Bellhouse Clare, Temple-Smith Meredith J, Bilardi Jade E
School of Health Sciences, Federation University, Mount Helen, VIC, Australia.
Department of General Practice, University of Melbourne, Parkville, VIC, Australia.
BMC Womens Health. 2018 Oct 29;18(1):176. doi: 10.1186/s12905-018-0672-3.
Miscarriage is a common event which is estimated to occur in approximately one in four confirmed pregnancies (Collins et al, Grief Matters Aust J Grief Bereave_ 17:44, 2014, St John et al, Aust J Adv Nurs_ 23:8, 2006). Social networks play an important role in supporting women following this event and positive support experiences can play a role in buffering women's experiences of grief, loss and psychological distress following miscarriage (Rowlands et al, J Reprod Infant Psychol_ 28:274-86, 2010, Stratton et al, Aust New Zeal J Obstet Gynaecol_ 48:5-11).
Women were recruited through existing networks known to the researcher, miscarriage support organisations and snowball sampling methods. Fifteen women living in Australia completed semi-structured interviews either in person or by telephone regarding their experiences of social support following miscarriage, and their recommendations for how this could be improved.
Women reported both positive and negative social support experiences following miscarriage. Women's partners were identified as their central support figures for most women in this study, and women also identified other women who had previously experienced miscarriage as helpful and supportive. Conversely, women also expressed they felt there was a vast silence surrounding miscarriage, with others being commonly uncomfortable discussing the event leading to feelings of loneliness and isolation. Many women also felt the societal tradition of not disclosing pregnancy until after the first trimester contributed to the stigma surrounding miscarriage, and lead to poorer support experiences.
Raising awareness of the psychological impact of miscarriage appears imperative to assist the community to support women experiencing this loss, as well as reducing the secret and hidden nature of the experience. The recommendations provided may assist well-meaning friends and family in providing appropriate support for their loved ones experiencing miscarriage. Yet as many people in the wider community are uncomfortable with others' grief, providing the recommended supports in the context of miscarriage would likely remain highly challenging.
流产是一种常见事件,据估计,在约四分之一的确诊妊娠中会发生(柯林斯等人,《悲伤问题:澳大利亚悲伤与丧亲杂志》17:44,2014年;圣约翰等人,《澳大利亚高级护理杂志》23:8,2006年)。社交网络在这一事件后对女性的支持中发挥着重要作用,积极的支持体验可在缓冲女性流产后的悲伤、失落和心理困扰体验方面发挥作用(罗兰兹等人,《生殖与婴幼儿心理学杂志》28:274 - 286,2010年;斯特拉顿等人,《澳大利亚和新西兰妇产科杂志》48:5 - 11)。
通过研究人员已知的现有网络、流产支持组织和滚雪球抽样方法招募女性。15名居住在澳大利亚的女性亲自或通过电话完成了半结构化访谈,内容涉及她们流产后的社会支持体验,以及对如何改善这种支持的建议。
女性报告了流产后积极和消极的社会支持体验。在本研究中,大多数女性将伴侣视为主要支持人物,女性还认为其他有过流产经历的女性很有帮助且能给予支持。相反,女性也表示她们觉得流产这件事周围存在巨大的沉默,其他人通常不愿谈论此事,这导致她们感到孤独和孤立。许多女性还认为在怀孕头三个月后才公布怀孕情况的社会传统加剧了围绕流产的污名化,并导致支持体验更差。
提高对流产心理影响的认识对于帮助社区支持经历这种损失的女性以及减少这种经历的隐秘性似乎至关重要。提供的建议可能有助于善意的朋友和家人为经历流产的亲人提供适当支持。然而,由于更广泛社区中的许多人对他人的悲伤感到不自在,在流产背景下提供建议的支持可能仍然极具挑战性。