Culpability, blame, and stigma after pregnancy loss in Qatar

Abstract

Background Following a miscarriage many women report feeling guilty and culpable for what has happened particularly when aspects of societal blame and stigma are involved. This research investigated the impact of cultural context on the experience of miscarriage. In particular, it focused on how elements of stigma and blame are linked to notions of miscarriage etiology and risk among Qatari women. Methods The research used an ethnographic approach. The data was collected over 18 months of fieldwork in Qatar, using semi-structured face to face interviews, and participant observation. A purposive sample of 40 women (primary participants) who had recently miscarried, participated in the study. Potential subjects were initially identified in the Women’s Hospital and were consented, and then interviewed in Arabic either in the hospital or at their preferred location. The interviews were audio recorded, transcribed and translated into English. Additional key interviews were performed with 20 secondary participants related to the miscarriage cohort including family members and husbands. Inductive thematic analysis of content was performed manually to extract themes. Results Two main themes emerged from the material looking specifically at miscarriage aftermaths: rhetorics of blame, self-blame and feelings of guilt; and miscarriage attitudes. Overall society is sympathetic and miscarriage is seen as normal and not particularly worrying, but understood to be upsetting to women. However, findings suggest there is some ambivalence around blame, culpability and stigma applied to miscarriage; some participants perceived miscarriage as a relatively normal and common event, whereas, others felt that miscarriage is resounding stigma and shame. Conclusion Miscarriage aftermaths are embedded in social, cultural and religious frameworks in relation to notions of risk and causation. Attention should be paid to ensure women and those around them are given appropriate and robust information about miscarriage causation to deflect discourses of blame that may be employed and reduce harm to women who suffer miscarriage.

Qualitative research in the Arabic language. When should translations to English occur? A literature review

“…, 16 , 17 , 18 , 19 , 20 , 21 , 22 Saudi Arabia (n = 5), 23 , 24 , 25 , 26 , 27 Jordan (n = 4), 28 , 29 , 30 , 31 and 3 studies each were conducted in the USA 32 , 33 , 34 and Qatar. 35 , 36 , 37 Two studies were conducted in Palestine, 38 , 39 and one study each was conducted in Canada, 40 Sweden 41 and Turkey. 42 …”

“… 12 , 14 , 15. , 16 , 20 , 22 , 27 , 29 , 30 , 31 , 33 , 38 , 40 , 42 Five studies used both interviews and focus groups, 20 , 24 , 36 , 37 , 38 and one study used an 18-month long ethnographic study method. 37 All of the included studies used thematic analysis to evaluate the data.…”

“…, 16 , 27 , 28 , 30 , 31 , 32 , 33 , 34 The explanation given for using this method was that some of the authors were English-speaking and the translation enabled them to access the data. 13 , 14 , 30 , 31 , 32 , 33 , 39 Authors mitigated any potential effects of translation on the quality of the analysis by involving bilingual researchers in the coding verification process, 14 retaining key words in Arabic, 36 , 37 or by having translators add notations to help ensure that the meaning of cultural idioms was not lost. 16 …”

“…An evaluation of trustworthiness and rigor was undertaken in 12 studies, with some authors explicitly describing each term and how they used them. 15 , 21 , 22 , 31 , 32 , 37 , 38 , 41 Saleh et al 30 mentioned using Lincoln and Guba's criteria without describing how. Others described some aspects of data validation.…”

Effectiveness of mindfulness-based stress reduction on depression, anxiety, and stress of women with the early loss of pregnancy in southeast Iran: a randomized control trial

“…In some cultures, spontaneous abortion is considered a punishment for ungratefulness to God. Therefore, studies in communities with different cultures and religious beliefs can provide a better perspective for the provision of supportive counseling services by health care workers [31,32]. In addition, the history of infertility, repeated abortions, chronic illness of the mother, the type of occupation of the father and mother, and the amount of family income can increase anxiety and stress in subsequent pregnancies [33,34].…”