Research Question❓
This study focuses on examining the experiences of a group of U.S. women who recently miscarried, as well as their perceptions of miscarriage stigma. Given the significance of understanding culturally desirable outcomes and behavior, this analysis attends to interrogate notions of miscarriage for designing more humane interventions for women who have experienced them. I seek to answer three questions:
In what ways do women who miscarried perceive their experience?
What are women’s perceptions of miscarriage stigma?
In what ways does miscarriage stigma become a social barrier that may hinder women in sharing their experiences with others?
Method ✍️
The sample for this study consists of 11 women who have experienced a miscarriage in the last 5 years. Participants were aged 24-47 (M= 31.82; SD=7.28). The majority of the sample was Caucasian (72%). One woman identified as Hispanic (9%), and two women identified as Hispanic and White (19%). All women lost at least one pregnancy before 20 weeks gestation. I used a purposive sample, selecting individuals because of their unique and important insights on the phenomenon I am interested in. I recruited participants through posting flyers on Reddit forums about miscarriage, giving out flyers to members of the Northern Colorado Doula Association to share, and using social media networks. Prospective participants who were interested in participating in the study were encouraged to reach out via email.
Procedures
Semi-structured interviews were conducted either face-to-face, over the phone, or via online video chat in this study. Interviews ranged from 34 to 47 minutes. The semi-structured interviews enabled an exploration of how women are socialized to think about miscarriage and their communication with others regarding the topic of miscarriage. This would not have been accessible through other methods, and it enabled a systematic collection of qualitative material. The face-to-face interview was held in a public site in Fort Collins chosen by the interviewee. The online interviews were conducted via FaceTime and Zoom. All interviews were recorded with smartphone apps.
Data analysis
I first analyzed my data with open coding. I coded participant transcripts via NVIVO software. Hybrid coding methods were used at this stage, including in vivo coding (using participants’ own words as codes) and descriptive coding (assigning words or short phrases to summarize data as codes) suggested by Saldaña (2016). After the first round of coding, I wrote an analytic memo to document my code choices and their operational definitions. In the memo, I also noted the emergent patterns and categories that I identified in the transcripts. Second, I coded the transcripts using Axial coding (Saldaña, 2016). In this process of inquiry, I intended to see what the relationships between each category are and refine the operationalization of concepts. Finally, I used selective coding to capture a sense of the overall content on large units of data, which resulted in a set of themes. Broad themes emerged from the selective coding.
Implications
The firsthand stories of the women who underwent miscarriages indicate that there is a need to raise awareness of miscarriage in both formal and informal education. The perception that only successful pregnancy is “normal” needs to change.
The public should be aware of the prevalence of the phenomenon and know medical explanations for its causes. In that way, they would be able to help women who miscarry comprehend the event and provide appropriate support.
Also, we must not allow the normal and healthy expression of grief to be considered a source of shame. My imperative is to strive to find ways not to normalize miscarriage as a natural part of life but to give voices to women.
The other thing we can strive for is coordinated communication among medical services professionals. The medical profession should try to alleviate the negative feelings they create when they talk to women about miscarriage by doing things like acknowledging the loss and being compassionate about it.
Challengs
Align everyone’s research goal in the interview guide
Since this project collaborated with another two graduate students from the Department of Communication, it is challenging to align everyone's research goal in one interview guide and make sure interview questions flow smoothly.
Difficult recruitment
Miscarriage remains a taboo topic for many. It was difficult to recruit miscarried women to participate in this project. Miscarriage can be a lonely and isolating experience.
Managing through emotionally intense conversations
There are a lot of tears and hugs involved in the interviews. It can be devastating for women to revisit the miscarriage experience. It takes time to emotionally process the collected information. I learned listening, compassion, and fast note-taking.
After Thoughts
I conducted this study from an inside perspective since I am a member of the population this study concerns. I experienced miscarriage once before I had my daughter. It was my first pregnancy, and the miscarriage was discovered at my 8-week prenatal check. I only shared my miscarriage story with a few close friends and family. Most of the time, I kept it secret from my friends at school and work, without questioning that impulse. It was not until the process of conducting this project that I recognized how strongly I had internalized the societal silences about miscarriage. Miscarriage is common; however, it is also stigmatized. I believe that my insider status allowed me to build rapport with participants rapidly. The rapport plays a significant role in allowing participants to be open and honest when talking about their miscarriage experiences.