The lived experience of miscarriage after infertility.

PURPOSE: To describe women's experiences of miscarriage after infertility treatments. Published studies in which fertile women were interviewed after miscarriage have found that the women universally look to another pregnancy as the solution to their grief. However, for women undergoing infertility treatments, the possibility of another pregnancy is not a certainty. Despite this, little is known about the unique experience of this group of women. Appropriate interventions based on evidence require research to discover these women's needs.
DESIGN: Phenomenology.
METHOD: Eight women who had experienced miscarriage after infertility were interviewed. Interviews were audiotaped and transcribed verbatim. Data saturation guided the sample size. Colaizzi's methods for phenomenologic analysis were used. Analyzed data were brought back to the women for fact checking and to ensure trustworthiness and reliability of the data.
RESULTS: Themes included : going back to "square one," an inner struggle between hope and hopelessness for future fertility, running out of time, anger/frustration, lack of understanding by others, guilty feelings, feeling alone/numb with their grief, and gaining strength from adversity. CLINICAL IMPLICATIONS: This study provides a first glimpse of women who miscarry after infertility treatments, and demonstrates that they feel profoundly alone, and grieve intensely. They worry that they caused the miscarriage, and find it difficult to hope that they will ever become pregnant again. Several women described being hospitalized for their miscarriage on postpartum units. This was unbearable for them, and should remind all of us in healthcare that this type of unthinking treatment of women who miscarry after infertility is not acceptable.