Abortion

Although induced and spontaneous abortion both involve the death of a fetus there are important differences in these experiences. In the former, pregnancy ends through an individual's choice while the latter is not because of, but often in spite of, the woman's and professionals' best efforts to save the baby. Women who have miscarried are often distressed by staff usage of the term ‘spontaneous’ abortion as this carries an unpleasant connotation and so this will be referred to as ‘miscarriage’ in this chapter.

Miscarriage

Up to 20% of recognized pregnancies end in miscarriage, defined as a pregnancy loss up to 24 weeks of gestation. Studies suggest that anxiety symptoms may be elevated for many months afterwards and a proportion of women may show depressive symptoms (Geller et al., 2004). Miscarriage has been compared to bereavement but the process of coping may be complicated by the abstract nature of the loss and the absence of memories of an individual. The loss is often hidden as many women will not have shared the news of their pregnancy at such an early stage and the support that unpleasant events often generates, may be absent. Our society lacks ritual acknowledgement of miscarriage and the prevailing view is often exemplified by the phrase ‘it was for the best’. A further aspect that is increasingly recognized is that miscarriage can be considered as a potentially traumatic experience. It clearly involves loss of life, and often fear, pain and loss of blood (Lee & Slade, 1996).