GRIEF AND BEREAVEMENT EXPERIENCES OF COUPLES WITH PRENATAL LOSS EXPERIENCE: EXAMINING PSYCHO-SOCIAL INTRICACIES IN A QUALITATIVE PHENOMENOLOGICAL STUDY A THESIS SUBMITTED TO THE GRADUATE SCHOOL OF SOCIAL SCIENCES OF MIDDLE EAST TECHNICAL UNIVERSITY BY BETÜL TANACIOĞLU IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT OF EDUCATIONAL SCIENCES JANUARY 2019 Approval of the Graduate School of Social Sciences Prof. Dr. Tülin Gençöz Director I certify that this thesis satisfies all the requirements as a thesis for the degree of Doctor of Philosophy. Prof. Dr. Cennet Engin Demir Head of Department This is to certify that we have read this thesis and that in our opinion it is fully adequate, in scope and quality, as a thesis for the degree of Doctor of Philosophy. Prof. Dr. Özgür Erdur Baker Supervisor Examining Committee Members Prof. Dr.Tuncay Ergene (Hacettepe Uni., EBB) Prof. Dr. Özgür Erdur Baker (METU, EDS) Prof. Dr. Semra Sungur (METU, MSE) Assist. Prof. Dr. Duygun Göktürk Ağın (METU, EDS) Assist. Prof. Dr. Sibel Akmehmet Şekerler (Boğaziçi Uni., ED) I hereby declare that all information in this document has been obtained and presented in accordance with academic rules and ethical conduct. I also declare that, as required by these rules and conduct, I have fully cited and referenced all material and results that are not original to this work. Name, Last name : Betül TANACIOĞLU Signature : iii ABSTRACT GRIEF AND BEREAVEMENT EXPERIENCES OF COUPLES WITH PRENATAL LOSS EXPERIENCE: EXAMINING PSYCHO-SOCIAL INTRICACIES IN A QUALITATIVE PHENOMENOLOGICAL STUDY Tanacıoğlu, Betül Ph.D., Department of Educational Sciences Supervisor: Prof. Dr. Özgür Erdur Baker January 2019, 259 pages The purpose of this study was to describe the experiences of partners who experienced pregnancy loss. For this purpose, qualitative methodology was preferred, and phenomenology method was used in order to reflect the participants' experiences related to pregnancy loss. After conducting pilot study to get feedback about the quality, wording, and structure of sentences; the interview questions were reviewed by the academicians and psychological counselors. The data of the study were gathered via semi-structured interviews with 10 couples (10 men and 10 women). The couples were interviewed separately, and the transcribed data were analyzed by using thematic analysis method. The codes and themes that were emerged from the data were shaped regarding the research questions and related literature. The results discovered from the data explained four main themes: motivation to have a baby, short-term and long-term effects of pregnancy loss and factors affecting the grief resolution. The findings of the study revealed that pregnancy loss reactions were similar to reactions to other losses people experience. Moreover, the differences between men and women were highlighted. Results regarding the coping of the bereaved participants showed that having a prior or subsequent child, having positive perceived support from the partner and social environment could be protective factors for the bereaved ones. The findings were discussed and interpreted in the light of data gathered and the related literature. Implications for further research and for psychological counseling practices were considered. iv Keywords: Pregnancy/prenatal loss, bereavement, effects of prenatal loss, socio-cultural factors, gender differences in grief. v ÖZ GEBELİK DÖNEMİNDE KAYIP YAŞAMIŞ ÇİFTLERİN YAS VE MATEM TECRÜBELERİ: NİTELİKSEL FENOMENOLOJİK BİR ÇALIŞMADA PSİKO-SOSYAL ETMENLERİN İNCELENMESİ Tanacıoğlu, Betül Doktora, Eğitim Bilimleri Bölümü Tez Yöneticisi: Prof. Dr. Özgür Erdur Baker Ocak 2019, 259 sayfa Bu çalışmasının amacı, gebelik kaybı yaşamış çiftlerin deneyimlerini tanımlamaktır. Bu amaçla, niteliksel metodoloji tercih edilmiş ve katılımcıların gebelik kaybına bağlı deneyimlerini yansıtabilmek için fenomenoloji yöntemi kullanılmıştır. Görüşme sorularının kalite, ifade ve cümle yapısı hakkında geri bildirim almak amacıyla yapılan pilot çalışmadan sonra, akademisyenler ve psikolojik danışmanlar tarafından görüşme soruları gözden geçirilmiştir. Araştırmanın verileri, 10 çift (10 erkek ve 10 kadın) ile yapılan yarı-yapılandırılmış görüşmeler yoluyla toplanmıştır. Çiftlerle görüşmeler ayrı/bireysel olarak gerçekleştirilmiştir ve deşifre edilen veriler tematik analiz yöntemi kullanılarak analiz edilmiştir. Verilerden çıkan kodlar ve temalar, araştırma soruları ve ilgili literatürle şekillendirilmiştir. Verilerden elde edilen sonuçlar dört ana temayı açıklamıştır: bebeğe sahip olma motivasyonu, hamilelik döneminde bebek kaybının kısa süreli ve uzun süreli etkileri ve yas çözümünü etkileyen faktörler. Araştırmanın bulguları, gebelik kaybı tepkilerinin insanların yaşadığı diğer kayıplara verdikleri tepkilere benzediğini ortaya koymuştur. Ayrıca, erkekler ve kadınlar arasındaki farklar vurgulanmıştır. Yaslı ebeveynlerin baş etme mekanizmalarıyla ilgili sonuçlara bakıldığında, kayıp öncesi ya da kayıp sonrası çocuğa sahip olmanın, partnerden ve sosyal çevreden olumlu algılanan desteğin, yas tutma sürecinde koruyucu faktörler olduğu gözlemlenmiştir. Bulgular, toplanan veriler ve ilgili literatür ışığında tartışılmış ve yorumlanmıştır. İleride yapılacak çalışmalar ve psikolojik danışmanlık uygulamaları için çıkarımlar tartışılmıştır. vi Anahtar Kelimeler: Gebelik dönemi/doğum öncesi kayıp, yas, doğum öncesi kayıpların etkileri, sosyo-kültürel faktörler, yas sürecinde cinsiyet farklılıklar. vii ACKNOWLEDGEMENTS I wish to express my deepest gratitude for the participants of this study who showed the courage and willingness to talk about their inner experiences, who opened their homes wholeheartedly. A special thanks to my academic supervisor Prof. Dr. Özgür Erdur Baker for her encouraging me and directing me when I was lost in the middle of theories and pages. With her encouragements, this thesis could have been written. I learned a lot from her both academically and personally. I wholeheartedly thank the committee members, Prof. Dr. Semra Sungur, Prof. Dr. Tuncay Ergene for their comments, and help. In all meetings, they showed new perspectives to me and enriched the study. I am grateful to Assist. Prof. Sibel Akmehmet Şekerler for her enthusiasm while guiding me through the qualitative research in my master years. She is an idol for me with her counseling skills, humanistic and very kind nature of personality. I want to thank to Assist. Prof. Duygun Göktürk Ağın for her suggestions regarding the phenomenological research and gender issues. Her perspective for gender issues would be an example for me. I need to express my love and thankfulness to my husband, Hasan. When I was writing my master thesis, he was my colleague, and a new friend. Now, he was my best friend, and my husband. I am very appreciative of the love, encouragement, positive energy and patience shown by him. I would like to express my deepest gratitude to my friend, Sercan. We met in METU, and I hope our friendship would continue. Thanks for all your support. It was very comforting to know that you were always there, and ready to help. I am forever grateful to my family. My mother always wanted us to work for our purposes, dreams and at the same time, enjoy the life we have had. My father was an idol for me because he has been always successful what he was doing at that moment. My sister, Büşra, always trusted in me and made me feel that I could resolve any problem in the life. I wish to state my thanks to Mehmet Ali Padir, with whom we helped each other to deal with the thesis issues. He could have dealt with my anxiety and help me as much as he could. Coffee breaks we had were the good times to be remembered. Thanks for Ayşe Ulu Yalçınkaya, Hilal Döner, Mustafa Alperen Kurşuncu, and Özden Sevil Gülen. We shared our PhD years that may be harder without you. viii Thanks for the friendship and devotion you showed to me: Melike, Sevda, Nihal, Kübra, Çiğdem, Meltem and Canan At the moment that I lost my hope, Merve Kaştan came out all of a sudden. She is probably the best home mate ever. Thanks for making me believe again to the existence of good people in the world. Thanks to Seda Akdemir for her advices both for the thesis and for the life. I appreciate the help by Burcu Tümkaya and Pelin Sarıkaya during the writing of this thesis. I want to thank to people who were very patient when I told them I had to study. Özge Öveç and Murat Sağınç, Songül Çavdar, Merve Yakar, Melike and Taha Şen, Levent and Pervin Şit, Burak and Ceyda. Marriage has lots of meanings in different contexts. For me, with marriage I met very nice people, and my family has broadened. Thanks for their support and patience: Nagehan and Mehmet Çelebi; Gamze, Fatma and Ali Aydın. I also want to thank to Mustafa Ölçüm for his continuous support and advices. During all the process, he could help me as much as he could, with all the success stories that inspired me. My colleagues, Meltem, Jale, Gülşen and our manager Emel Zeynep Dansuk were the ones who supported me during the doctorate education. Thanks! ix TABLE OF CONTENTS PLAGIARISM ........................................................................................................................ iii ABSTRACT ............................................................................................................................ iv ÖZ...........................................................................................................................................