This thesis describes qualitative research using a post-kleinian, psychoanalytic
clinical approach, into the emotional experience of pregnant women who have
experienced previous miscarriages.
Despite a growing interest in matters regarding pregnancy and infertility; the
impact of a woman's emotional response to the traumatic event of her previous
miscarriages during a current pregnancy has received little research attention,
although a wider category of stillbirth has been the subject of many studies. The
existing literature identified various emotional states associated with the interruption
of pregnancy but seemed to lack a deeper understanding or a meaningful connection
between these states.
My interest was aimed principally at an investigation of the mental state and
what is associated with the emotional experience connected to the loss and how the
way in which the loss itself was confronted had an impact on the experience and on
the new pregnancy.
The pivotal basis for the research question aimed to examine what features
characterise the state of mind of pregnant women with a history of miscarriage and
what contribution can be made by a brief psychoanalytic intervention.
The design of the research project was based on psychoanalytically-oriented,
monthly sessions which took place at the hospital during the pregnancy, with one
session after the birth and two other follow-up sessions. The research group included 8
mothers between the ages of 32 and 39 each of whom had a history of at least two
miscarriages prior to their current pregnancy..
A number of research methods were considered, and grounded theory was chosen
as the most appropriate for the analysis of the data. Analysis of the material, using
this approach, generated concepts and categories which proved useful in shedding
light on the mass of complex material.
What emerged from the research is that the experience of recurrent miscarriage
had destabilised the sense of identity of these mothers and seriously undermined their
trust in the creative process. In particular, in this group of women, it raised
persecutory feelings in relation to internal figures who it was felt would not give permission to become a parent and made the women feel dominated by an inexorable
The concepts developed here have significance not only for clinical work but also
constitute a useful tool for any professional working with children and parents-to-be,
helping them to understand the emotional reactions of these women in order to deal
with the anxiety resulting from the risk of losing their baby once again.
The study was carried out within a hospital environment within which, for various
reasons, it was difficult to adhere to the original objectives and this imposed certain
constraints which will be the subject of further reflection in the final chapter.
Brief psychotherapeutic intervention for pregnant women with a history of
miscarriage seems to be a justifiable course of action. This is supported not only by the
fact that all the women in the study successfully brought their pregnancies to term but
also by their responses to the questionnaire, by the follow-up sessions, and by my own
assessment of the work undertaken together.
Moreover, the preventive function of this intervention was particularly important:
it activated in these mothers an ability to ask for help after our sessions had concluded
and helped them to develop trust in someone who would be able to support and assist
them in their relationship with the child.
Additionally, the understanding reached through this study will inform preventive
and consultation work while suggesting further research questions.
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