Pregnancy Loss and Experiences of Support Among Syrian Refugee Families Displaced in Lebanon

Background & Purpose: In addition to the multiple losses experienced by refugee families—loss of loved ones, loss of home, loss of country—more than 15% of families will experience pregnancy loss, defined as miscarriage or stillbirth (World Health Organization, 2022). Feelings of stigma, shame, and guilt may be common after experiencing such a loss. Many families do not receive appropriate and respectful care when they lose their baby. And factors such as the presence or absence of support networks may help to exacerbate or ameliorate these feelings. Despite being such a common experience for women of childbearing age, pregnancy loss is still an under-researched and under-discussed topic, especially in war-affected contexts. Furthermore, nearly all research on pregnancy loss focuses exclusively on mothers and does not consider the impact of such loss on fathers or the family as a unit of analysis.

Methods: The research used a qualitative phenomenological approach to explore pregnancy loss among Syrian refugee families who have been displaced and are living in Lebanon. The foundation of the research was 13 collaborative family interviews (CFIs) with mother-father dyads (n=26) who had experienced pregnancy loss within the past 5 years. CFIs were followed by one-on-one interviews with just the mother (n=15) or father (n=12) and two focus groups with mothers (n=8) and fathers (n=7) who had experienced pregnancy loss. The viewpoints and experiences of practitioners (physicians, midwives, nurses, etc.) were elicited through one-on-one interviews (n=3) and four focus group discussions (n=10). In total, 36 mothers, 32 fathers, and 13 practitioners participated in the research. The data were organized using Dedoose and analyzed using interpretive phenomenological analysis. The findings were organized into the following themes: supports, attitudes, contextual factors, psychosocial impacts and recommendations. This paper focuses on supports.

Results: The data uncovered three themes related to supports for families who have experience pregnancy loss. The first theme—formal supports—included the attitudes and actions of medical and mental health professionals towards families who have experience pregnancy loss and community outreach or awareness raising programs that are primarily geared towards women of childbearing age. The second theme—informal supports—included a range of mechanisms that can help or hinder a family’s healing process. Some examples of informal supports that were relevant in the data included one’s partner (e.g., husband or wife), family support including extended family such as in-laws, community support from neighbors or friends, religious support within the community, and cultural support delineated by the customs and traditions that Syrians engage in to address pregnancy loss. The third theme explored barriers to support, which included financial, legal, access, and awareness of supports.

Conclusions & Implications: This research adds substantially to the sparse literature on the experiences of pregnancy loss among refugee populations. By focusing on a variety of formal and informal supports that both hinder and help families through an oftentimes challenging period, the research suggests ways that social work practice and policy may be improved to better meet the needs of war-affected and displaced families.