Communicatively coping with miscarriage: The impact of emotional support and narrative coherence on women\u27s individual and relational well -being

Miscarriage may be a frightening and difficult event. In times of difficulty, such as miscarriage, individuals may have trouble communicating about their experiences. Even though some women are unaware of their miscarriages and others view their miscarriage(s) are insignificant events, most women who have knowingly experienced a miscarriage consider it an emotionally painful event, particularly when they feel they have lost a baby they had grown attached to (Kirkley-Best & Kellner, 1982; Malacrida, 1997; Reinharz, 1987). Despite this potential difficulty, little is known about how individuals communicate about this type of trauma. Research on narrative suggests that “storying” one’s difficulties is the primary way that individuals make sense of traumatic experiences (Pennebaker, Mayne, & Francis, 1997; Weber, Harvey, & Stanley, 1987). Additionally, stories that are more complete, organized, or coherent may be more likely to facilitate coping. In a stressful experience like miscarriage, creating a coherent narrative may help women understand their experiences and may aid them in coping with grief. Even with the evidence of the benefits of creating narratives, little research has examined what might help to facilitate narrative sense-making. One factor that may lead individuals to the process of narrating their experiences is social support. Supportive communication is an essential component within the formation and development of interpersonal relationships (Burleson, Albrecht, Goldsmith, & Sarason, 1994). Additionally, research shows that talk may aid in the coping process (Caplan, Haslett, & Burleson, 2005; Pennebaker, Zech, & Rimé, 2001). However, miscarriage is often not talked about by spouses or members of one’s social network, because of gender differences (Black, 1992; Puddifoot & Johnson, 1997), and the taboo nature of the topic (Rajan and Oakley, 1993; Ujda & Bendiksen, 2000). Thus, talking through the experience of miscarriage may facilitate one’s ability to cope and more completely narrate her experience. In this study, 140 women who had experienced a miscarriage completed an online questionnaire designed to assess support from one’s spouse, a member of one’s social network, support from the Internet, and well-being and marital relational satisfaction. Participants also wrote out the story of their miscarriage experience. Stories were then rated and assessed for overall coherence. Results from a structural equation model indicate that narrative coherence did not mediate the relationship between various sources of social support and the outcome variables of overall well-being and relational satisfaction. However, spousal support was associated with decreased mental health symptoms and perceived stress and higher self-esteem. Spousal support was also positively associated with marital relational satisfaction following a miscarriage, whereas support from the internet was negatively related to marital relational satisfaction. Support from a member of one’s social network was not significantly associated with well-being or marital relational satisfaction, thus highlighting the importance of the spousal relationship following a miscarriage