Aside from several small-scale clinical reports and studies from the 1960s and 1970s, the literature and research exploring the effects of miscarriages on women’s emotional and mental health has only recently developed and expanded (Toedter, Lasker, & Janssen, 2001). In the 1980’s bereaved parents began to express themselves more about their experiences surrounding reproductive loss (Toedter, Lasker, & Janssen, 2001). These couples began writing and sharing their experiences with the intention to reach out to other bereaved couples. Social scientists followed this initiative and contributed to their movement with information on education and pregnancy, reproductive grief and loss, self-help books and support groups (Toedter, Lasker, & Janssen, 2001). From this point on larger quantitative studies using standardized measures involving women, couples and families have been designed to explore the emotional impact of miscarriage (McCreight, 2008).
With many studies now being published on reproductive loss and grief, meta-analyses are emerging comparing results from around the world (Toedter, Lasker, & Janssen, 2001). To consolidate and compare all these results, Toedter, Lasker, & Alhadeff (2001) developed the Perinatal Grief Scale (PGS) as a tool to measure the range of feelings, symptoms and emotions when grieving. The PGS involves 104 items formatted on a Likert scale, ranging one to five. The researchers chose the scale items based on previous research in perinatal loss and supported these with additional questions from the Texas Inventory of Grief (Toedter, Lasker, & Janssen, 2001). The authors highlight that the PGS is being used in research throughout the United States as well as “many other countries” (Toedter, Lasker, & Janssen, 2001, p. 207). Until 2001, only one report independent from the PGS authors had been published examining the reliability and validity of the PGS (Toedter, Lasker, & Janssen, 2001). The results of this report are not included or discussed in the aforementioned literature.
Other grief scales regarding reproductive loss have since been developed. The Munich Grief Scale is a modified and shortened version of the PGS and measures sadness, fear of future losses, feelings of missing the baby, guilt, anger, the meaning of the pregnancy and difficulty surrounding lost expectations, hopes and fantasies for the baby (Brier, 2008). The Perinatal Grief Intensity Scale is another tool designed to measure the intensity of the grief following miscarriage (Brier, 2008). The most recent scale is based on a meta-analysis of theoretical, clinical, counselling and academic research literature on the subject of reproductive loss (Brier, 2008). The Perinatal Bereavement Grief Scale is designed to measure grief post-reproductive loss by directly examining the extent to which the woman yearned for her loss (Brier, 2008).
Wright argues that the research on pregnancy loss is largely inconsistent and contradictory (2011). Inconsistencies in terminology and evidence are apparent throughout the research regarding pregnancy loss. Wright identifies length of time a woman may feel the emotional effects of her loss, maternal age and perinatal grief, subsequent births and perinatal grief and instruments of measurement as primary aspects of the research which show significant inconsistency (2011).