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Western Michigan University ScholarWorks at WMU Dissertations Graduate College 8-2019 A Phenomenological Investigation of Women’s Infertility and Miscarriage Grief Experiences Tristan McBain Western Michigan University, [email protected] Follow this and additional works at: https://scholarworks.wmich.edu/dissertations Part of the Counseling Psychology Commons, and the Obstetrics and Gynecology Commons Recommended Citation McBain, Tristan, "A Phenomenological Investigation of Women’s Infertility and Miscarriage Grief Experiences" (2019). Dissertations. 3501. https://scholarworks.wmich.edu/dissertations/3501 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. A PHENOMENOLOGICAL INVESTIGATION OF WOMEN’S INFERTILITY AND MISCARRIAGE GRIEF EXPERIENCES by Tristan D. McBain A dissertation submitted to the Graduate College in partial fulfillment of the requirements for the degree of Doctor of Philosophy Counselor Education and Counseling Psychology Western Michigan University August 2019 Doctoral Committee: Glinda Rawls, Ph.D., Chair Alan Hovestadt, Ed.D. Gary Bischof, Ph.D. Robert Powell, Ph.D. Copyright by Tristan D. McBain 2019 ACKNOWLEDGMENTS There are several individuals I wish to acknowledge for their contributions toward the completion of this dissertation and my own professional development throughout the doctoral program. First, I would like to thank my committee chair, Dr. Glinda Rawls, and my doctoral committee: Drs. Alan Hovestadt, Gary Bischof, and Robert Powell. I cannot adequately capture in words the growth that I have gained from your mentorship and feedback on this project. There are also a number of WMU faculty that I wish to recognize for the sharing of their knowledge, time, and resources. The faculty are: Drs. Patrick Munley, Stephen Craig, Jennifer Foster, Patricia Reeves, Mark St. Martin, Carla Adkison-Johnson, Joseph Morris, Beverly Vandiver, Stephanie Burns, Kelly McDonnell, and Crystal Duncan-Lane. I would also like to express my gratitude to the sixteen women who participated in this study and were the lifeblood of this project. Finally, I would like to thank my family and friends for their enduring support and encouragement. I would be remiss if I did not also acknowledge Pacha, Harlow, my late Zeke, and especially Joey, who all spent countless hours by my side, on my feet, or in my lap for every word of this dissertation. Tristan D. McBain ii A PHENOMENOLOGICAL INVESTIGATION OF WOMEN’S INFERTILITY AND MISCARRIAGE GRIEF EXPERIENCES Tristan D. McBain, Ph.D. Western Michigan University, 2019 Infertility and miscarriage are reproductive losses that often produce grief reactions in affected women. This phenomenological study investigated the grief experiences of infertility and miscarriage through the ambiguous loss and disenfranchised grief frameworks in order to better understand both the obscurity of reproductive loss and how the resulting grief may be invalidated. Sixteen women volunteered to participate in this study and each fell into one of the following three categories: women affected by infertility without miscarriage (4); women affected by miscarriage without infertility (4); and women affected by infertility and miscarriage (8). A phenomenological hermeneutic approach was utilized to uncover the meaning of the participants’ grief experiences related to infertility and miscarriage and the themes that emerged were the result of a recursive process of thematic analysis. Themes that related to the ambiguity of the loss included: (a) loss of normative life experiences; and (b) a more personal loss. Themes that related to how the grief is disenfranchised included: (a) stigma leads to silence; (b) a lack of clear grieving rituals; and (c) elements of insensitive encounters. Finally, themes that related to improving counseling services for affected women included: (a) further training; (b) increasing access to appropriate resources; and (c) characteristics of validating support. Participants indicated that most people acknowledge that reproductive loss produces grief, however; what they believe can be improved is how other individuals understand the pervasiveness of their pain. Implications for the counseling profession and areas for future research are discussed. TABLE OF CONTENTS ACKNOWLEDGMENTS ....................................................................................................... ii LIST OF TABLES .................................................................................................................. vi CHAPTER I. INTRODUCTION ....................................................................................................... 1 Overview of the Study Topic .............................................................................. 1 Infertility .................................................................................................... 1 Miscarriage ................................................................................................ 2 Disenfranchised Grief ................................................................................ 3 Ambiguous Loss ........................................................................................ 3 Focus of the Study .............................................................................................. 4 Statement of the Problem ........................................................................... 4 Purpose Statement ...................................................................................... 7 Significance of the Study ........................................................................... 8 Definition of Terms .................................................................................. 10 Summary ........................................................................................................... 10 II. LITERATURE REVIEW .......................................................................................... 13 Introduction ....................................................................................................... 13 Infertility ........................................................................................................... 14 Definitions and Statistics ......................................................................... 14 The Study of Infertility ............................................................................ 18 Miscarriage ....................................................................................................... 40 ii Table of Contents—Continued CHAPTER Definitions and Statistics ......................................................................... 40 The Study of Miscarriage ......................................................................... 42 Grief Within the Field of Counseling ............................................................... 70 Clinical Definitions and Guidelines ......................................................... 70 Counselor Training and Ability to Work with Grieving Clients ............. 72 Infertility Grief ......................................................................................... 74 Miscarriage Grief ..................................................................................... 75 Disenfranchised Grief ....................................................................................... 76 Typology of Disenfranchised Grief ......................................................... 77 Counseling Interventions ......................................................................... 79 Applications of Disenfranchised Grief .................................................... 80 Ambiguous Loss ............................................................................................... 80 Assumptions of the Theory ...................................................................... 82 Counseling Interventions ......................................................................... 83 Applications of Ambiguous Loss ............................................................. 85 Summary ........................................................................................................... 85 III. METHODOLOGY .................................................................................................... 87 Research Design ............................................................................................... 87 Phenomenological Approach ................................................................... 87 Research Questions .................................................................................. 89 Role of the Researcher ............................................................................. 90 iii Table of Contents—Continued CHAPTER Participants ............................................................................................... 92 Sampling Strategy and Recruitment ........................................................ 94 Informed Consent ..................................................................................... 96 Data Collection Methods ......................................................................... 98 Data Procedures ....................................................................................... 99 Data Analysis ........................................................................................
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