The psychodynamics of spontaneous abortion.

Abstract

Grieving following spontaneous abortion is common, but generally not recognized by family, friends, and professional caregivers. This article reviews the literature and identifies the characteristics of grief associated with early reproductive loss.

The Psychological Sequelae of Miscarriage: A Critical Review of the Literature

“…Silence is a common response to the woman's loss [7,22,36]. The lack of culturally accepted rituals, as simple as condolence cards or as complex and public as a funeral, may further exacerbate the woman's sense of isolation.…”

“…If the pregnancy is lost, the resulting narcissistic injury can be very powerful. Feelings of emptiness, shame, helplessness and low self-esteem are commonly expressed [22,35,36]. The woman cannot create an identity for the lost baby, by naming, holding, burying or photographing the dead child as she could later in pregnancy.…”

Extreme phobias following missed abortion and D & C

“…As recently as 1984 it has been observed that there has been little attention given in the literature to the psychological effects of spontaneous abortion (Stack, 1984). What has been written in this area has tended to focus almost entirely on feelings of grief and guilt (Ewy & Ewy, 1984;Harris, 1984;Hutti, 1986;Leppert & Pahlka, 1984;Panuthos & Romeo, 1984;Stack, 1984;Wall-Haas, 1985;Wolff, Nielson, & Schiller, 1970), while ignoring anxiety.…”

“…What has been written in this area has tended to focus almost entirely on feelings of grief and guilt (Ewy & Ewy, 1984;Harris, 1984;Hutti, 1986;Leppert & Pahlka, 1984;Panuthos & Romeo, 1984;Stack, 1984;Wall-Haas, 1985;Wolff, Nielson, & Schiller, 1970), while ignoring anxiety. In their study, Seibel and Graves (1980) did question women about anxiety and found slightly more than half reported feeling nervous and/or afraid after a spontaneous abortion.…”

Grief and mourning reactions following abortion and miscarriage

“…Pathological grief reactions following miscarriages have been correlated with narcissistic injury, wherein a woman sees the loss as a part of herself rather than a separate entity (Stack, 1984). Interestingly, this reaction has not been seen in women who suffer induced abortions, possibly because of the women's increased need to dissociate from the fetus before the procedure takes place.…”