TOP TAKE-AWAYS: SEARCHING FOR MEANING AFTER PREGNANCY LOSS

Ten women who had a miscarriage at age 35 or older were interviewed. The primary research question was: “How do women of advanced maternal age perceive and describe their experience of miscarriage?”

All women in the study described intense grief following their loss. They described how the uncertainty of loss and the reason for the loss made coping more difficult. Further complicating their grief was the fact that others did not recognize their grief as real. Others may not perceive miscarriage as a death to be mourned and there are no strongly established social rituals following a miscarriage.  

The grief associated with miscarriage is complicated, and others do not always recognize the need to grieve. But grief is a normal and expected reaction to a pregnancy loss.

The women in this study described trying to make sense of their loss, questioning how and why the loss happened. Making meaning of the loss may give women a sense of control.  However, fixation on finding meaning may also lead to self-blame and feelings of guilt.

Some women had difficulty fully conceptualizing the baby that was lost, but every woman identified that she had lost something that she had very much wanted.  

Relationships with others helped some women to find meaning in their loss. Some women found supportive partners to be helpful. Other women felt that is was helpful to to talk with others who had been through a similar loss.  Women also described seeking formal support in a number of ways, including pregnancy loss support groups or individual therapists.

Women often try to find meaning in their pregnancy loss. However, all of the women in the study had difficulty finding meaning in their loss.  Having the support of others is helpful, but finding meaning in the loss will likely take time.

Nearly all women described recognizing that they grieved differently from their partners.  One participant wrote, “my husband has admitted, he says ‘Its different for me. I hate to say it, I don’t feel it like you feel it.’”

Incongruent feelings can complicate the grieving process, but is commonly reported by couples after miscarriage.

Many of the women described pregnancy loss as something that prevented them from realizing their dream of new or renewed motherhood. Other women described pregnancy loss as inconsistent with their picture of what it means to be female.  

For others, the pregnancy loss made it difficult for them to identify their status. When they were pregnant, they were mothers-to-be. What is their status or identity after the loss?

One woman described that previous losses led her to say “we’re pregnant” in a future pregnancy, instead of “we’re having a baby,” because while she knew she was pregnant, she was not sure that the pregnancy would lead to having a baby.

Some women described the sense that time was running out and they were worried they would never experience motherhood. While some women described considering other paths to motherhood, other women described feeling that their path to motherhood may be ending.

Miscarriage can threaten one’s perception of motherhood and/or womanhood.  In addition to the physical loss experienced, women may also experience a perceived loss of status as a productive woman and/or successful mother.  

This study highlights that grief is a normal reaction to a pregnancy loss. And while finding meaning in the loss can be helpful, it likely will not happen quickly nor easily. Giving yourself the time and space to grieve is important - and know that you are not alone.

Carolan, M., & Wright, R. J. (2017). Miscarriage at advanced maternal age and the search for meaning. Death Studies, 41, 144-153. doi:10.1080/07481187.2016.1233143