Motivation and emotion/Book/2024/Pregnancy loss and emotion

Pregnancy loss and emotion:
What are the emotional consequences of pregnancy loss for parents?

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Overview

Scenario: Mrs. E, a 30-year-old professional woman with no prior psychiatric history, miscarried 8 weeks into a planned second pregnancy. No surgical or medical intervention was required. She had a strong support system. She experienced sadness and disappointment following the miscarriage but had no other symptoms until presenting to her obstetrician’s office for a follow-up visit 3 weeks following the loss. She began crying uncontrollably in the waiting room, triggered by the presence of several visibly pregnant patients. The crying eased with support from her physician and did not recur. She conceived again 2 months later and in the years following reported only some recurrent sadness around the anniversary of the expected delivery date. the "problem" Miscarriages cause emotional distress and reaction. Demonstrates emotions and handling of a miscarriage are different and fluctuating. Healing from a miscarriage is not linear.

Focus questions: What are emotions? What is a pregnancy loss? Specific emotions associated to different pregnancy loss situations (early, late and intervention) Male partners experiences grief and emotions

Figure 1: External signs of the passions from Le Brun. J. Pass

What are Emotions?

Emotion are a term used to describe the complex psychological states we experiences to our physical and mental state with subjective, physiological, and behavioural elements.

• Subjective Experience is the internal aspect of emotion, how one feels inside.

• Physiological Response explains how emotions often trigger physical reactions in the body. For instance, fear might cause an increased heart rate, while happiness might lead to a feeling of warmth or lightness.

• Behavioural Response indicates the way emotions are expressed externally, such as facial expressions, body language, and actions. Smiling, crying, or shouting are examples of behavioural responses to emotions.

Primary vs Secondary emotions:

Emotions can be broadly categorised into primary (basic) emotions and secondary (complex) emotions. The six basic emotions present from birth are sadness, happiness, fear, anger, surprise and disgust. Secondary emotions are more complex and often involve a combination of primary emotions. Examples include shame, guilt, pride and jealousy.

Why do emotions happen?

The expression of emotions occurs everyday, multiple times to every person for a number of reasons:

Survival: Emotions can trigger quick responses to danger (e.g., fear triggering a fight-or-flight response). Communication: Emotions help convey how we feel to others, facilitating social interactions and relationships. Decision Making: Emotions can influence choices and behaviour, often providing a gut feeling or instinctual guidance. Motivation: Emotions can drive actions, such as the pursuit of goals or avoidance of harmful situations.

What is a pregnancy loss?

Pregnancy loss, also known as miscarriage, refers to the spontaneous loss of a pregnancy before the foetus can survive outside the womb, typically before the 20th week of gestation. It is a relatively common experience affecting 15-20% of know pregnancies, with 80% of these occurring during the first trimester. In Australia, it is estimated to occur in up to one in four confirmed pregnancies (Bellhouse, C., Temple-Smith, M., Watson, S., & Bilardi, J. 2019).

Early vs Late Pregnancy Loss:

A miscarriage can happen both early into the pregnancy, within the first 12 weeks (Figure 2 shows a foetus at 12 weeks), or late into the pregnancy, usually occurring between 13 and 20 weeks old pregnancy.

Medical Intervention Pregnancy Loss:

Figure 2: Pregnant women and partner

Pregnancy loss and emotions

Basic and complex emotions with pregnancy loss:

Shock and numbness may set in, particularly when the loss is unexpected, leaving parents feeling detached and disoriented. Anger and frustration can arise, sometimes directed at oneself, a partner, or medical professionals, while guilt may follow, with parents questioning if they could have done something to prevent the loss. At the same time, encountering pregnant women or newborns can trigger jealousy and resentment. Many women feel surprised and isolated at the intensity of their reaction, unaware of how common it is ().

Grieving due to Pregnancy Loss and miscarriages:

Experiencing a pregnancy loss, is an emotionally devastating event that can trigger a wide range of intense feelings. Grief and profound sadness are often at the forefront, as parents begin to grieve over their wishes, hopes, and dreams for their unborn child and family. Perinatal grief signifies a specific situation in which someone does not grieve for a consciously-known person, but for a fantasised child with whom a bond has been formed even before his or her birth (). The grieving process will relate strongly to these fantasies and ideals.

Anxiety and Depression:

Anxiety and fear about future pregnancies are common, as is a deep sense of loneliness and isolation, exacerbated by a lack of societal awareness and support for pregnancy loss. Depression can take hold, with persistent low mood and a sense of emptiness.

Does a Late Pregnancy Loss amplify associated emotions

Having to cope with late pregnancy loss has increased due to medical advances in prenatal diagnosis that have made it possible to detect many fetal anomalies that will cause death in infancy (Hunfeld, J. A. M., Wladimiroff, J. W., & Passchier, J. 1997). For example, Potter Syndrone is a fatal Congenital Disorder where there is a lack of amniotic fluid and kidney failure in an unborn infant. When detected, due to the complications it brings on the child's life and low chances of survival, many parents will be adviced medical intervention to miscarriage the child. Specific emotions to late pregnancy loss are believed to include guilt (`it was my fault') and loss of self-esteem (`other women have managed to bring healthy babies into the world') alongside similar emotions of grief, sadness, loneliness and/or emptiness.

Medically Intervened Pregnancy Loss

Emotions associated with abortions are complex and can vary widely from person to person, influenced by individual circumstances, cultural and societal factors, and personal beliefs. Common emotions include relief, particularly if the pregnancy posed health risks or if it was unwanted or unplanned, providing a sense of regained control over one's life and future. However, this relief can be accompanied by feelings of sadness, grief, and loss, as the decision to terminate a pregnancy is often emotionally charged. Guilt and shame are also prevalent, especially in environments where abortion is stigmatized or morally contested. Some individuals may experience anger, either directed towards themselves, their partners, or the situation that led to the need for an abortion. Anxiety and fear about the procedure, potential future fertility, and judgment from others can also play a significant role. Additionally, ambivalence and confusion are common, as conflicting emotions can coexist, making the psychological landscape surrounding abortion particularly intricate and deeply personal.

Mens emotions following a miscarriage

Men's experience, as they share their feelings and try to support their partners during a pregnancy loss has received little attention. The emotional struggles faced by a male partner most commonly include feelings of grief and depression.  In comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent needs. Many men feel profound sadness and grief over the loss of the baby, similar to what their partner experiences. They may also feel a sense of helplessness, as they cannot alleviate their partner's physical and emotional pain, which can be distressing and frustrating.

Key points

Overview:

• Miscarriages cause emotional distress and reaction
• Demonstrates emotions and handling of a miscarriage are different and fluctuating
• Healing from a miscarriage is not linear.

What are emotions:

• Subjective
• Physiological, and
• Behavioural elements.
• Locationist View

Primary vs Secondary:

• The six basic emotions vs a combination of primary emotions
• Ekman and his proposed criteria for emotions

Why do emotions happen?:

• Survival, Motivation, Decision making, Communication

What is pregnancy loss:

• Before the 20th week of gestation
• Affecting 15-20% of know pregnancies
• Affecting 1/4 pregnancies in Australia

Early vs Late Pregnancy Loss:

• Early into the pregnancy, within the first 12 weeks or late into the pregnancy, usually occurring between 13 and 20 weeks old pregnancy.

Medically Intervened Pregnancy Loss:

• Woman's decision and unwanted pregnancies
• Doctors decision regarding issues with woman's life and safety

Emotions associated with pregnancy loss:

• Greif - 5 stages
• Primary emotions such as sadness, anger
• Secondary complex emotions such as blame, isolation and loneliness
• Anxiety and depression
• Attachment styles and coping

Does a late pregnancy loss amplify associated emotions?

• Fetal anomalies

Medically intervened pregnancy loss:

• An unwanted pregnancy: sad, relieve, anxiety, guilt, shame
• A wanted pregnancy: Disappointment, blame, sadness

Mens emotions following a miscarriage:

• men grief with angry
• failure to recognise males emotions in the situation

Learning features

Quiz

Choose your answers and click "Submit":

1 Male partners emotions during a pregnancy loss are just as important as a Females:

	True
	False

2 A pregnancy loss will always result in a grieving mother:

	True
	False

Conclusion

• The Conclusion is arguably the most important section
• Suggested word count: 150 to 330 words
• It should be possible for someone to only read the Overview and the Conclusion and still get a pretty good idea of the problem and what is known based on psychological science

Suggestions for this section: What is the answer to the sub-title question based on psychological theory and research? What are the answers to the focus questions? What are the practical, take-home messages? (Even for the topic development, have a go at the likely take-home message)

See also

Provide internal (wiki) links to the most relevant Wikiversity pages (esp. related motivation and emotion book chapters) and Wikipedia articles. Use these formats:

• Light triad (Book chapter, 2021)
• Collaborative authoring using wiki (Wikiversity)
• Self determination theory (Wikipedia)

Suggestions for this section: Present in alphabetical order Use sentence casing Include the source in parentheses

References

Broquet, K. (1999). Psychological reactions to pregnancy loss. Primary care update for ob/gyns, 6(1), 12-16.

Hunfeld, J. A. M., Wladimiroff, J. W., & Passchier, J. (1997). The grief of late pregnancy loss. Patient Education and Counseling, 31(1), 57-64.

Karali, H. F., Farhad, E. S., Poh, D. S. C., Phong, Y. W., Soorianarayanan, P., Ting, J. S., & Zaigham, M. T. (2021). Comparing psychological impacts on male partners after experiencing various types of early pregnancy loss: A systematic literature review. International Journal of Clinical Obstetrics and Gynaecology.

Murphy, F. A., & Hunt, S. C. (1997). Early pregnancy loss: men have feelings too. British Journal of Midwifery, 5(2), 87-90.

Neugebauer, R., & Ritsher, J. (2005). Depression and Grief Following Early Pregnancy Loss. International Journal of Childbirth Education, 20(3).

Wheeler, S. R., & Austin, J. K. (2001). The impact of early pregnancy loss on adolescents. MCN: The American Journal of Maternal/Child Nursing, 26(3), 154-159.

Suggestions for this section: Important aspects of APA style for references include: Wrap the set of references in the hanging indent template. Use "Edit source": {{Hanging indent|1= the full list of references}} Author surname, followed by a comma, then the author initials separated by full stops and spaces Year of publication in parentheses Title of work in lower case except first letter and proper names, ending in a full-stop Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop Provide the full doi as a URL and working hyperlink The most common mistakes include: Incorrect capitalisation Incorrect italicisation Citing sources that weren't read or consulted

External links

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• Six top tips for writing a great essay (University of Melbourne)
• The importance of structure (skillsyouneed.com)

Suggestions for this section: Only select links to major external resources about the topic Present in alphabetical order Include the source in parentheses after the link