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An Interpretative Phenomenological Analysis

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An Interpretative Phenomenological Analysis Edith Cowan University Research Online Theses: Doctorates and Masters Theses 2015 Women’s experiences of pregnancy loss: An interpretative phenomenological analysis Esther Lea Kint Edith Cowan University Follow this and additional works at: https://ro.ecu.edu.au/theses Part of the Psychology Commons Recommended Citation Kint, E. L. (2015). Women’s experiences of pregnancy loss: An interpretative phenomenological analysis. https://ro.ecu.edu.au/theses/1723 This Thesis is posted at Research Online. https://ro.ecu.edu.au/theses/1723 Edith Cowan University Research Online Theses: Doctorates and Masters Theses 2015 Women’s experiences of pregnancy loss: An interpretative phenomenological analysis Esther Lea Kint Edith Cowan University Recommended Citation Kint, E. L. (2015). Women’s experiences of pregnancy loss: An interpretative phenomenological analysis. Retrieved from http://ro.ecu.edu.au/theses/1723 This Thesis is posted at Research Online. http://ro.ecu.edu.au/theses/1723 Edith Cowan University Copyright Warning You may print or download ONE copy of this document for the purpose of your own research or study. The University does not authorize you to copy, communicate or otherwise make available electronically to any other person any copyright material contained on this site. You are reminded of the following: Copyright owners are entitled to take legal action against persons who infringe their copyright. A reproduction of material that is protected by copyright may be a copyright infringement. Where the reproduction of such material is done without attribution of authorship, with false attribution of authorship or the authorship is treated in a derogatory manner, this may be a breach of the author’s moral rights contained in Part IX of the Copyright Act 1968 (Cth). Courts have the power to impose a wide range of civil and criminal sanctions for infringement of copyright, infringement of moral rights and other offences under the Copyright Act 1968 (Cth). Higher penalties may apply, and higher damages may be awarded, for offences and infringements involving the conversion of material into digital or electronic form. Women’s Experiences of Pregnancy Loss: An Interpretative Phenomenological Analysis Esther Lea Kint, BSc (Psych) Hons Faculty of Health, Engineering and Science Edith Cowan University Western Australia A thesis submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy Date of Submission: 29th May 2015 USE OF THESIS The Use of Thesis statement is not included in this version of the thesis. iv v Abstract Over the past three decades, research has proliferated on the incidence of grief severity following pregnancy loss, with many research studies citing the existence of ‘complicated’ and ‘unresolved’ grief. It is argued that this emphasis on grief severity has overshadowed other aspects of the bereavement experience that might differ from grief as it has been defined. Understanding the experience of loss in pregnancy instead of categorising it, would allow for new and varied understandings of the meaning women attribute to their experience of losing a baby. Furthermore, paying attention to women’s interpretations and understandings of pregnancy loss provides valuable insight into care that is perceived as meaningful and supportive. Utilising interpretative phenomenological analysis (IPA), a qualitative research method, the current study explored the experience of pregnancy loss among nineteen bereaved women with a history of miscarriage or stillbirth. The findings revealed that bereaved women struggle with a unique, complex and pervasive bereavement experience, that is largely unacknowledged and misunderstood. Women conveyed a strong desire for others to acknowledge and validate their loss, and to facilitate rather than suppress their grief. In addition, women identified a need to remain connected to their deceased baby, and for others to recognise the profound and enduring nature of their grief. Perceptions of support were identified as a critical catalyst in determining women’s bereavement experiences, and revealed both positive and negative attributions of professional and social support. In particular, women identified a need for increased public awareness of pregnancy loss, more sensitive and empathic care, continued support to facilitate contact with the baby, improved continuity of care to support grieving, and enhanced support in the subsequent pregnancy to assist with anxiety management. The implications of these findings for future research and practice are discussed. vi The study provides a context within which women’s experiences can not only be recognised as widespread and rational emotional processes following pregnancy loss, but that those suffering can also receive appropriate, specialised professional support and social acceptance by the wider community. vii Statement of Confidentiality Ethical clearance from the Edith Cowan University Ethics Committee was granted in March 2009. Ethical clearance from the Women and Newborn Health Service was granted in March 2010. Participant confidentiality was protected at all times, including all correspondence between myself and research supervisors. Pseudonyms for the bereaved participants and their family members are utilised throughout the thesis. All verbatim quotes were scrutinised for information that could render the participants identifiable, to ensure participants remained anonymous. viii The declaration page is not included in this version of the thesis x xi Acknowledgements I would like to begin by conveying my heartfelt gratitude to the participants who took part in this research. My sincerest thanks and appreciation to all the mothers who were willing to share their stories of grief and loss. I feel forever privileged to have been a part of your journey, and your strength and resilience has inspired me greatly. I hope that I have done justice to your words and experiences, and that the newfound knowledge gained through this research will assist healthcare providers to improve bereavement support services for women like you. I would also like to acknowledge and thank my amazing supervisory team. To my principal supervisor, Professor Lynne Cohen, thank you for your continued support, advice, humour and timely feedback. Your guidance was pivotal in the conceptualisation and early development of the project, and throughout the research process. To my associate supervisor, Belinda Jennings, thank you for your support, encouragement, and expert advice. Your knowledge and expertise in the field of perinatal loss was invaluable, and your feedback during the analysis and write up stages of the project ensured I was able to stay on track! You were able to recognise the project’s worth, and I hope I have been able to do it justice. I admire your commitment towards ensuring women affected by pregnancy loss receive optimal care, and I look forward to continuing our professional relationship in the aftermath of this project. Finally, I would like to thank my family and friends for their patience, understanding, and unwavering support whilst I completed this thesis. It was a long and arduous process, but you all showed empathy and encouraged me to persevere. It was well worth it. xii xiii Table of Contents ABSTRACT ............................................................................................................................................. V CHAPTER 1: INTRODUCTION .......................................................................................................... 1 PREVALENCE AND CAUSES OF PREGNANCY LOSS ............................................................................................ 1 PSYCHOLOGICAL CONSEQUENCES OF PREGNANCY LOSS ................................................................................ 2 THE UNIQUE NATURE OF PREGNANCY LOSS .................................................................................................... 3 IMPACT OF PREGNANCY LOSS ON THE SUBSEQUENT PREGNANCY ............................................................... 5 STATEMENT OF THE PROBLEM ............................................................................................................................ 6 THE PHENOMENOLOGICAL PERSPECTIVE ......................................................................................................... 7 Husserl and Transcendental Phenomenology ...................................................................................... 9 Heidegger and Hermeneutic Phenomenology ................................................................................... 10 Merleau-Ponty and Existential Phenomenology .............................................................................. 11 Gadamer and Linguistic Phenomenology ............................................................................................ 11 DEFINITIONS ........................................................................................................................................................ 14 STRUCTURE OF THE THESIS .............................................................................................................................. 15 CHAPTER 2: LITERATURE REVIEW ............................................................................................. 19 UNDERSTANDINGS OF GRIEF AND LOSS .......................................................................................................... 19 Historical Perspectives of Grief ...............................................................................................................
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