Effects of Miscarriage on Men

D.F.

Soci 351

April 12, 2010

The Effects of Miscarriage on Couples and Men

One in four pregnancies end in a miscarriage or still birth. Miscarriages have a profound effect on the mother, however what is often ignored is the affect on the partner and the relationship of the couple. After a miscarriage the relationship can suffer and both the man and woman will go through the stages of grief.

I have had multiple experiences with the loss of a child. My fiance and I have had two unexpected pregnancies. Both of which ended in miscarriages. The experience of grief was very different for the two of us. I had very little connection with our first loss. I didn't even know I was going to be a daddy till shortly before they were gone. I was 17 at the time and very immature and very scared. the relationship became very hard and there were lots of hurdles to challenges that needed to be over come. After two years of grief, emotional talks, and trying to understand one another we got our second surprise. This time I was alerted immediately, unfortunately it was an ectopic pregnancy, the baby wasn't supposed to make it past it's first trimester. My fiance and I enjoyed the time we had with our baby but it was only a few short weeks. I felt the grief but not as much as her. I wanted to know if this was normal and if other families went through the same experiences with miscarriage and grief.

The basic definition of miscarriage is when a pregnancy does not make it to the 20th to 24th week due to the fetus not being able to survive. Any pregnancy that end after the 20th to 24th week is refereed to as a still birth. The reason there is a four week window is because the time of fetus gestation, or the time at which the fetus is almost fully developed and can survive outside the womb varies in protocol from country to country. Miscarriages can happen for any number of reasons, most of which are out of the control of the mother. Chromosomal defects, lack of specific hormones, uterine malformations, and ectopic pregnancy, are just some of the common causes of miscarriages.

With any type of loss there is some for of grief. There are several ideas on the grieving process; there is the classic five step process which include denial, anger, bargaining, depression, and finally acceptance (Bolden). There are also other ways to look at and analyze grief, it can be viewed as tasks to over come or dramas of internal conflict. All of these models can be helpful to treating someone with depression but these models do have their short comings. Grief is an individualized experience, and grief will never be the same for any two people. Even for the same person each experience with grief can be drastically different. The steps of grief can be very difficult on people psychologically. Multiple emotions or different emotions can be felt at any one time during the grieving process. People going through grief may feel like they are taking two steps forward and three steps back because the stages of grief are clear cut unlike their emotions.

Most of the studies of miscarriage and still birth have to do with the medical aspect of it and how to prevent these things from happening. Less than half of the miscarriage articles had to do with the actual psychological ramifications of the event. The articles that do entail the psychological aspects are mostly geared toward women. There is little focus on the partner or the relationship after the miscarriage. Reports have shown that women that go through a miscarriage and still birth can go through a range of experiences and emotional responses. A common response to miscarriage and not being able to get pregnant for most women who are actively trying, are feelings of inadequacy, and having their “femininity challenged” (Carter p.219). Women who go to their doctors and can get a diagnosed reason for their miscarriage have been found to have “lower levels of anxiety” ( p.809). At the other end of the spectrum are women with inconsistent reasons for their miscarriage who tend to have feelings of “personal responsibility and self-blame” (Nikcevic p.810). These results of studies however tend to follow the five stages of grief, in Carter's and Nickcevic's example. It is a type of anger where the sufferer blames or get angry at oneself for not being able to do more, however this can also be interpreted as bargaining where the mother may be talking about “what if” and “if only”. The examples given by these two authors are from the mothers point of view and only their immediate response. Extensive follow up was not done in either of their studies.

However, the emotional support for women who have had still births has increased exponentially since the 1980's. Due to the high grade technology hospitals that have developed in the last 30 years there has been a change in focus from the physical body in the earlier years to the physical and emotional aspects of health. “Women were hastily and unceremoniously separated from their dying or dead babies and told such things as 'about this', and ''you’re young enough to have another child'”, this obviously left women feeling like they need to get over it; they would suppress grief and their pain. Since then there has been a shift in priorities when it comes to still births. Hospitals offer grief support, photographs, encourage healthy grieving and attachment with the child, and will now allow the mother to hold the child. This is in contrast to previous practive of sedating the mother to prevent interactions between the mother and the child, and the mother and the doctors (Davidson 278-280). There are a lot of steps being taken for the mother but little for the father and the grief he endures. The typical protector, or support model of the male partner falls apart when the mother begins going to grief counseling or finding other avenues of help other than him. There is also no programs telling him what to expect and what he can do to help.

Men have been in studies when it come to infant death, this however is a lot different than miscarriages and still births. This is because the father can physically hold the child and can form a physical bond to the child, with miscarriage and still births the connection is there it is just never as tangible and strong as actually holding a child. SIDS (sudden infant death syndrome) is a unfortunate natural occurrence where children die of natural causes, and usually there is nothing the parents can do. In this research men often felt badgered by police because they felt they were being blamed, in a few cases the mothers would do the same and lash out at their partner. This lashing out is typical but can really be extremely damaging; while the father is trying to be supportive and strong for the mother, he is being attacked from all angles and may not have other coping mechanisms other than becoming defensive. The impact on the relationship can be devastating. The coping mechanism for these men were the classic ones for most men. The include focusing on something else, spending a lot of time on their work, exercising and walking, self medicating with alcohol or drugs, and emotionally removing themselves. Emotional removal is used to hide their emotions as to not appear weak and keep up the image of being strong for their partners (Edwards p.140-152) While the effects on men dealing with SIDS may be far different than miscarriage and still births it can be assumed that some, if not all, of these traits and actions will carry over.

Through research and content coding, the goal was to determine the affects of miscarriage and still birth on men and relationships. After reviewing the literature on the subject, when there is a miscarriage/still birth and depending on the relationship of the couple before, the man will go through a grieving process. But, because of the lack of physical bond with the child, the grieving process will not be as intense or as long lasting as the mothers. The relationship may still suffer after the man's grieving process is complete. The literature on the subject showed that the mothers need the emotional support because of the physical maternal bond that is developed with the child. Where as with the father, being a father is just an idea and not a reality due to the lack of a physical connection with the child and the responsibility of bearing the child is not his. This means that the mother will have tend to have an extended grieving time above and beyond the father‘s. The father will also do the typical male protector stereotype reaction and try to move on with everyday life as quickly as possible. The mother may still be grieving and this will have ramifications for the relationship such as fighting, lack of intimacy, and poor or reduced communication.

The sample used for this content coding was forums on the internet dealing specifically with miscarriages and still births. Miscarriage forums for men were also looked for but could only sub-forums were geared toward men. The 20 most recent postings with three or more replies were analyzed. This was chosen so that the person who started the discussion could theoretically give updates, and that other opinions and stories could be analyzed as well. While looking at forums, key words and phrases were looked for and kept track of. These were words like grief, anger, depression, failure, and unfair. Synonyms to these words were also counted. Forums that expressed relationship problems and the feelings of men were read more closely. Looking for evidence of how the relationship was going and how it developed, and to try and interpret how, the man that posted, was feeling. Three large forums were looked at and one sub-forum for men was analyzed and was used to collect data.

From the results only nine of the 60 forum topics looked at did not have to do with the key words or phrases. 20 of the 60 forum topics discussed one or more of the 5 stages of grief. These were men and women expressing anger, depression, denial and or bargaining however, acceptance, the final stage of grieving, was never discussed. Women claimed they failed or it was reported that they felt like failures, where men never felt like this. There were only eight problems posted about relationships, two of which were reported to fail and one improved. Out of 11 men a majority said they wanted to help but didn't know how and many were concerned about why their grief wasn't as strong as their partners.

The data did show that almost every person that posted, including the men, were going through some kind of grief. Most of the men were also trying to fill the protector role and help their partner through their grief. There were some women that did post about relationship troubles. The troubles expressed were often that their partner was feeling like they were unimportant and were being over shadowed by the miscarriage or still birth. There were also relationship problems with family members, friends, and co-workers. The one relationship that did get better was solved through communication and sitting down and talking about what each person was feeling. Men also felt guilt for not being as sad as partner, one woman described it as “okay” because as a man, he couldn't understand the “maternal connection” his partner was feeling. One woman actually turned to drugs to help her through her grieving which from the literature it seemed unusual and was reported that it was more likely for a man to do this.

From the data collected a few conclusions can be made. The majority of posts found and looked at were made by women, so the data is skewed and data desired to confirm the hypothesis was lacking. Also the men that did post to this form were exceptions to the male stereotype and only a small percentage of men that actually go through this can actually be represented in this study. Full extensive research can not be done on the subject in this test because all that can be recorded is what they put on these forums.

From the literature review I was expecting a mainly female base reaching out for support and discussing their relationships and their grief with other people. I was surprised to find that very rarely was a significant other even mentioned. The women were there to talk about their loss and try to cope with it any way they could. While there was not an overwhelming support for my hypothesis there were snippets of support from several subjects. For example three men expressed that they did not feel much or they did not feel as sad as their partner after the miscarriage. This both supports and rejects my hypothesis. My hypothesis stated that the men would feel grief but on a lower scale. Some men did go through grief and some did not when they were making their posts. The findings showed that men show lessened emotional distress than there female counterpart after a miscarriage or still birth. The other half of my hypothesis was that there would be difficulty in the relationship after a miscarriage. While very little data was collected about relationships there was some data that showed support for my hypothesis. Due to the lessened emotional response some women would be frustrated by their partners because they appeared not to care; like the fathers experiencing SIDS the men just wanted to move on and be strong for their partners. While some relationships fell apart the one relationship that seemed to improve was fixed by communication. The data though is inconclusive because things could have changed as more time passed.

Grief is a very complicated experience. It only gets more complex when there is the death of a child. Men can never have that maternal connection to the child and can there fore only be an echo of the mothers grief and rarely anything more than that. Grief is a time consuming process and when one partner is ready to move on while the other is not can cause friction in the relationship

References

Bolden, Lori A. "A Review of On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss." Counseiing and Vaiues. 51. (2007): 235-237.

Carter, Shannon K,. "Gender Performances During Labor and Birth in the Midwives Model of Care." Springer Sciences. 26 (2009): 205-223.

Davidson, Deborah. "A technology of care: Caregiver response to perinatal loss." Women's Studies International Forum 31 (2008): 278-284.

"Directory." Miscariage Support. Yuku, 2010.

"Directory." Miscariage Support- everybody Communities. NZ forum, 2010. .

Edwards, Shane, Tim McCreanor, Manga Ormsby, Nick Tuwhangai, and David Tipene-Leach. "Maori Men and the Grief of SIDS." Death Studies. 33 (2009): 130-152.

"Message Board." Silent Grief. ProBoards, 2010. .

Nikcevic, Ana V., Sarah A. Tunkel, Andrzej R. Kuczierrczyk, and Kypros H. Nicolaides. "Investigation of the cause of miscarriage and its Influence on Women's Psychological Distress." British Journal of Obstetrics and Gynaecology. 106.Aug (1999): 808-813.