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The experience of miscarriage in England and Qatar

Despite recent scholarly interest in women's health and reproduction, an area that has remained neglected is reproductivedisruptions - when the linear narrative of conception, birth and the progress of the next generation- are, in some way, interrupted (Inhorn 2007). It is these moments of problematised reproduction upon which this research focuses, by investigating pregnancy loss to provide a focused and contemporary anthropological look at the issue. A cross-cultural comparison is at the heart of the project with ethnographic research conducted in two settings: Qatar and England.

The main objective of this work was to collect nuanced and detailed data about the experience of pregnancy loss. At least one in five known pregnancies end in miscarriage (Royal College of Obstetrics and Gynaecology 2008) and, thus, it is an extremely common women's health issue. Furthermore, it has the potential to cause significant physical and emotional harm for the woman and those close to her. The research aims to make a significant contribution to a considerable medical problem by gaining knowledge about the experience of miscarriage and move towards improving care for women who are miscarrying.

Miscarriage is often met with silence: this is an experience were it might not be possible to articulate one's true feelings, so women may express themselves as much through what they do as what they say. This is why a key technique in this research will be an approach from material culture studies. We observed attitudes expressed in clothing, home decoration, gifting and other activities regarding both the mother and the expected child. 

We looked at miscarriage as a social event as much a biomedical one, which influenced by a number of factors including: the meaning placed on bearing children and notions of motherhood, religious and cosmological understandings of the foetus and of loss, ideas around foetal personhood and notions of pregnancy risk. The social, technological and medical context in which pregnancy loss occurs will affect the ways in which women experience such an event. Advances in medical technology and low infant-mortality rates have raised expectations as to the successful outcome of each pregnancy in both contexts. The early confirmation of pregnancy means that women are aware of pregnancies at a much earlier stage than in previous generations. This is likely to impact experiences of pregnancy loss, as miscarriage which might have gone unnoticed or unconfirmed are now experienced as loss. Furthermore, such early detection means women are aware of However, social norms around reproduction and family structure, such as family size and fertility rates, differ in these contexts which are likely to impact miscarriage experience and management. The research looked at mourning rituals and behaviours around miscarriage in these two settings.

The ethnographic research explored the following questions and themes:

  • What is the cultural understanding of conception and the pregnant body and how does this affect how pregnancy loss is understood?
  • How is "the baby" perceived, constructed and negotiated differently in different cultural settings? For example, when is a foetus considered a human or part of society? At what point is the pregnancy made public- for this will affect the way a miscarriage is managed?
  • How is a mother born? We often forget that the birth of a baby is simultaneously the creation of another kin category: that of mother. So the loss of a baby may also be a loss of motherhood with considerable repercussions for the woman in question, both individually and in her relationship with her family.
  • How do new medical technologies technologies impact on the way foetuses are perceived? For example, does the common practice of early scanning in Qatar contribute to investing the foetus with personhood at an early stage?
  • What is the relationship between childbearing and childbirth relate and the role of women in society? Family size and rates of reproduction differ greatly between the Qatari and the English context. How does this affect experience of miscarriage?
  • What are the different social beliefs regarding the causes, preventative measures and curative treatments of miscarriage? How does this fit in with notions of risk and blame?
  • What are the practices and behaviours around miscarriage? Are there rituals, either formal or informal? Who is told of a miscarriage?
  • How does the father experience miscarriage? What is the role of the father in the experience of miscarriage?

Qatar

The research team followed 20 women through their pregnancies to better understand more about the experience of pregnancy in Qatar. We interviewed 40 Qatari women who recently experienced a miscarriage. Health professionals, religious leaders, traditional healers and family members were included in the research.

England

We interviewed 40 women in England who recently had a miscarriage. In depth interviews were conducted with these women and, at times, their partners.

Please contact Susie Kilshaw  (s.kilshaw@ucl.ac.uk) if you are interested in hearing more about the research.

Publications and Outputs

2018. Kilshaw, S. (available online 2017) Qatari Intersections with Global Genetics Research and Discourse. Anthropology and Medicine

2017. Kilshaw, S. Birds, meat, and babies: The multiple realities of foetuses in Qatar. Anthropology and Medicine 24(2): 189-204.

2017. Kilshaw, S. "How culture shapes perceptions of miscarriage". Sapiens.

2017. Kilshaw, S., Omar, N., Major, S., Mohsen, M.,  El Taher, F., Al Tamimi, H., Sole, K., and D. Miller Causal explanations of miscarriage amongst Qataris. BMC Pregnancy and Childbirth. 17(250): 1-12.

2016. Kilshaw, S., Miller, D. Al Tamimi, H., El-Taher, F., Mohsen, M., Omar, N., Major, S. and K. Sole. Calm vessels: Cultural expectations of Pregnant Women in Qatar. Anthropology of the Middle East 11(2): 39-59.

We have a number of publications in process at the moment and will update this page periodically. The team have also been working with hospitals in Qatar to help improve care for women who miscarry. 

Research Team:

Dr Susie Kilshaw (UCL Anthropology); Prof Danny Miller (UCL Anthropology); Dr Krtistina Sole (Weill Cornell Medical College Qatar); Dr Stella Major (Weill Cornell Medical College Qatar); Dr Halima Al Tamimi (Hamad Medical Corporation, Qatar); Dr Faten El Taher (Hamad Medical Corporation); Ms Mona Mohsen (Weill Cornell Medical College Qatar); Ms Nadia Omar (Weill Cornell Medical College Qatar)

The research is funded by the Qatar National Research Fund through their National Priorities Research Programme (grant number: NPRP No.: 5 - 221 - 3 - 064