New Tool Will Help Healthcare Professionals Quickly Identify Patients Struggling Emotionally After Reproductive Loss

SAN DIEGO (April 25, 2023) – The Institute of Reproductive Grief Care, the global authority on reproductive grief care research and education, today announced that its Reproductive Grief Screening Tool research was published in the Cureus Journal of Medical Science.

“This newly published, groundbreaking, peer-reviewed study validates the success of our Reproductive Grief Screening Tool in quickly identifying patients who struggle emotionally after reproductive loss,” said Michaelene Fredenburg, president and CEO of the Institute of Reproductive Grief Care.

About the Journal

The study was published in the Cureus Journal of Medical Science, a medical journal for doctors, researchers and patients that eliminates barriers to the generation and dissemination of groundbreaking, new medical knowledge through open access. It was founded by Dr. Adler, the Dorothy & TK Chan Professor of Neurosurgery and Radiation Oncology (Emeritus) at Stanford University and Dr. Muacevic, the medical director of the European Radiosurgery Center in Munich, Germany and professor at the University of Munich Hospitals.

“Cureus’s decision to publish this study validates the importance of identifying and helping patients who experience complicated grief reactions after pregnancy and reproductive loss,” added Fredenburg. Cureus only accepts about half of submitted research papers.

About the Study

The Institute partnered with Dr. Cara Buskmiller of the University of Texas in Houston (UTHealth) to create and evaluate the Reproductive Grief Screening Tool. UTHealth is one of the nation’s most comprehensive academic health centers, and a national resource for health care education, innovation, scientific discovery and excellence in patient care.

This study designed and validated a five-item questionnaire to detect complicated grief reactions after reproductive loss of any type. Dr. Buskmiller led the clinical trials to validate the Reproductive Loss Screening Tool.

The study showed success in capturing patients struggling emotionally after reproductive loss. This investigator-created Screening Tool showed as internally consistent and meeting Fornell and Larcker criteria for discriminant validity.

“I am pleased that this research is receiving the attention it deserves,” said Dr. Buskmiller. “Our goal is for the reproductive grief screening tool to become a standard part of patient care.”

About the Reproductive Grief Screening Tool   

One in four pregnancies end in miscarriage, and this is just one type of reproductive loss. 2.4 million fetal and neonatal deaths occur globally in the perinatal period – 4 times more than the annual number of deaths from cancer. These numbers don’t include infertility, which carries its own repeated, emotional pain. Research shows that up to 60% of bereaved parents experience depression, anxiety and PTSD after reproductive loss. The Reproductive Grief Screening Tool is designed to quickly identify these patients.

“Our Reproductive Grief Screening Tool is a critical part of recognizing, identifying and caring for patients who struggle emotionally after reproductive loss,” explained Fredenburg. “This Tool allows physicians to quickly identify those struggling, so that they can take next steps to promote a healthy grieving trajectory.”             

The questionnaire was patterned after the extensively validated “Brief Grief Questionnaire,” which was created to employ non-traumatic but specific language about grief. This Reproductive Grief Screening Tool was validated with 140 women at a large academic center against well-studied instruments for anxiety (7-item Panic Disorder Severity Scale), trauma (22-item Impact of Events Scale), and reproductive grief (33-item Perinatal Grief Intensity Scale).

The five questions included in the Reproductive Grief Screening Tool:

  1. How much trouble are you having in accepting your loss?
  2. How much does your emotional response interfere with your life?
  3. How often are you having mental images of your loss?
  4. How often are you avoiding things that you used to do because of your loss?
  5. Since your loss, are you having difficulty in connecting with other people, including family and friends?

“We are thrilled at the publication of our study in this cutting edge research journal,” added Fredenburg. “We look forward to healthcare professionals using this Tool to bring hope and healing to those who grieve after reproductive loss.”


The Institute of Reproductive Grief Care is the global authority on reproductive grief care. It offers education, research, expertise and support after reproductive loss without religious or political affiliation. Its goal is to accelerate the widespread adoption of a reproductive grief standard of care, bringing comfort and hope to millions who often grieve alone and in silence for years or decades.

The Institute’s online courses are accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. The Institute of Reproductive Grief Care is approved by the California Board of Registered Nursing, Provider # 17434. It is also approved by the National Association of Social Workers (NASW) and the California Association of Marriage and Family Therapists (CAMFT) to sponsor continuing education for LMFTs, LCSWs, LPCCs, and LEPs. We maintain responsibility for our program and its content. The Institute also certifies healthcare professionals and others in reproductive grief care.

The Institute offers books, memorial items, and other healing resources directly to those affected, including the “Forget Me Not Signature Collection” of sympathy cards, jewelry and comfort boxes. The national campaign, promoting the “Forget Me Not” flower as a symbol of reproductive loss remembrance, won the grand prize of “Nonprofit Communications Campaign of the Year” by Public Relations Daily in 2022. All Institute proceeds from sales of “Forget Me Not” items go directly to helping those impacted. The Institute is a 501(c)(3) nonprofit. For more information, see the Institute’s introductory video and visit