Date of Award

August 2015

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Mike Allen

Committee Members

Nancy Burrell, Hayeon Song, Patricia Stevens, Sarah Morgan


Disenfranchised Loss, Health Communication, Miscarriage, Narrative, Pregnancy Loss, Women's Stories


Guided by Harter’s narrative framework for health communication this thematic narrative analysis sought to understand women’s experiences of early pregnancy loss with focus on sense making and communication by gathering stories from women who lost a wanted or accepted pregnancy at or prior to at twenty weeks in utero. Ten women ranging in age from twenty-six to seventy years old participated. Time since loss experience ranged from two months to forty years prior to the interview. Ellingson’s crystallization technique was employed with focus given to creating two related texts. Analysis of both individual core narratives at the time of loss and sub-stories located across the entire interview data strengthened early pregnancy loss understanding. Three core narrative summaries provide commonalities of experience within the following convergent core narratives: (a) conceptualization (what was lost?) (b) secret motherhood (disenfranchised grief), and (c) anchoring emotions (talking helps). Two sub-stories occur throughout the data, lost at sea and processing EPL. Lost at sea consists of three themes: (a) blindsided by the unexpected, (b) lack of acknowledgment within interpersonal interactions, and (c) EPL as marginalized by society. Processing EPL consists of: (d) cause of EPL, (e) emotional anchors, and (f) “time heals…it doesn’t erase.” The six themes indicate participants’ shared reactions from the first moments of experiencing loss to current understandings of the EPL experience. The three core narratives symbiotically interact with the six themes to provide a coherent picture of the participants’ early pregnancy loss experiences. Stories gathered provide a depth of understanding early pregnancy loss experiences and communication surrounding the topic both closer to the time of incident and how women understand the experience at the time of interview. Results contribute support for and extension of existing knowledge of disenfranchised grief and the power of the story in the context of early pregnancy loss. Results suggest that in situations of disenfranchised grief of early pregnancy loss, the first step in moving toward working with and/or living in one’s new normal is the ability to speak of the early pregnancy loss. The results provide a deep understanding of the emotional turmoil women experience at time of early pregnancy loss and how the emotions may resurface many years after the event. The new normal exists on a continuum. Women often continue to understand, live into, and with the unexpected early pregnancy loss years beyond the occurrence. As demonstrated through participant’s stories, even though the pain remains the ability to create an alternative option to the original family plan exists. As the data demonstrates, women experience communicative interactions that fail to acknowledge EPL and that acknowledge EPL. Often communication regarding early pregnancy loss is described as societally and interpersonally disenfranchised, silenced, dismissed, and not talked about. Apparent in the stories, the inability to acknowledge and talk about EPL within interpersonal and societal contexts detracts from a woman’s ability to work through the emotions that accompany such a blindsiding event. However, when interactions involve the acknowledgment of EPL, communication is described as anchoring, supportive, and assisting with coping with the pain of loss. Particularly salient to participants’ adjustment to the situation, or new normal, were the memorable moments where practitioners said or did things that positively impacted the participants’ EPL experience. Participants’ stories indicate women benefit from telling stories of early pregnancy loss. The stories remain present long beyond the loss occurrence, highlighting the potential need for more discussions to occur both with women recently experiencing early pregnancy loss and women carrying the secret motherhood story years beyond the occurrence. Understanding “time heals…it doesn’t erase” may warrant further investigation of stories from women experiencing early pregnancy loss and the need to provide discussion with an avid, empathic listener. Women may benefit from anchoring conversations whether the loss occurred recently or long ago.

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Communication Commons