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

Résumé

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.