Guilt and Emptiness: Women's Experiences of Miscarriage

Adolfsson, Annsofie; Larsson, Per‐Göran; Wijma, Barbro; Berterö, Carina

doi:10.1080/07399330490444821

Cited by 101 publications

(143 citation statements)

References 30 publications

(47 reference statements)

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“…We did not restrict our criteria to any particular definition or operationalization of self-blame, guilt, or shame. Exploratory studies that did not expressly seek to understand selfblame, guilt, or shame yet reported them in their results were excluded because doing so would bias the review by not also including all exploratory studies that did not find evidence of self-blame, guilt, or shame (e.g., Adolfsson, Larsson, Wijma, & Bertero, 2004;Clyman, Green, Rowe, Mikkelsen, & Ataide, 1980;DeFrain, Martens, Stork, & Stork, 1990;DeFrain, Millspaugh, & Xie, 1996;Frost & Condon, 1996;Hsu, Tseng, Banks, & Kuo, 2004;Mandell, McAnulty, & Reece, 1980;Robinson, 2011;Samuelsson, Radestad, & Segesten, 2001;Smialek, 1978;Taub, 1996). 3.…”

Section: Study Eligibilitymentioning

confidence: 99%

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

Duncan

Cacciatore

2015

Omega (Westport)

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This is the first systematic review of the evidence on the prevalence of self-blame, guilt, and shame in bereaved parents. A search of PsychINFO, MEDLINE, Embase, CINAHL, PubMed, and Science Direct resulted in 18 studies for the period 1975 to 2013 which the authors have appraised. Self-blame, guilt, and shame are common in bereaved parents, albeit to varying degrees, with differential relationships to sex, and diminishing over time. There is some evidence that guilt and shame predict more intense grief reactions and that self-blame predicts posttraumatic symptomology, anxiety, and depression in bereaved parents. Heterogeneity of the studies and numerous methodological concerns limit the synthesis and strength of the evidence and the generalizability of the findings. Self-blame, guilt, and shame are commonly experienced by bereaved parents. Awareness of these affective states may assist clinicians in the identification of bereaved parents who are at a higher risk of developing adverse psychological outcomes. Overall, self-blame, guilt, and shame have received very little attention in the bereavement research, leaving many unanswered questions. Implications for practice and recommendations for future research are discussed. Self-blame, guilt, and shame are common in bereavement and may hinder the healthy progression of mourning (Buckle & Fleming, 2011;Humphrey, 2009;Rando, 1986 , 1989). However, self-blame, guilt, and shame have received relatively little attention in parental bereavement research. Reviews of guilt and shame in bereavement are either not current or comprehensive, narrative in style and therefore more susceptible to researcher bias or focused on various types of bereavement rather than parental bereavement specifically (Buckle & Fleming, 2011;Humphrey, 2009;Rando, 1986). Miles and Demi (1986) have proposed the only current theory of guilt in bereaved parents. While clinicians acknowledge that self-blame, guilt, and shame often hinder the progression of normal grieving, there are currently no robust, empirically tested theories of self-blame, guilt, and shame in bereaved parents to guide either diagnoses or interventions. This is the first systematic review of the literature on self-blame, guilt, and shame in bereaved parents characterized by a specific research question, inclusion and exclusion criteria, an explicit search strategy, systematic data extraction procedure, coding and analysis of the studies, methodological appraisal, and a synthesis of the available evidence text. These characteristics reduce the likelihood of reviewer bias or selective citation and provide readers with the information necessary to appraise both the included studies and the systematic review itself (Mulrow, 1994;Pai et al., 2004).Defining Self-Blame, Guilt, and Shame Both guilt and shame are self-conscious emotions involving self-blame (Tangney & Salovey, 1999) and, because they are intimately related, they are more difficult to observe as separate phenomena (Blum, 2008;Kubany & Watson, 2003;Silfver, 2007). ...

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Section: Study Eligibilitymentioning

confidence: 99%

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

Duncan

Cacciatore

2015

Omega (Westport)

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“…Kvinnan undrar varför missfallet uppstod och kan skuldbelägga sig själv, eftersom det är hennes kropp som avbryter graviditeten (4). Hur kvinnan/paret upplever missfallet beror på om hon/de har börjat fantisera om sitt kommande barn och sätta sig in i en ny identitet som förälder.…”

Section: Teoretiskt Ramverkunclassified

Kvinnors upplevelser av tidig graviditet, efter att ha upplevt ett eller flera missfall tidigare i livet

Rosenbrink¹,

Milihate²,

Adolfsson³

2012

Nordic Journal of Nursing Research

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IntroduktionMissfall är ett spontant avbrytande av en graviditet innan fostret är livsdugligt. För att det ska räknas som missfall, får fostret inte ha en vikt som överstiger 500 g, vilket motsvarar ett foster i graviditetsvecka 20-22. Missfall uppstår i 15-20 % av alla kända graviditeter, oftast innan 13:e graviditetsveckan och klassificeras då som tidigt. Missfall mellan 13:e och 22:a graviditetsveckan klassificeras som sena. Risken ökar i takt med kvinnans ålder. Vanligaste orsaken till missfall är kromosomavvikelser hos fostret. Andra orsaker är missbildningar i uterus och infektioner. Autoimmuna sjukdomar, hormonella sjukdomar och rökning är faktorer som ökar risken för att drabbas av missfall. Kvinnan får symtom som blödning med eller utan smärtor i nedre delen av buken eller ryggen. Missfall diagnostiseras som komplett eller inkomplett. Om missfallet diagnostiseras som komplett, behövs ingen vidare medicinsk åtgärd. Om missfallet diagnostiseras som inkomplett kan en operativ behandling behövas, för att tömma livmodern (1). Vid missed abortion dör fostret i livmodern utan att stötas ut. Utvärderad behandling med läkemedel kan ges vid missed abortion som alternativ till operativt ingrepp (2). Teoretiskt ramverkPå senare år har forskningen runt upplevelsen av missfall kommit fram till att många kvinnor sörjer sitt blivande barn vid ett missfall, på samma sätt om de skulle sörja en avliden anhörig (3). Kvinnan undrar varför missfallet uppstod och kan skuldbelägga sig själv, eftersom det är hennes kropp som avbryter graviditeten (4). Hur kvinnan/paret upplever missfallet beror på om hon/de har börjat fantisera om sitt kommande barn och sätta sig in i en ny identitet som förälder. Detta kan ske på ett tidigt stadium i graviditeten och i dessa fall kan ett tidigt missfall vara en väldigt tragisk händelse (5). Författare A A har tidigare forskat runt kvinnors upplevelse av missfall och har stor insikt i hur den emotionella omvårdnaden av kvinnor som genomgått missfall, eller är oroliga för att drabbas av missfall har satts i fokus under senare år i Skaraborgs län, Sverige. Vårdpersonal har sedan år 2005 utbildats på barnmorskemottagningar och gynekologiska mottagningar i länet. Utbildningen har fokuserat på hur kvinnor mår i samband med missfall, för att kunna ge ett bättre bemötande till dessa kvinnor och för att minska den tidigare tystnaden runt missfall. Utbildningen har resulterat i en mer tillgänglig vårdkedja för kvinnorna. Tidigare sökte många oroliga, gravida kvinnor med blödning i tidig graviditet vård på akutmottagningen, eftersom deras symtom inte sågs som allvarliga när de sökte vård under öppen mottagningstid. Nu ger barnmorskor på mödrahälsovården råd till kvinnan utifrån hennes oro och kroppsliga symtom, när kvinnan ringer dit för rådgivning. Om behov finns för en ultraljudsundersökning hänvisas kvinnan till gynekologisk mottagning. Barnmorskan på den gynekologiska mottagningen ger kvinnan en tid till läkare på kontorstid samma dag, eller inom en till två dagar. Kvinnor med konstaterat missfall er...

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“…• Early miscarriage…a miscarriage that occurs before the week 13 • Complete miscarriage…all of the remains of the terminated fetus are ejected from the uterus • Incomplete miscarriage…remains of the terminated fetus must be removed either surgically or with medication • Missed abortion…a fetus that has expired and has not been diagnosed as terminated • Ectopic pregnancy…where a fertilized egg has found its way into the fallopian tubes and must be removed surgically or with medication Losing a pregnancy is an emotionally challenging event for the woman in particular but it can have some effect on their partner or other family members [8][9][10]. Some emotional reactions that woman may experience after a miscarriage run the spectrum of emotional issues and include feelings of guilt and emptiness, grief and sadness, physical and emotional numbness, difficulties in sleeping and concentrating, eating and digestive disorder and of course weeping and crying.…”

Section: Environmental Factorsmentioning

confidence: 99%

The EKC-Model Provides Empathy, Knowledge and Care for Women that Encounter Health issues During the Reproductive Life

Adolfsson¹,

Jordmorfag²

2016

Int J Gynecol Clin Pract

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The EKC model (Empathy, Knowledge and Care) provides the necessary empathy, knowledge and care for the women who encounter health issues during their reproductive life. This approach to caring requires that healthcare workers are knowledgeable in order to confirm that a patient has suffered a miscarriage or a IUFD (Intra-uterine fetus death). Through understanding and training in the EKC model the healthcare professional increases their ability to be sympathetic and empathetic to a patient's needs. The workers get training in sexual and reproductive health in order to intimately understand how they affect the lives of individuals and their families.Sexual and reproductive health is a cross-sectional science that includes medicine, psychology, sociology and the caring sciences. Some of the more commonly experienced issues are in the areas of spontaneous abortion, miscarriages, invitrofertilization and adoption. Issues such as sexual abuse and violence towards women is another issue that is treatable with the EKC model. Pregnant women with diabetes type 1 fall under "maternity and diabetes" issues.Intimate knowledge about how the grieving process works is essential to be able to provide the necessary support to the patient. It is possible that the support will give them the courage and motivation to try and conceive again. One key aspect of the EKC model is to provide open and clear communication between the healthcare personnel and the patient, whether that communication is done face-to-face or otherwise. The structured EKC conversation provides a viable tool to help healthcare professionals assist their patients in coming to terms and resolving their loss.

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Guilt and Emptiness: Women's Experiences of Miscarriage

Cited by 101 publications

References 30 publications

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

Kvinnors upplevelser av tidig graviditet, efter att ha upplevt ett eller flera missfall tidigare i livet

The EKC-Model Provides Empathy, Knowledge and Care for Women that Encounter Health issues During the Reproductive Life

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