The hegemonic role of biomedical discourses in the construction of pregnancy loss

Abstract

Background and problemPregnancy is constructed as a joy-filled and natural experience with a taken-for-granted expectation that the outcome will be a healthy baby. However, in South Africa approximately 1 in 4 pregnancies end in miscarriage and the stillbirth rate is 24 per 100 live births. Despite the overwhelming statistics, reproductive loss is considered a cultural taboo and continues to be silenced in various ways by the medical fraternity and society in general. AimOur study aimed to demonstrate the role that biomedical discourses play in shaping both women’s experiences of reproductive loss as well as how those close to them respond to these losses. The study was located within a social constructionist framework. MethodsSeven South African women were recruited via snowball sampling to participate in in-depth interviews. A discourse analysis was conducted to deconstruct hegemonic discourses implicit in the participants’ dialogues. FindingsThe adoption of medical framing of miscarriage and the social awkwardness of loss framed the participants talk about their miscarriages. Our study highlights the centrality of biomedical discourses in influencing both the experiences of our participants as well shaping social discourses. The adoption of the medical framing of miscarriage were identified in the following themes: no answers to first trimester miscarriage and the normalization of miscarriage. The social awkwardness of loss were identified as lack of cultural scripts, lack of acknowledgement and unhelpful words and actions. ConclusionThe paper highlights the power inherent in medicine and demonstrates how this hegemony pervades societal understandings of reproductive loss. Caught in this crossfire are grieving mothers with few alternatives in terms of their grief processes.