Couples May Change After Miscarriage

Pregnancy Loss Can Strengthen Relationship, or Tear It Apart

From the WebMD Archives

Oct. 8, 2003 -- Pregnancy loss can greatly affect a couple's relationship. It can either tear them apart, or bring them closer together. A new study shows the outcome all depends on how they handle it. "This is an outcome of pregnancy loss that has not yet been named, but it can have a serious effect on a couple's relationship," says researcher Kristin M. Swanson, RN, PhD, professor of family and child nursing at the University of Washington School of Nursing in Seattle.

Her study appears in this month's Psychosomatic Medicine.

Since 1982, Swanson has been studying this issue -- how women and men can get through miscarriage.

Research of first-time fathers shows the baby does not become real -- or at least a man does not consider himself a father -- until the first time he holds the baby in his arms, Swanson tells WebMD.

Thus, when there is pregnancy loss, he and she will have very different experiences, she explains. "His physical reminder of the pregnancy is seeing her. But she has experienced the baby biologically everyday. That baby has been inside her. Therefore, their reactions are different when the fetus is lost."

Men, Women, and Pregnancy Loss

Swanson bases her current insights on surveys completed by 185 women after their pregnancy loss -- one week, six weeks, one month, and one year later.

Women answered two basic, open-ended questions:

  • How has your miscarriage affected your relationship with your partner?
  • How has your miscarriage affected your sexual relationship?

One year after the loss, 28% were pregnant, 29% were trying to get pregnant, and 34% were avoiding pregnancy.

How women perceived changes in their relationships varied greatly, Swanson reports. One year after pregnancy loss:

  • 23% said their interpersonal relationship with their husband was closer, but only 6% said their sexual relationship was closer.
  • 44% felt the interpersonal relationship had returned to premiscarriage status; sexually, 55% thought their sexual bond had also returned.
  • 32% felt more distant from their husbands interpersonally; 39% felt more distant sexually.

Those who felt closer or "back to normal" were more likely to be pregnant again. They had more emotional strength; they also said their partners were able to share feelings about the loss.

When relationships had grown more distant, partners had done less to show they cared. Women in distant relationships reported more negative feelings --depression, anger, confusion, and tension.

"Women who were sexually more distant avoided intercourse, experienced less desire, and saw sex as a functional necessity, fearful reminder of loss, and source of tension," writes Swanson.

Women in distant relationships may have felt abandoned, she says. When men shared their feelings, women felt it helped them pull through a difficult time. Words of Wisdom

In counseling couples, Swanson finds that "naming what they have lost" helps them get to the heart of issues surrounding pregnancy loss.

Women will say, "I lost my baby."

But for men, the answer varies: For some, it's 'I lost a baby;' for others, it's 'a future baby.' "Or, if you give them more time, they will say, 'I lost her, she's just not herself, I want her to get back to how she was,'" Swanson tells WebMD.

The bottom-line message: If men don't respond, the relationship will be at risk. "Show her you care, be extra attentive," says Swanson. "You can bring your relationship closer if you can keep communication open."

Doctors, Midwives, Nurses Can Help

Whoever is involved at the hospital -- doctor, nurse, midwives -- can help grieving parents get through this trauma of pregnancy loss, says Nadine Kaslow, PhD, a professor of psychology at Emory University School of Medicine in Atlanta.

"Doctors can talk to couples, prepare them that this is a difficult time emotionally, tell them it's really important that they talk about what miscarriage means to them," Kaslow tells WebMD. "Talk to them realistically about what has happened. Then make an appointment to see them back in a month, together." Follow-up is very important, she says.

A nurse or midwife can also offer guidance and encourage couples to talk about their feelings about the pregnancy loss. "Give them ideas of how to cope effectively, that what a miscarriage means is different things to different people," she advises.

Sometimes, it helps couples to have a ceremony or ritual to mark the loss -- just as you would a newborn that has died, Kaslow says. "You do grow attached to the fetus."

Sometimes, couples go to their church. Others donate nursery items and toys to charity. Others may buy a teddy bear or another symbol to mark that presence in their lives, she says.

Sure, women can find support through groups and other women who have been through pregnancy loss. But the reaction of her partner is the most critical to the relationship. Just remember, he may grieve the loss in a different way. Try to get him to open up, to talk about it, Kaslow says.

Show Sources

SOURCES: Swanson, K. Psychosomatic Medicine, October 2003; vol 54. Kristin M. Swanson, RN, PhD, professor, family and child nursing, University of Washington School of Nursing, Seattle. Nadine Kaslow, PhD, professor, psychology, Emory University School of Medicine, Atlanta.
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