The misunderstood loss

Miscarriage-statistic_02

For personal reasons, this isn’t an easy post for me to write. However, as the above image demonstrates 1 in 4 pregnancies ends in miscarriage; to put it more humanly, that’s a quarter of could-be-mothers losing their could-be-child. And that’s only the reported miscarriages, and the known pregnancies, the actual figure could be a lot higher. It’s a taboo subject, expected mothers don’t wish to offload their problems onto anyone, or perceive themselves to be failures as they have been unable to have a healthy pregnancy (Herz, 1984) and a lot (especially in my case) don’t want the sympathy.
But it’s a fact of life; miscarriages happen and parents are left behind.

Miscarriages are defined as “the unintended end of a pregnancy before a foetus can survive outside of the mother which is recognised as being before the 20th week of gestation” (Bory & Lasher, 1982). 80% of these occur in the first trimester (Broquet, 1991).

Miscarriages can happen to those who have been trying for a baby, to those who fell pregnant accidentally, to those who know they are pregnant and are expecting a healthy child at the end of a 9 month wait, and to those who don’t know they are pregnant until the miscarriage occurs.

This post is an overview of a paper by Maker & Ogden (2003) who look into the psychological effects of a miscarriage on the woman. Many people assume that once a miscarriage occurs the only feelings that are produced are grief and depression – probably one of the reasons why it’s such a taboo subject, as these emotions are difficult to discuss, but as explained in this qualitative research it’s not as simple as that.

Through qualitative interviews, Maker & Ogden looked at the themes within the women’s answers to the questions, and picked out three “dynamic” stages which the women involved in the research went through post-miscarriage. They’re dynamic because they are ever-changing, and the time period they occur is unique to the individual, and it’s not just a static state of grief and depression which is what previous research suggests.

1. Turmoil
This is the initial impact. This is where the woman realises what has happened, that a miscarriage has occurred, and that she has lost the foetus – whether or not she knew that foetus existed, whether or not it was wanted or unwanted, planned or unexpected. Many women feel unprepared.
Some examples given in the paper were women not realising what they were going through, because they had never been educated on the biological process of miscarriage. One women in particular was confused because the bleeding occurred over a period of a few days to a week, rather than one large loss of blood. (Just a small example of how women should be educated on matters regarding their own body and pregnancy, but now is not the time for my rant on that…)
Many women feel shock, others feel denial, leading them to not believe that what has happened has happened to them and leaving them wondering why. This leads onto the next stage.

2. Adjustment
Women are strong creatures, and we know that when this happens to us we have to come to terms with it. We need to boost our own sense of self, considering we feel as though our body has just failed us in one of the worst ways possible. We need to know that we, as women, as people and as bodies, are still worth something.
A lot of the women in this research took part in what is called “social comparison” which is just a fancy way of comparing themselves to other people. They talked about how others have it worse, they focussed their attention on individuals who have a worse situation; such as terminal illnesses, other women with infertility, and in some cases other women who have had “worse miscarriages” than them. One women explained that she felt relieved she had her miscarriage when she did, as some women have miscarriages very late in the pregnancy, or even go on to deliver still borns, and in her opinion that was worse than the early miscarriage she had had.
However, all the women in the research also craved a satisfactory cause for what had happened. They wanted something to blame for their loss, which is only natural. However many miscarriages occur without a known cause. The majority of miscarriages are due to genetic faults of the foetus – it was genetically never going to survive. Others can be due to an underlying healthy condition with the mother. However, causes of miscarriage are very rarely identified for particular incidents, making it harder for the mother to move on. However, as I have already identified, women are strong creatures, so we do.

3. Resolution
This is the beginning of the end. This is where the mother begins to move on. There were three running themes with the women in this research; a decline in negative emotions (therefore an increase in mood, an increase in productivity, etc), viewing the miscarriage as a learning experience, and assessing the miscarriage within the women’s past and future.
Many of these women viewed the miscarriage as a learning experience, as in it gave many of them a new reason for living. One woman described how she changed jobs after her miscarriage, not because she blamed her career for it, but because she realised life is too short to not be happy and you have to make changes in your life. For others it made them realise how desperately they did want a child, for others it made them realise the opposite as they came to terms with the fact that their miscarriage actually left them feeling relieved, which is okay too.
Many of the women were clear on one thing, it changed the way they viewed their past, and their future. For some it changed their relationships, and it changed the way they viewed motherhood and pregnancy. This obviously differed depending on if the women already had children, or if they expected the pregnancy or not. However it was a continuous theme that the women assessed and coped with their pregnancy lost through their past experiences and what they wanted for their future, making it easier for them to move on.

 

There we have it. Losing a pregnancy does not necessarily result in a drop of mood, a constant feeling of depression, or the loss of the will to live. It is an upsetting time, whether the pregnancy was wanted or not, expected or not, it’s a horrible feeling to have your body betray you to the point of losing a possible child.

I think one of the most important things to remember that if you’ve ever experienced a miscarriage, whatever you felt at the time towards it and whatever you feel now will be completely unique to you and your situation, but it is completely normal. Whatever you feel- whether it’s guilt, anger, upset, loss, depression, relief- it is healthy, and is okay. You’ve lost something that you maybe never expected to lose, and however you emotionally react to that, just use this research to know that it is okay and you will eventually adjust and it will be resolved, even if those feelings do not totally disappear.

However the authors described the stages of overcoming a miscarriage extremely well, as a “process that involves shifting emotions and active coping” and were insistent in whatever the women’s opinions, whatever the situation was in which they had their miscarriage, it was a pivotal point in all of the women’s lives.

and personally, I couldn’t agree more.


For more information on miscarriages, visit the NHS Choices website: http://www.nhs.uk/conditions/miscarriage/Pages/Introduction.aspx
For support on miscarriages, visit the miscarriage association website:
http://www.miscarriageassociation.org.uk/support/


Makes, C., & Ogden, J. (2003) The miscarriage experience: more than just a trigger to psychological morbidity? Psychology and Health, 18, 403-415.

 

 

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