Advertisement

Sex Roles

, Volume 76, Issue 5–6, pp 380–392 | Cite as

Disrupted Transition to Parenthood: Gender Moderates the Association Between Miscarriage and Uncertainty About Conception

  • S. Katherine Nelson
  • Megan L. Robbins
  • Sara E. Andrews
  • Kate Sweeny
Original Article

Abstract

Miscarriage is a devastating yet common experience shared by women and their partners. Doctors often recommend that couples attempt to conceive again after the experience of a miscarriage, yet little is known about the emotional toll of conception following miscarriage. In the current study, we addressed two primary research questions: (a) How does experiencing a miscarriage relate to recalled emotional experiences of uncertainty surrounding efforts to conceive again? and (b) does gender moderate the association between miscarriage and retrospective accounts of emotions surrounding efforts to conceive? An online sample of parents from across the U.S. (N = 429; 84.4 % married or cohabiting) reported their number of prior miscarriages and completed online questionnaires assessing recalled psychological adjustment (anxiety, rumination, positive and negative emotions) during their efforts to conceive their youngest child. In addition, they provided written responses regarding their experiences during this time. Participants’ responses were quantitatively analyzed for word use using LIWC, a text-analysis software program, to obtain an observational indicator of emotions. For women but not men, miscarriage was associated with recalled anxiety, rumination, and negative emotions surrounding efforts to conceive a child, as well as the use of more negative emotion, sadness, and anxiety words when describing efforts to conceive. Thus, miscarriage seemed to taint the emotional experience of trying to conceive again, and this consequence seemed particularly poignant for women.

Keywords

Gender Pregnancy Fertility Miscarriage Distress Emotion Uncertainty 

Notes

Compliance with Ethical Standards

Conflicts of Interest

We have no potential conflicts of interest

Informed Consent

All participants provided informed consent prior to answering any questions. As part of the informed consent procedure, participants were informed that they would be answering questions about their experiences and emotions during their most recent pregnancy and that they had the option to discontinue their participation at any time.

References

  1. Adolfsson, A. (2011). Meta-analysis to obtain a scale of psychological reaction after perinatal loss: Focus on miscarriage. Psychological Research and Behavior Management, 4, 29–39. doi: 10.2147/PRBM.S17330.CrossRefGoogle Scholar
  2. Armstrong, D. S. (2002). Emotional distress and prenatal attachment in pregnancy after perinatal loss. Journal of Nursing Scholarship, 34, 339–345. doi: 10.1111/j.1547-5069.2002.00339.x.CrossRefPubMedGoogle Scholar
  3. Armstrong, K. A., & Khawaja, N. G. (2002). Gender differences in anxiety: An investigation of the symptoms, cognitions, and sensitivity towards anxiety in a nonclinical population. Behavioural and Cognitive Psychotherapy, 30, 227–231. doi: 10.1017/S1352465802002114.CrossRefGoogle Scholar
  4. Beutel, M., Deckardt, R., von Rad, M., & Weiner, H. (1995). Grief and depression after miscarriage: Their separation, antecedents, and course. Psychosomatic Medicine, 57, 517–526.CrossRefPubMedGoogle Scholar
  5. Blackmore, E. R., Cote-Arsenault, D., Tang, W., Glover, V., Evans, J., Golding, J., & O’Connor, T. G. (2007). Previous prenatal loss as a predictor of perinatal depression and anxiety. The British Journal of Psychiatry, 198, 373–378. doi: 10.1192/bjp.bp.110.083105.CrossRefGoogle Scholar
  6. Blohm, F., Friden, B., & Milsom, I. (2008). A prospective longitudinal population-based study of clinical miscarriage in an urban Swedish population. BJOG: An International Journal of Obstetrics and Gynaecology, 115, 176–183. doi: 10.1111/j.1471-0528.2007.01426.x.CrossRefGoogle Scholar
  7. Brier, N. (2008). Grief following miscarriage: A comprehensive review of the literature. Journal of Women’s Health, 17, 451–464. doi: 10.1089/jwh.2007.0505.CrossRefPubMedGoogle Scholar
  8. Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6, 3–5. doi: 10.1177/1745691610393980.CrossRefPubMedGoogle Scholar
  9. Chojenta, C., Harris, S., Reilly, N., Forder, P., Austin, M.-P., & Loxton, D. (2014). History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum. PLoS ONE, 9, e95038. doi: 10.1371/journal.pone.0095038.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Cohn, M. A., Mehl, M. R., & Pennebaker, J. W. (2004). Linguistic markers of psychological change surrounding September 11, 2001. Psychological Science, 15, 687–693. doi: 10.1111/j.0956-7976.2004.00741.x.CrossRefPubMedGoogle Scholar
  11. Creswell, J. D., Lam, S., Stanton, A. L., Taylor, S. E., Bower, J. E., & Sherman, D. K. (2007). Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing? Personality and Social Psychology Bulletin, 33, 238–250. doi: 10.1177/0146167206294412.CrossRefPubMedGoogle Scholar
  12. Cumming, G. P., Klein, S., Bolsover, D., Lee, A. J., Alexander, D. A., Maclean, M., & Jurgens, J. D. (2007). The emotional burden of miscarriage for women and their partners: Trajectories of anxiety and depression over 13 months. British Journal of Obstetrics and Gynaecology, 114, 1138–1145. doi: 10.1111/j.1471-0528.2007.01452.x.CrossRefPubMedGoogle Scholar
  13. Engelhard, I. M. (2004). Miscarriage as a traumatic event. Clinical Obstetrics and Gynecology, 47, 547–551. doi: 10.1097/01.grf.0000129920.38874.0d.CrossRefPubMedGoogle Scholar
  14. Everett, C. (1997). Incidence and outcome of bleeding before the 20th week of pregnancy: Prospective study from general practice. British Medical Journal, 315, 32–36. doi: 10.1136/bmj.315.7099.32.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Feather, N. T. (1984). Masculinity, femininity, psychological androgyny, and the structure of values. Journal of Personality and Social Psychology, 47, 604–620. doi: 10.1037/0022-3514.47.3.604.CrossRefGoogle Scholar
  16. Gates, G. J. (2011). How many people are lesbian, gay, bisexual, and transgender? Los Angeles: The Williams Institute.Google Scholar
  17. Gillespie, R. (2000). When no means no: Disbelief, disregard and deviance as discourses of voluntary childlessness. Women’s Studies International Forum, 23, 223–234. doi: 10.1016/S0277-5395(00)00076-5.CrossRefGoogle Scholar
  18. Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59, 93–104. doi: 10.1037/0003-066X.59.2.93.CrossRefPubMedGoogle Scholar
  19. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford.Google Scholar
  20. Hays, S. (1996). The cultural contradiction of motherhood. New Haven: Yale University Press.Google Scholar
  21. Kong, G., Chung, T., Lai, B., & Lok, I. (2010). Gender comparison of psychological reaction after miscarriage—A 1-year longitudinal study. British Journal of Gynaecology, 117, 1211–1219. doi: 10.1111/j.1471-0528.2010.02653.x.CrossRefGoogle Scholar
  22. Koropeckyj-Cox, T., Romano, V., & Moras, A. (2007). Through the lenses of gender, race, and class: Students’ perceptions of childless/childfree individuals and couples. Sex Roles, 56, 415–428. doi: 10.1007/s11199-006-9172-2.CrossRefGoogle Scholar
  23. Lok, I. H., Yip, A. S.-K., Lee, D. T.-S., Sahota, D., & Chugn, T. K.-H. (2010). A 1-year longitudinal study of psychological morbidity after miscarriage. Fertility and Sterility, 6, 1966–1975. doi: 10.1016/j.fertnstert.2008.12.048.
  24. Love, E. R., Bhattacharya, S., Smith, N. C., & Bhattacharya, S. (2010). Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: Retrospective analysis of hospital episode statistics in Scotland. British Medical Journal, 341, c3967. doi: 10.1136/bmj.c3967.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Low, C. A., Stanton, A. L., & Danoff-Burg, S. (2006). Expressive disclosure and benefit finding among breast cancer patients: Mechanisms for positive health effects. Health Psychology, 25, 181–189. doi: 10.1037/0278-6133.25.2.181.CrossRefPubMedGoogle Scholar
  26. Lueptow, L. B., Garovich-Szabo, L., & Lueptow, M. B. (2001). Social change and the persistence of sex typing: 1974–1997. Social Forces, 80, 1–36. doi: 10.1353/sof.2001.0077.CrossRefGoogle Scholar
  27. Lyubomirsky, S., Layous, K., Chancellor, J., & Nelson, S. K. (2015). Thinking about rumination: The scholarly contributions and intellectual legacy of Susan Nolen-Hoeksema. Annual Review of Clinical Psychology, 11, 1–22. doi: 10.1146/annurev-clinpsy-032814-112733.CrossRefPubMedGoogle Scholar
  28. Margolis, R., & Myrskyla, M. (2015). Parental well-being surrounding first birth as a determinant of further parity progression. Demography, 52, 1147–1166. doi: 10.1007/s13524-015-0413-2.CrossRefPubMedPubMedCentralGoogle Scholar
  29. McGreal, D., Evans, B. J., & Burrows, G. D. (1997). Gender differences in coping following loss of a child through miscarriage or stillbirth: A pilot study. Stress Medicine, 13, 159–165. doi: 10.1002/(SICI)1099-1700(199707)13:3<159::AID-SMI734>3.0.CO;2-5.CrossRefGoogle Scholar
  30. Murphy, F. A. (1998). The experience of miscarriage from a male perspective. Journal of Clinical Nursing, 4, 325–332. doi: 10.1046/j.1365-2702.1998.00153.x.CrossRefGoogle Scholar
  31. Nelson, S. K., Kushlev, K., & Lyubomirsky, S. (2014). The pains and pleasures of parenting: When, why, and how is parenthood associated with well-being? Psychological Bulletin, 140, 846–895. doi: 10.1037/a0035444.CrossRefPubMedGoogle Scholar
  32. Nolen-Hoeksema, S. (2001). Gender differences in depression. Current Directions in Psychological Science, 10, 173–176. doi: 10.1111/1467-8721.00142.CrossRefGoogle Scholar
  33. Ockhuijsen, H. D. L., van den Hoogen, A., Boivin, J., Macklon, N. S., & de Boer, F. (2014). Pregnancy after miscarriage: Balancing between loss of control and searching for control. Research in Nursing and Health, 37, 267–275. doi: 10.1002/nur.21610.CrossRefPubMedGoogle Scholar
  34. Pennebaker, J. W. (2011). The secret life of pronouns: What our words say about us. New York: Bloomsbury Press.Google Scholar
  35. Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528–537. doi: 10.1037/0022-3514.58.3.528.CrossRefPubMedGoogle Scholar
  36. Pennebaker, J. W., Mehl, M. R., & Niederhoffer, K. G. (2003). Psychological aspects of natural language use: Our words, our selves. Annual Review of Psychology, 54, 547–577. doi: 10.1146/annurev.psych.54.101601.145041.CrossRefPubMedGoogle Scholar
  37. Pennebaker, J. W., Chung, C. K., Ireland, M., Gonzales, A., & Booth, R. J. (2007). The development and psychometric properties of LIWC2007. Austin: LIWC.net.Google Scholar
  38. Piccinelli, M., & Wilkinson, G. (2000). Gender differences in depression: Critical review. The British Journal of Psychiatry, 177, 486–492. doi: 10.1192/bjp.177.6.486.CrossRefPubMedGoogle Scholar
  39. Puddifoot, J. E., & Johnson, M. P. (1999). Active grief, despair, and difficulty coping: Some measured characteristics of male response following their partner’s miscarriage. Journal of Reproductive and Infant Psychology, 17, 89–93. doi: 10.1080/02646839908404587.CrossRefGoogle Scholar
  40. Pudrovska, T. (2009). Parenthood, stress, and mental health in late midlife and early old age. Journal of Aging and Human Development, 68, 127–147. doi: 10.2190/AG.68.2.b.CrossRefPubMedGoogle Scholar
  41. Ridgeway, C. L., & Correll, S. J. (2004). Unpacking the gender system: A theoretical perspective on gender beliefs and social relations. Gender and Society, 18, 510–531. doi: 10.1177/0891243204265269.CrossRefGoogle Scholar
  42. Sedgh, G., Singh, S., & Hussain, R. (2014). Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning, 45, 301–314. doi: 10.1111/j.1728-4465.2014.00393.x.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Slade, P., O’Neill, C., Simpson, A. J., & Lashen, H. (2007). The relationship between perceived stigma, disclosure patterns, support and distress in new attendees at an infertility clinic. Human Reproduction, 22, 2309–2317. doi: 10.1093/humrep/dem115.CrossRefPubMedGoogle Scholar
  44. Spence, J. T., & Buckner, C. E. (2000). Instrumental and expressive traits, trait stereotypes, and sexist attitudes: What do they signify? Psychology of Women Quarterly, 24, 44–62. doi: 10.1111/j.1471-6402.2000.tb01021.x.CrossRefGoogle Scholar
  45. Swanson, K. M. (2000). Predicting depressive symptoms after miscarriage: A path analysis based on the Lazarus paradigm. Journal of Women’s Health & Gender-Based Medicine, 9, 191–206. doi: 10.1089/152460900318696.CrossRefGoogle Scholar
  46. Sweeny, K., & Andrews, S. A. (2014). Mapping individual differences in the experience of a waiting period. Journal of Personality and Social Psychology, 106, 1015–1030. doi: 10.1037/a036031.CrossRefPubMedGoogle Scholar
  47. Sweeny, K., Andrews, S. A., Nelson, S. K., & Robbins, M. L. (2015). Waiting for a baby: Navigating uncertainty in recollections of trying to conceive. Social Science & Medicine, 141, 123–132. doi: 10.1016/j.socscimed.2015.07.031.CrossRefGoogle Scholar
  48. Tausczik, Y. R., & Pennebaker, J. W. (2010). The psychological meaning of words: LIWC and computerized text analysis methods. Journal of Language and Social Psychology, 29(1), 24–54. doi: 10.1177/0261927X09351676.CrossRefGoogle Scholar
  49. Wade, N. G., Vogel, D. L., Liao, K. Y.-H., & Goldman, D. B. (2008). Measuring state-specific rumination: Development of the Rumination about an Interpersonal Offense Scale. Journal of Counseling Psychology, 55, 419–426. doi: 10.1037/0022-0167.55.3.419.CrossRefGoogle Scholar
  50. Watson, D., & Clark, L. A. (1994). The PANAS-X: Manual for the Positive and Negative Affect Schedule-Expanded Form. Unpublished manuscript. University of Iowa, Iowa City.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • S. Katherine Nelson
    • 1
  • Megan L. Robbins
    • 2
  • Sara E. Andrews
    • 2
  • Kate Sweeny
    • 2
  1. 1.Department of PsychologySewanee: The University of the SouthSewaneeUSA
  2. 2.University of California, RiversideRiversideUSA

Personalised recommendations