Candidate: Colleen A. Thebert-Wright

Degree of: Doctor of Philosophy

Department: Counselor Education and Counseling Psychology

Title: Women's Experiences With Coping After Late Pregnancy Loss: A Qualitative Study

Date: Tuesday, June 25, 2002, 1:00 p.m. - 3:00 p.m.
3210 Sangren Hall, Merze Tate Center

Committee:
Dr. Patrick H. Munley, Chair
Dr. Suzanne Hedstrom
Dr. Jianping Shen

Abstract:
Pregnancy has been described as a crisis, a developmental period requiring a woman to adapt to profound psychological and somatic change. Resolving the maturational crises related to pregnancy is viewed as a necessary part of preparing oneself for motherhood and achieving maternal identity. The experience of stress may compromise a woman's ability to achieve these developmental tasks. Since a prior pregnancy loss may involve the experience of sudden and unexpected fetal demise, the subsequent pregnancy may be described as high risk and the mother's maternal identity attainment may have been compromised. Relatively little research attention has been directed to the experience of a subsequent pregnancy followed by a late pregnancy loss from the self-reported accounts of the women themselves.

This qualitative study investigated how women experience and cope with a subsequent pregnancy that follows a late pregnancy loss. Eight women who experienced a late pregnancy loss, a loss occurring after 20 gestational weeks, and then experienced a subsequent pregnancy and healthy delivery, were interviewed regarding their experiences with coping during their subsequent pregnancy. Four areas of inquiry were explored during semi-structured interviews with participants. How do women describe and make meanings of their experience of a subsequent pregnancy following a late pregnancy loss? How do woman cope during a subsequent pregnancy after late pregnancy loss, and which coping approaches are experienced as helpful? What do women experience as helpful and supportive from friends, family and health-care professionals during pregnancy after late pregnancy loss? What might these women wish to offer others who were contemplating or were experiencing subsequent pregnancies?

Interviews with participants were transcribed and data analyzed using the constant comparative method (Marshall & Rossman, 1995). Women participants were also interviewed a second time for a member check interview. Individual summaries of their responses to the research questions were reviewed and emerging themes discussed. Several themes emerged from the analysis related to women's experiences in coping during the subsequent pregnancy. These themes included: (a) contradictory emotions, (b) fear; (c) fearful attachment and persistent vulnerability; (d) obsessive mission, worry and the wish to hurry the end; (e) awareness that the delivery does not end the worry or the grief; (f) the need for information; (g) differentiating the pregnancy experiences; (h) understanding grief and random events; (i) the decision toward conscious presence and active parenting; (j) provision for the lost child; (k) acceptance of caring for oneself; (l) embrace the experience, the healing aspects of pain; and (m) altered self and worldview. Women's descriptions of what they experienced as helpful and supportive from friends, family and health care professionals during the subsequent pregnancy are also presented. Findings are discussed in terms of their implications for health care professionals and their possible implications for future research.

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