Dean Swanson Talks about Healing After Miscarriage

In a Q&A on the site “Shine,” Dr. Kristen Swanson, Dean of the Chapel Hill School of Nursing discusses the process of healing after a miscarriage.

In the article, Dean Swanson says, “One of the first things I say to couples who come to see me is that when you lose something, you have to name it for yourself to know what it is. You also have to allow your partner to name for his or herself. Usually, for the mother—it’s the loss of a child that is the hardest. Interestingly, for a lot of partners, their biggest loss is their access to their partner, this feeling of “I wish I could do something to lift her out of this but I don’t know what to do.”

Read the complete article: On Lisa Ling’s new website, women find ways to cope with tragedy

Dean Swanson: linking teacher’s miscarriage to fight and fall may be premature

Kristen M. Swanson, PhD, RN, FAAN

A high school Spanish teacher in New York City miscarried last week after she fell to the ground while breaking up a fight between two students. interviewed the Dean of the UNC Chapel Hill School of Nursing, Kristen Swanson about the incident in the story Teacher Breaks Up Fight, and Miscarries (Swanson is in the text story, not the video).

In the story, Dean Swanson, who is an expert in miscarriage, comments:

 Batista faces a “constant coming to terms with loss. It’s a death of a life that was short. It’s a death that’s a bit confusing, because you never got to meet the person you’re grieving. But you’re also grieving the loss of yourself as a mother or dad and the scenario around it that never gets to be,” she said.

“We don’t know what ultimately could have caused it,” she said. “It could very easily have been that there was a silent miscarriage happening all along and it just began to complete itself at that time — coincidental to it, not caused by it.”

Dean Swanson comments on Bush’s miscarriage on

Dean Kristen Swanson

In a story on, UNC Chapel Hill School of Nursing Dean Kristen Swanson comments on George W. Bush talking about the miscarriage his mother had when he was a teenager:

“Let’s put ourselves in Barbara Bush’s position,” says Kristen Swanson, the study’s lead investigator and a nurse who is also dean of the nursing school at the University of North Carolina at Chapel Hill (UNC). “She’s home, bleeding, cramping and passes the fetus. She scoops it up, puts it in a jar and says, Drive me to the hospital. She says to her son, I’m in the middle of a miscarriage, and this is the fetus that I just passed. There is nothing sinister in this.”

Read the complete article: George W. Bush, His Mom and Her Fetus: Not So Weird After All. Swanson is an expert on miscarriage and how couples respond emotionally to it. She began her work on miscarriage 25 years ago with her dissertation, “The Unborn One: A Profile of The Human Experience of Miscarriage,” and has continued studying this area both as an investigator and as a consultant to other researchers’ works. 
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Dean Kristen M. Swanson’s Latest Study Featured on Conceive Magazine Web site

Dean Kristen M. Swanson recently published a study in the Journal of Women’s Health and Gender-Based Medicine about the best counseling methods to help couples who have recently

Conceive Magazine Web site today published an article about Dean Kristen M. Swanson's latest study about the benefits of nurse-led counseling sessions for couple recently suffering a miscarriage or pregnancy loss.

Conceive Magazine Web site today published an article about Dean Kristen M. Swanson's latest study on the benefits of nurse-led counseling sessions for couple recently suffering a miscarriage or pregnancy loss.

suffered a miscarriage or early pregnancy loss to process their emotions and grief. Her research determined that couples are best helped by participating in nurse-led counseling sessions.

A stand-alone article about her research was published on the Conceive Magazine Web site today, Sept. 23, 2009. The magazine has a circulation of nearly 200,000 readers. To read the article click here:

Talking With a Nurse Best Helps Couples Grieving a Pregnancy Loss

Although existing research shows that men and women process grief and recovery from miscarriage or early pregnancy loss differently, they are best able to resolve their loss together if they undergo three one-hour long couple-focused nurse-led counseling sessions, according to a study conducted by Kristen M. Swanson, RN, PhD, FAAN, dean of the University of North Carolina at Chapel Hill School of Nursing.

Published in the most recent issue of the Journal of Women’s Health and Gender-Based Medicine, Swanson’s study, funded by the National Institute of Nursing Research, National Institutes of Health, compared three couples-focused interventions to no treatment in order to identify strategies

Dean Kristen M. Swanson recently a study based on her research into how nurse-led counseling helps men and women grieving a pregnancy loss process their emotions.

Dean Kristen M. Swanson recently published a study based on her research into how nurse-led counseling helps men and women grieving a pregnancy loss process their emotions.

to help men and women with the resolution of depression and grief during the first year after miscarriage. This study was the first published randomized clinical trial of interventions to support couples after miscarriage.

“During the study, I found that, while men and women both experience sadness after a pregnancy loss, they are, most often, grieving over different things – while women typically mourn the loss of an unborn child, their husband or partner is more likely to mourn the loss of the relationship he had with the woman as she withdraws into her sadness,” Swanson said. “But even though couples tend to feel distraught over separate aspects of the pregnancy loss, we found that both individuals responded most favorably to an intervention that involved three hour-long counseling sessions with a nurse.”

Existing research shows that 85 percent of couples have limited discussions (if any) about their feelings surrounding miscarriage, even though most women wish to talk about it. In her earlier research, Swanson discovered that at one year after miscarriage, couples are likely to experience decreased emotional and physical intimacy if they have not openly shared their feelings or if the male has not demonstrated his concerns by doing little things to show he cares.

Swanson’s latest study divided 341 couples who were within 12 weeks of miscarrying into three groups – one that received three counseling sessions with a nurse (nurse caring), another that included three video and workbook modules (self caring) and a third that combined one nurse-led session with three self-caring modules (combined caring). A fourth group that received no intervention was included as a control. All interventions were offered at one week, five weeks and 11 weeks after study enrollment.

Each intervention was based on Swanson’s Theory of Caring and Meaning of Miscarriage Model. These frameworks were based on Swanson’s earlier studies with women after miscarriage. The first defines five distinct characteristics of caring relationships and the latter identifies six common issues that confront couples after miscarriage.

Overall, the study showed that while women’s grief  resolution was accelerated by participation in any of the three intervention arms, their resolution of depression was best enhanced through receipt of three one-hour long, couples-focused nurse-led counseling sessions, Men’s responses were more complex. While the men in the nurse caring and control interventions took equally long to resolve their symptoms of depression, men who received either the self or combined caring intervention actually took longer than controls to resolve their depression. Men’s grief resolution, on the other hand, was most rapidly abated among those receiving the combined-caring intervention. Examination of men’s complex responses to treatment suggest that grief (a transitional response to loss) and depression (be it situational or clinical in origin) need to be studied and treated as different emotional responses.

“Through these findings, we saw that the three nursing-led counseling sessions were the most effective way to support the couple as a unit. They provided more time for the nurse and couple to connect and jointly address the meaning of miscarriage in the overall context of their lives,” Swanson said.

All improvements in depression were self-reported. Compared to women in the combined-caring, self-caring, or control arms, women who received three nurse counseling sessions were from 3.0 to 7.9 times more likely to realize a faster decline in their symptoms of depression.

Swanson acknowledges certain limitations to the study: the study sample was predominantly white and all couples were heterosexual. A notable strength of the study was that statistical analysis took into account how each individual’s healing was impacted by their mate’s recovery.

This research was funded by the National Institute of Nursing Research, National Institutes of Health, 5 R01 NR005343.


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