Research Project - the male perspective of miscarriage

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MALE PERSPECTIVE OF MISCARRIAGE

Literature Review

        A miscarriage or spontaneous abortion was described by Niven and Walker (1996) as a psychologically challenging for couples. It is the loss of the expected child (McCreight, 2004; Kimble, 1991; Murphy, 1998) for the period of pregnancy with the opportunity of hopes and dreams; and possibly, the disruption of relationship with one’s partner (Speckhard, 1997) can be as depressing for women and also with men.

         This phenomenon exists before the legal age of the fetus life viability, which is 24 weeks gestation. According to reports, the rate of early miscarriage is something like 30% at four weeks gestation, while 20% between four and about thirteen (13) weeks gestation (Rajan and Oakley 1993). Moreover, it has been estimated that about 80% of all conceptions closes stage in fetal death, and the sad thing is that, majority of these happen without the knowledge of the woman (Rajan and Oakley 1993).

          Miscarriage continues to be a significant problem among women. In fact, in most literatures, grief, ethical dilemmas, depression and health effects are some of the topics which are strongly associated among women as far as miscarriage are concerned, and very limited studies tackle and measured the involvement and perspective of men on the issue.  During pregnancy as well as birth, the impact of the role of fathers is not clear and they are valued just as persons “to support” the mother.  

        Studies have reported that fathers who had the chance to see their babies on ultrasound manifested greater sense of loss as compared to those who had not seen (Armstrong, 2001; Johnson & Puddifoot, 1998; McCreight). Worth (1997) revealed that fathers of stillborn offspring experience a dissatisfying relationship knowing that have not protected their child for the duration of pregnancy and did not have the occasion to nurture him or her (McCreight).

        So  much experiences have already been shared about the mother ’ s experience and struggles emotionally in relation to perinatal loss, but too little studies were known about father’s experiences and how they are being affected by the perinatal loss of their child?

        Thus, to explore the experiences and perspectives of men following miscarriage is the concern of this study. Much as miscarriage has been considered as one major event in women’s lives, this is just as the same for men.  All this time, men may have accepted that no one have understood their experience of emotional upheaval due to the situation. There may be those who believe that family, their friends or even the society did not consider their experience of miscarriage also as a loss of their hopes, aspirations and dreams, to some extent, so as their fatherhood role. To them feelings were simply brushed aside as one with very little significance.  The emotional disorder experienced by these men after many months needed the establishment of the therapeutic relationship.

         Two reliable academic published sources (Puddifoot and Johnson, 1997 & Murphy, 1997) confirmed that miscarriage experiences of women create unpleasant impacts to their male partner. Both qualitative (exploratory) studies adopted the phenomenological approach in gathering data and stressed out that the roles and emotional difficulties of men brought about by miscarriage have been overlooked for so long a time; while much of their experiences were not so expressed on literatures.

         Puddifoot and Johnson based randomly selected the pool of participants. After the referrals of staff nurses from gynaecological wards of hospitals, located in the northeast of England; Twenty (20) out of forty two (42) men whose partners had struggled from spontaneous abortion before the 24th week of pregnancy were chosen randomly and responded positively for a discussion on their experience and their reactions to the latest miscarriage of their female partner. Initial contact with the men was made via referrals from gynaecological wards of hospitals in the northeast of England by nursing staff on the wards, which approached men after their partners had miscarried. Using the thematic approach with reference to the principle of Potter and Wetherell (1987), the following areas as the main variables of the study were analyzed: the disclosure of one’s feelings to others, the feelings related to their perspective partners' miscarriage, imagery associated to the unborn child, the explanations of causality or apportioning of blame, and also the experience of the male partner specifically in the hospital~medical context. The authors pointed out that, judging one’s own reaction; not recognizing the pain suffered by men out of the circumstances; as well as the confidence on the authenticity of one’s own reaction were the perceived weaknesses of the said study.

          On the other hand, Murphy’s study was quite more complicated in terms of selecting study participants. The decision was based on Harker’s (1993) work that suggested participant should be the better half of women, who just had miscarriage at least six months later. Other than that ethical issues need have to be settled since Lee (1993) argued that as far as surrounding sex, reproduction and death would be part of the questions, those are considered taboo in Western cultures. Thus, more formal approaches were observed from local branches of the national charities to let them understand the nature of the study conducted.  After the consent was granted, data were gathered through the use of the unstructured interview. Initially, a preliminary interview; measures were taken to preserve confidentiality as well as anonymity were discussed; clearly, participants were made to understand that they could withdraw any time they want, without penalty. For each selected participant, interview lasted about 30 minutes to one hour and all responses were tape recorded. One observation in this study is that, the author has not elaborated clearly the weaknesses of the study.

         According to PATH (2007), around the world, reproductive health programs have increasingly recognized men as a vital audience for their services. Men have health concerns of their own and their health status as well as behaviors also affects the reproductive health of women. In cases of miscarriage, the views and roles of men are somehow seldom considered probably since the focal point of prenatal classes is more on the women’s physical care, with men’s concerns seldom addressed (Mason & Elwood, 1995). Jordan (1990) sought that the birth of a child was recognized as one of the important key transitions into fatherhood, saying men, at an instance, may not believe that they are fathers until actual birth comes and how happy they are during the said moments.  Just imagine how fathers are when their baby dies during pregnancy or shortly after?

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         Therefore, this study provides deeper understanding of the miscarriage experience by women from the perception of the men and this perception is extremely relevant to nursing practice, knowing that, it is nurses who deliver care regardless of gender of the clients during their limited hospitalisation period.

                 Early miscarriage is a common social and health event. This is supported by documented data collected at one Brisbane, Australia, hospital that revealed, some 440 women in one year who were hospitalized and went for surgical procedures due to ...

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