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The loss of possibility

7 February 2006

Although more and more couples are trying for a first baby later in life there has been little research into older women’s experience of early miscarriage.

The research took place between 1999 and 2000 in the South West of England. Women were contacted at the time of their miscarriage and interviewed between three and twelve months later. Women were chosen who had been admitted to three different hospitals, so that their views about different types of care could also be gathered.

Nearly all of the women were either married or living with partners, and most were working. Many already had children, but others had experienced fertility problems, early miscarriage, later miscarriage and stillbirth. Also, some women had had another miscarriage or were pregnant again by the time that they were interviewed. It was important to see whether these different experiences effected how the women felt about early miscarriage (one that occurs within the first 12 weeks of pregnancy).

There were many reasons why the women had tried for a pregnancy, although not all of the pregnancies were planned. Some saw it as their last try for a baby, while others were getting pregnant for the first time. Some were with the same partner and others with new partners. While none of the women suggested that they had delayed having babies because of their career, with hindsight some thought that their employers could have helped more in allowing them to be both workers and mothers. Helpful factors were thought to be better pay and not being made to feel guilty about career breaks. Some of the women said that work had been useful after their miscarriage – through being supportive and allowing time off – although many reported that they had not been able to talk about how they were feeling.

Whether or not the pregnancy was planned, the miscarriage was seen as an important event. It was variously described – like having a period or giving birth – but others said that it was different to anything else that they had experienced. The miscarriage was seen as a physical loss (losing a baby) and an emotional loss (not becoming a mother), and this did not depend on whether or not the woman already had children. Some emphasised, however, that the miscarriage showed that at least they had been able to get pregnant.

Nearly all the women talked about ageing. While some considered they were too old to try for another pregnancy (because they ‘felt too old’ or their periods had stopped), others felt young enough to try again. Feelings about age and time were not necessarily related to the woman’s actual age in years, but were more to do with how she felt about her body. Most of the women were not aware that the risk of miscarriage increased with age and thought that this had added to their sense of shock.

Women’s experiences of early miscarriage are unique and complex

During the miscarriage, and after, health care staff were usually praised for being sensitive and caring, but sometimes insensitive comments had been made about the woman’s age. These kinds of comments can add to the distress and lead to the woman blaming herself for the miscarriage. Where women were given the opportunity to discuss their concerns after their miscarriage this was appreciated, although some women suggested that there could have been better signposting to support agencies such as the Miscarriage Association.

While it is clear that women’s experiences of early miscarriage are unique and complex, the overall message that emerged from this study was that more information should be available all women. While older women will benefit from more support when a miscarriage occurs, perhaps younger women, too, need to be informed of the increased risks associated with conceiving later in life.

Dr Julia Frost is happy for anyone to contact her regarding any of the issues discussed in this article:

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