Silent grief: A qualitative study on the emotional and social impact of early gestational loss.

BACKGROUND

Early gestational loss is a common event, yet its emotional and social impact is often underestimated. From the earliest weeks of pregnancy, many women develop a psychological bond with the baby and an emerging maternal identity. When miscarriage occurs, the loss is often perceived as the death of a child rather than a minor clinical episode, resulting in disenfranchised grief.

AIM: To understand the emotional and social experiences of women following early gestational loss.

METHODS

An interpretative phenomenological qualitative design was employed with a purposive sample of 17 women in Spain who had experienced early gestational loss prior to 22 weeks. Data were generated through in-depth online interviews and analysed iteratively guided by interpretative phenomenological analysis principles and COREQ standards.

FINDINGS: Three main themes emerged: the significance attributed to pregnancy as a "real baby"; the social silence and minimisation of the loss; and the subsequent emotional journey. The loss affects their identity as a woman. Participants described intense and persistent emotions such as sadness, guilt, loneliness, fear, and anxiety. Symptoms consistent with post-traumatic stress also appeared, particularly in subsequent pregnancies. Lack of social validation and professional support intensified suffering, whereas empathetic care and peer support facilitated grieving.

CONCLUSIONS

Early gestational loss represents an experience with a profound emotional, social, and identity‑related impact for women. There is a need to develop humanised healthcare models that acknowledge this grief and provide emotional and psychological support from the earliest moments. Midwives, as frontline professionals in perinatal care, play a pivotal role in recognising and validating this grief.