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Miscarriage Effects on Couples’ Interpersonal and Sexual Relationships During the First Year After Loss: Women’s Perceptions

From the University of Washington Schools of Nursing (K.M.S.) and Medicine (Z.A.K.), Seattle, Washington; the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, Rockville, Maryland (S.H.P); and the Simmons College, Graduate School for Health Studies, Nursing Department, Boston, Massachusetts (F.P.).

Address reprint requests to: Kristen M. Swanson, RN, PhD, FAAN, Professor and Chairperson, Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195. Email: kswanson{at}u.washington.edu

OBJECTIVES: To describe inductively women’s perceptions of the effects of miscarriage on their interpersonal and sexual couple relationships (IR and SR); and, guided by the Lazarus Emotions and Adaptation Model, to compare IR and SR patterns 1 year after loss for differences in backgrounds, contexts, appraisals, reappraisals, and emotions.

METHODS: This was a secondary analysis of data gathered at 1, 6, 16, and 52 weeks postmiscarriage from 185 women. Text data were content-analyzed. Relationship differences were examined using MANCOVA with Bonferroni adjusted pairwise comparisons.

RESULTS: There were three relationship patterns: closer, as it was, and more distant. At 1 year, women whose IR (44%) was as it was (vs. closer [23%] or more distant [32%]) or whose SR (55%) was as it was (vs. more distant [39%]) coped less passively and appraised less miscarriage impact. Women whose IR or SR was as it was (vs. closer) were more likely to have children and (vs. more distant), miscarried at an earlier gestation, conceived again, and experienced fewer negative events. Those whose IR was closer or as it was and whose SR was as it was (vs. IR or SR more distant) had less disturbed emotions, more emotional strength, and partners who performed more caring acts. Women whose IR was closer and whose SR was as it was (vs. more distant) had partners who engaged in more mutual sharing.

CONCLUSIONS: Women differed in perceptions of how miscarriage affected their IR and SR. The Lazarus Model helped explain those differences.

Key Words: miscarriage, • perinatal loss, • emotions, • sexual relationship, • couples, • marriage.

Abbreviations: a = as it was;; c = closer;; d = more distant;; IMS = Impact of Miscarriage Scale;; IR = interpersonal relationship;; IRB = Institutional Review Board;; MANCOVA = multivariate analysis of covariance;; MCP = Miscarriage Caring Project;; SR = sexual relationship.

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