Print A miscarriage can be a time of great sadness for the father as well as the mother. There are a number of support services available if you need them. Many fathers are unsure how to deal with the loss of a baby after a miscarriage. A miscarriage can be a very distressing event for both parents. It is normal to experience a range of emotions, such as sadness, helplessness and anger. These feeling may change over time.

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See other articles in PMC that cite the published article. For both groups, state anxiety and pregnancy-specific distress were highest in the first trimester and decreased significantly over the course of pregnancy.

Compared to women without prior miscarriage, women with prior miscarriage experienced greater state anxiety in the second and third trimesters. Having a living child did not buffer state anxiety in women with a prior miscarriage. Attention to patterns of distress can contribute to delivery of appropriate support resources to women experiencing pregnancy after miscarriage and may help reduce risk for stress-related outcomes. Miscarriage is a widely used lay term, but there is substantial variability in its definition.

Less is known, however, about how experiences of miscarriage might influence levels of emotional distress during pregnancy following miscarriage. Therefore, the purpose of the current study was to examine patterns of maternal distress across pregnancy in women with and without a history of prior miscarriage. During the last two decades, research on the psychological impact of miscarriage has grown, including studies of women who have experienced miscarriage exclusively and mixed-sample studies of various types of perinatal loss including miscarriage, stillbirth, and neonatal death.

This body of research has established an empirical foundation for understanding the lived experiences of miscarriage. For example, women who experience miscarriage worry about future pregnancies Geller et al.

Prenatal distress has been associated with negative perinatal outcomes including spontaneous abortion, structural malformations, preeclampsia, low birthweight, and preterm delivery Dunkel-Schetter et al. Therefore, because women experiencing pregnancy subsequent to miscarriage are at increased risk for prenatal distress, it is critical to understand the types, patterns, and moderators of distress experienced by this population in order to develop interventions to prevent undesirable stress-related outcomes.

Distress in pregnancy subsequent to miscarriage has been assessed at various time points. Some investigators have assessed prenatal distress retrospectively, during the postpartum period. However, it is likely that distress changes across this period of time. For instance, reaching anticipated prenatal milestones has been found to lower maternal anxiety in pregnancy subsequent to loss Phipps, In this study, 10 women with a history of miscarriage were compared to 25 women without a history of miscarriage during the first and third trimester, although 5 of the women with a history of miscarriage and 7 of the women without a history of miscarriage were lost to follow-up at the third trimester assessment.

Women with a history of miscarriage experienced greater pregnancy-specific anxiety at the first trimester assessment compared to their counterparts who had not experienced miscarriage. At the third trimester assessment, this difference was no longer significant, because anxiety had decreased more dramatically in the miscarriage group. However, these findings are tentative due to the greatly reduced sample size. Psychological distress variables were examined once each trimester in 82 women with a history of perinatal loss.

However, no comparison group was included. There is also evidence, although mixed, that women who have experienced miscarriage have lower socioeconomic status on average than women who have not experienced miscarriage Price, These maternal characteristics, and not miscarriage history alone, may contribute to different emotional states during pregnancy for women who have and have not had a prior miscarriage.

Thus, when examining the impact of miscarriage history on subsequent pregnancy, it is important to control for maternal characteristics that are correlated with miscarriage status. With rare exception e. In addition, most samples have been composed of primarily White, married, educated women of middle to upper socioeconomic status DeBackere et al.

Another factor that may influence psychological distress in pregnancy subsequent to miscarriage or perinatal loss is having a living child. Other researchers have not reached such conclusions. For example, in a study of emotional responses during the first year following miscarriage, Swanson et al. Overall, investigations of the impact of living children on psychological distress in pregnancy subsequent to miscarriage have produced divergent results, which may be a result of methodological differences.

For example, the samples of previous studies differ in regards to when the living child was born e. Furthermore, in these studies, investigators examined the impact of parity status on distress in pregnancy subsequent to miscarriage at one time point only. The Current Study The purpose of the current study was to determine whether patterns of general and pregnancy-specific maternal distress, assessed across the three trimesters of pregnancy, were influenced by prior history of miscarriage, controlling for relevant demographics variables.

Two hypotheses were tested: Compared to pregnant women who have not experienced miscarriage, women with a history of miscarriage will experience: Hypothesis 1: higher general distress state anxiety in the first, second, and third trimesters of pregnancy.

Hypothesis 2: higher pregnancy-specific distress in the first, second, and third trimesters of pregnancy. Also explored was whether parity status moderates the impact of miscarriage status on generalized and pregnancy-specific distress. The current study was designed to redress the limitations of previous research. Both a comparison group and longitudinal methods assessment at the first, second, and third trimester were used to examine prenatal distress in a socioeconomically and ethnically diverse sample of women.

In addition, examining both general and pregnancy-specific distress allowed exploration of whether prior miscarriage and parity status affects these types of distress differently. Covariates of hypothesized relationships were identified and controlled. The participants in this study were part of a larger longitudinal study of psychosocial variables in pregnancy; data were collected from to Lobel, Cannella et al.

Eligibility for the larger study required participants to be at least 9 weeks of gestation at recruitment, to be at least 18 years old, and to speak English fluently, as the research was not designed to accommodate non-English speakers or the unique issues surrounding adolescent pregnancy. Participants were patients of a prenatal care facility in a large university-affiliated medical center located in the northeastern region of the United States.

Attrition generally occurred as a result of participants declining interviews at particular visits, or leaving the prenatal care facility prior to completion of interviews. Table 1 includes a detailed demographic description of the participants.



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Receiving a diagnosis Many participants reported lengthy diagnosis trajectories, and being treated for individual symptoms e. Female B, age 27, FG3. I mean that helped me hugely psychologically Female A, age 60, FG2. Thus, education for health professionals was a prerequisite for diagnosis, and diagnosis was a prerequisite for participants to access education.


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Published studies in which fertile women were interviewed after miscarriage have found that the women universally look to another pregnancy as the solution to their grief. However, for women undergoing infertility treatments, the possibility of another pregnancy is not a certainty. Despite this, little is known about the unique experience of this group of women. Design : Phenomenology Method : Eight women who had experienced miscarriage after infertility were interviewed. Interviews were audiotaped and transcribed verbatim.

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