S., Gallos, I. D., Dhillon-Smith, R. K., Podesek, M., Stephenson, M. D., Fisher, J., Brosens, J. J., Brewin, J., Ramhorst, R., Lucas, E. S., McCoy, R. C., Anderson, R., Daher, S., Regan, L., Al-Memar, M., Bourne, T., MacIntyre, D. A., Rai, R., Christiansen, O. B., . . . Coomarasamy, A. (2021). Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet, 397(10285), 1658–1667.

Schäfer, S. K., Sopp, M. R., Fuchs, A., Kotzur, M., Maahs, L., & Michael, T. (2023). The relationship between sense of coherence and mental health problems from childhood to young adulthood: A meta-analysis. Journal of Affective Disorders, 325, 804–816.

Tian, X., Li, Y., & Solomon, D. H. (2023). How do qualities of supportive conversations affect heart rate variability during conversations about the death of a parent? Health Communication, 1–16.

Tomkiewicz, J., & Darmochwał-Kolarz, D. (2023). The diagnostics and treatment of recurrent pregnancy loss. Journal of Clinical Medicine, 12(14), 4768.

Turesheva, A., Aimagambetova, G., Ukybassova, T., Marat, A., Kanabekova, P., Kaldygulova, L., Amanzholkyzy, A., Ryzhkova, S., Nogay, A., Khamidullina, Z., Ilmaliyeva, A., Almawi, W. Y., & Atageldiyeva, K. (2023). Recurrent Pregnancy Loss Etiology, Risk Factors, Diagnosis, and Management. Fresh Look into a Full Box. Journal of Clinical Medicine, 12(12), 4074.

Tyrlik, N. (2013). Predictors of Pregnancy-Related Emotions. Journal of Clinical Medicine Research.

VandeVusse, A. J., Mueller, J., Kirstein, M., Strong, J., & Lindberg, L. D. (2023). “Technically an abortion”: Understanding perceptions and definitions of abortion in the United States. Social Science & Medicine, 335, 116216.

You, M., & Ju, Y. (2020). Modeling embitterment dynamics: The influence of negative life events and social support mediated by belief in a just world. Journal of Affective Disorders, 274, 269–275.






How to Cite

Samreen, R., Rashid, S., & Nadeem, B. (2024). Moderating Role of Sense of Coherence on the Relationship between Grief and Embitterment among Women’s Experiences Fetal Demise/Spontaneous Abortion. Qlantic Journal of Social Sciences, 5(2), 424-432.

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