TOP TAKE-AWAYS: THINKING ABOUT WHAT COULD HAVE BEEN

Callander, Brown,Tata, and Regan (2007) studied the thought processes of 62 women, between the ages of 24 and 44, who had expereinced recurrent miscarriages.

• The average age was 35; 
• The average number of miscarriages was 4.45;
• The average amount of time since the most recent miscarriage was 6.45 months; 
• 27 of the women had children and 35 did not have children; 
• 69.4% reported high levels of anxiety;  
• 33.9% reported high levels of depression.   

The study focused on counterfactual thinking, a common thought process after traumatic events.  

What is counterfactual thinking?  

A cognitive process that involves thinking about the event as it “could” or “should” have been.

What did they find?

Counterfactual Thinking can have negative psychological effects on wellbeing.

-For those experiencing recurrent miscarriage, Counterfactual Thinking seems to be a regular part of a process to make sense of the experience and gain individual control.  

-However, the more someone thinks counterfactually about a pregnancy, as it “could” or “should” have been, the more anxiety they experienced.  

-The longer the length of time that someone had thoughts about the pregnancy as it “could” or “should” have been, the more anxiety and depression they experienced.

What is our take-away?

It is common for women to think about what they did to cause a miscarriage or what they could have done to prevent it. This, in and of itself, makes women feel bad.  In addition, it creates a sense of hope that changing the behavior will change the outcome in subsequent pregnancies. However, when that behavior doesn’t change the outcome in future pregnancies, the negative feelings are often exacerbated.

Even though women often long for some sense of control in pregnancy loss, the hard reality is that miscarriage is most often out of our control.  

Reference:

Callander, G., Brown, G.P., Tata, P., & Regan, L. (2007). Counterfactual thinking and psychological distress following recurrent miscarriage.  Journal of Reproductive and Infant Psychology, 25, 51-65.