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Conceptual Framework

Loss

Stages of Grief: Denial Anger Bargaining Depression Acceptance Mothers with Miscarriage Chronic Sorrow

Effects of Loss

Management of Loss Process

Extent of Support

Lived Experiences of Mothers with Miscarriage

The Conceptual Framework explains the relationship between concepts that this research study is focusing on and its relationship with the supporting theories that will guide the interpretations of the significant statements from the research participants. The process will start with the occurrence of miscarriage by the other that will cause a disparity between what is the ideal and what is real leading to the mothers experience of loss. As the mother experience Loss, effects of the loss will then be noticed and observed by the people around her. Effects of the loss cover all aspects of a mothers life including the physical, emotional, social, intellectual and even spiritual part. As the people around her get to notice the effects of loss to them, support of all kind will be given by them to assist the mothers as they deal with the loss and with that support mothers are able to manage the feelings of loss. Two possible outcomes might be taken into consideration as the mothers deal with the loss. One is the positive outcomes where the mother will undergo the 5 Stages of Grief as specified by Elizabeth Kubler-Ross (1969) which starts with the Denial stage, followed by the Anger Stage, afterwards the Bargaining stage, then the Depression stage and lastly the Acceptance stage where the mothers have already dealt with loss and ready to continue her life. The other one is the negative outcome of dealing with loss that leaves the mother in a state of non-acceptance of reality which increases the discomfort and strengthened the feelings of chronic sorrow of the mothers.

Table 1 presents the General Effects of Loss to the Mothers

Positive Response -Acceptance -Faith -Diversion

Negative Response -Pain -Bargaining -Sadness -Regrets

PAIN

When you lose something valuable to you, it affects you in several aspects of your life and one is your emotional aspect. Burke et al (1999) defined the concept of chronic sorrow as an ongoing disparity which results from a loss. Loss in this case triggers the emotion of chronic sorrow that further ends up with depression or sadness which is defined by Kubler-Ross (1969) as the fourth stage of the grief process. Kubler-Ross also stated that when a mother experienced depression through a miscarriage, the mother will not just lose her baby but also the joy and fulfilment that it brought to her.

SADNESS

Crying is an effective way to express and release an inner emotion that seems to burden you inside. When sadness envelops a person, it triggers an emotional breakdown to the mother because of the combined factors such as the prominence of loss, the emotional effects of it as well as the environmental aspects that may intensify the grief that the mother is experiencing. Sadness is a normal process that a bereaved person will experience, especially if the attachment to the lost thing is prominent but it might differ from one person to another considering the extent of bond that person had with the lost thing and also the way people handle loss may be different in the sense that some people tend to view things in different perspectives. (Hinton 2012)

ACCEPTANCE

All of us have our own interpretation of loss and how we will manage it, according to Sheri and Bob Stritof (2009) Acceptance is a long process that will require tons of courage and patience not only by the mothers but their significant others as well. Gerber-Epstein et al, (2009) once stated that anger is one thing, but acceptance is another and it is the only way to move on; meaning when a mother is able to accept the situation, it means that she is moving on with her life and building a positive outlook of the future.

DIVERSION

Diverting the attention to other more joyful and positive things is a defensive stance that most people not only mothers who experienced loss will consider doing. It is somehow an escape from reality of the loss but on the contrary, people tend to accept things when they have other else to attend to hat will hinder hem from thinking about the problem and focus mainly on the new thing.

FAITH

The American Pregnancy Website (2011) noted that mothers tend to require or need a more supportive environment, especially during the time they are facing loss and grief because it helps them a lot to go through the process of acceptance of loss. The society we have today seems to have a negative connotation about the idea of miscarriage, which is why the immediate family of the mothers as well as other significant people will surely help them have a more positive outlook and acceptance of the situation. In this case, the faith of the mother helps her get through the process of loss and is what is providing her with a positive outlook in life aside from the support she is getting from her spouse and relatives.

REGRETS

Kubler-Ross (1969) in her 5 stages of grief theory defined bargaining as one of its stages which implies the idea of regret in a manner where statements with if or if only are being observed. Regrets are felt when you wish you could do more to prevent an untoward event from happening. Since miscarriage is an unexpected incident, mothers tend to have regrets about their pregnancies like they would say that they should have taken more care of themselves when they are pregnant or if they have done this or did that would it make any difference.

BARGAINING

The third stage of the grief process according to Kubler-Ross (1969) is bargaining that comes after anger. This stage technically speaks about the mothers thoughts about the miscarriage that helps her attain peace of mind and gives her the benefit of the doubt that she hasnt done anything that causes the problem. Statements by the mother like Wala naman akong ginawang masama and wala naman akong ininom na gamot are exampl es of statements that clearly identify that the mother is under the stage of bargaining because she is clearing her thinking that she hasnt done anything that could or would have caused the unpleasant event to the unborn child.

SUMMARY
The general effects of loss to the mothers are divided into positive and negative responses. The study found out that the general effects of loss to the mothers is more than the positive which means that mothers truly went to the process of pain and the emotional breakdown from the loss of their child. Pain is the feeling that we felt when we lose something valuable to us, Bargaining is the doubt that we didnt do something wrong that causes the problem, Sadness is an emotional pain associated with loss which leads to emotional breakdown and crying, and Regrets is something that you wish that you didnt do to avoid untoward event to happen, these formulated themes are considered as negative response because they causes negative effects to the mothers.

Table 2 presents the Support that he Mothers are getting as they deal with the Loss Great Support -Acceptance -Faith -Support -Pain No Support

SUPPORT

Since the mothers are in a breakdown state, support coming from her significant others is vital for her to be able to get going and continue her life. Miller (2011) noted that it is through the own will and initiative of the relatives to support the grieving mother because most mothers tend to be socially isolated and unaware of their environment once they experienced something awful like miscarriage. Physical support is important since most physical problems might manifest in the mothers. This is to ensure their physical recovery and health. Emotional support is the most vital one because mothers tend to be damaged emotionally more than other aspects of her life. Emotional help will guarantee that all affected wounds will be healed. Financial support is important also since none of the treatments will be done if not with financial considerations.

FAITH Limbo (2010) in his article wrote that various aspects of a mothers life affect her ways in dealing with loss and one of these aspects is the religious affiliation the mother has. It greatly affects her perception of loss and the way she manages the process of acceptance.

ACCEPTANCE

All of us have our own interpretation of loss and how we will manage it, according to Sheri and Bob Stritof (2009). Acceptance is a long process that will require tons of courage and patience not only by the mothers but their significant others as well. Gerber-Epstein et al (2009) stated that anger is one thing, but acceptance is another and it is the only way to move on, meaning when a mother is able to

accept the situation, it means that she is moving on with her life and building a positive outlook of the future.

PAIN

Danielsson (2011) emphasized that both mother and her spouse experience depression/anxiety meaning a miscarriage doesnt only cover the mothers but it encompasses even the people close to the mother. Limbo (2010) in his article wrote that it is not just wished child who was taken away from the couple when miscarriage occurs, but the hopes and dreams of having a family vanishes as well, which is why, it is really painful for them to accept the scenario.

SUMMARY

The support that the mothers get from their husband, family and relatives as they deal with loss is divided into great support and no support. The study found out that husband, family and relatives actually gave the great support needed by the mothers as they come along the process of loss and acceptance Acceptance is a long process that require tons of courage and patience not only by themselves but also from their husband and significant others, Faith is the strong religious belief and trust to God. And Support is drawing loved ones close providing anykind of assistance offered wether a shoulder to cry on or financial support. These formulated themes are considered a great support for mothers as they come along the process of loss.

Table 3 presents the Management ways utilized by the Mothers to deal with Loss
Effective Management -Acceptance -Faith -Compliance -Diversion Ineffective Management -Sadness (Crying)

COMPLIANCE

Do what your doctor tells you and your condition will improve or at least be far less likely to worsen as stated by Hofmann (2009).

ACCEPTANCE

All of us have our own interpretation of loss and how we will manage it, according to Sheri and Bob Stritof (2009). Acceptance is a long process that will require tons of courage and patience not only by the mothers but their significant others as well. Gerber-Epstein et al (2009) once stated that, anger is one thing, but acceptance is another and it is the only way to move on, meaning when a mother is able to accept the situation, it means that she is moving on with her life and building a positive outlook of the future.

SADNESS (Crying)

Zipp (2012) stated in her article that it is a perfectly normal reaction and is the mind's way of dealing with the emotional overload of the miscarriage. Because miscarriage can occur very quickly, the impact on both mind and body can be profound and thus, the need for this personal space is a necessity.

DIVERSION

As stated by the website HTDW Community (2012), after getting over the initial loss of their unborn child, many women have been found to blame themselves for the miscarriage. Women start thinking that they must have done something wrong and that they did not take good care, so thats why the miscarriage happened. They start finding fault in everything they did and even remember the smallest of details which they feel was the cause of miscarriage. What women need to realize is that sometimes miscarriages are a result of things beyond their control. Sudden medical emergencies of history of miscarriage in the family are also contributing factors. Women need to stay away from such thoughts and stop blaming themselves.

FAITH

The HTDW Community (2012) posted in its website that if mothers follow a religious tradition, a mother should embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you such as praying, meditating or going to church can offer solace. If youre questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community. SUMMARY
The management ways utilized by mothers as they deal with loss is divided into effective and ineffective management. The study found out that mothers who experience miscarriage were able to utilized an effective management as they deal with loss by acceptance, faith, compliance and diversion. Acceptance is a long process that require tons of courage and patience and acceptance of reality that it is gone and it cant be back anymore, Faith is the strong religious belief and trust to God, Compliance is complying to what the doctors wanted you to do to help easily recover from loss or to avoid condition to worsen. And Diversion is diverting of emotions or feelings from someone that we lost to turning aside to someone or something that we wanted our attention to draw. These formulated themes are considered effective ways to utilized mothers feelings when they dealing with loss.

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