Culpability, blame, and stigma after pregnancy loss in Qatar

Halima Al Tamimi,Nadia Omar,Stella Major,Susie Kilshaw,Faten El Taher,Mona Mohsen

doi:10.1186/s12884-019-2354-z

Abstract

BackgroundFollowing a miscarriage many women report feeling guilty and culpable for what has happened particularly when aspects of societal blame and stigma are involved. This research investigated the impact of cultural context on the experience of miscarriage. In particular, it focused on how elements of stigma and blame are linked to notions of miscarriage etiology and risk among Qatari women.MethodsThe research used an ethnographic approach. The data was collected over 18 months of fieldwork in Qatar, using semi-structured face to face interviews, and participant observation. A purposive sample of 40 women (primary participants) who had recently miscarried, participated in the study. Potential subjects were initially identified in the Women’s Hospital and were consented, and then interviewed in Arabic either in the hospital or at their preferred location. The interviews were audio recorded, transcribed and translated into English. Additional key interviews were performed with 20 secondary participants related to the miscarriage cohort including family members and husbands. Inductive thematic analysis of content was performed manually to extract themes.ResultsTwo main themes emerged from the material looking specifically at miscarriage aftermaths: rhetorics of blame, self-blame and feelings of guilt; and miscarriage attitudes. Overall society is sympathetic and miscarriage is seen as normal and not particularly worrying, but understood to be upsetting to women. However, findings suggest there is some ambivalence around blame, culpability and stigma applied to miscarriage; some participants perceived miscarriage as a relatively normal and common event, whereas, others felt that miscarriage is resounding stigma and shame.ConclusionMiscarriage aftermaths are embedded in social, cultural and religious frameworks in relation to notions of risk and causation. Attention should be paid to ensure women and those around them are given appropriate and robust information about miscarriage causation to deflect discourses of blame that may be employed and reduce harm to women who suffer miscarriage.

Highlights

Following a miscarriage many women report feeling guilty and culpable for what has happened when aspects of societal blame and stigma are involved
Among the miscarried women who were approached, forty women participated in the study; one woman was ineligible to participate as she had experienced three consecutive miscarriages in the last six months, and three women were not willing to participate
Deviations from the expected gender role by miscarriage can be seen as a disruption in one’s reproductive life, and thereby, likely to be linked to stigma and self-blame [41]

Summary

Introduction

Following a miscarriage many women report feeling guilty and culpable for what has happened when aspects of societal blame and stigma are involved. This research investigated the impact of cultural context on the experience of miscarriage It focused on how elements of stigma and blame are linked to notions of miscarriage etiology and risk among Qatari women. In addition to its potential physical and emotional harm to the woman and family members [11], many women feel a sense of responsibility or guilt following a miscarriage [7, 8, 12, 13]. It can be associated with loss of self-esteem as women feel that they are unable to. Cultural, and state emphasis on pronatalism and a women’s role in reproduction, reactions of guilt and blame following a miscarriage are likely

Objectives

Methods

Results

Discussion

Conclusion