Women's Experiences with Coping after Late Pregnancy Loss: A Qualitative Study
Abstract
Pregnancy has been described as a crisis, a developmental period requiring a woman to adapt to profound psychological and somatic change. Resolving the maturational crises related to pregnancy is viewed as a necessary part of achieving maternal identity. Stress may compromise a woman’s ability to achieve these developmental tasks. Since a prior pregnancy loss may involve the experience of sudden and unexpected fetal demise, the subsequent pregnancy may be described as high risk and the mother’s maternal identity attainment may have been compromised. Relatively little research attention has been directed to the experience of a subsequent pregnancy followed by a late pregnancy loss from the self-reported accounts of the women themselves. Eight women who experienced a late pregnancy loss, a loss occurring after 20 gestational weeks, and then experienced a subsequent pregnancy and healthy delivery, were interviewed regarding their experiences with coping during their subsequent pregnancy. Interviews with participants were transcribed and data analyzed using the constant comparative method (Marshall & Rossman, 199S). Several themes emerged from the analysis related to women’s experiences in coping during the subsequent pregnancy. These themes included: (a) contradictory emotions; (b) fear, (c) fearful attachment and persistent vulnerability; (d) obsessive mission, worry, and the wish to hurry the end; (e) awareness that the delivery does not end the worry or the grief; (f) the need for information; (g) differentiating the pregnancy experiences; (h) understanding grief and random events; (i) the decision toward conscious presence and active parenting; (j) provision for the lost child; (k) acceptance of caring for oneself; (1) embrace the experience, the healing aspects of pain; and (m) altered self and worldview. Women’s descriptions of what they experienced as helpful and supportive from friends, family, and health care professionals during the subsequent pregnancy are also presented. Findings are discussed in terms of their implications for health care professionals and their possible implications for future research.