Post-Miscarriage Coping Strategies Admist The COVID-19 Pandemic: A Qualitative Descriptive Study

Abstract

Miscarriage is a relatively common occurrence, affecting up to 26% of pregnancies. Despite its prevalence, miscarriage remains stigmatized and under-discussed, often leaving women to grieve in silence. The COVID-19 pandemic further exacerbated global mental health, increasing psychological vulnerability among pregnant, postpartum, and bereaved women. This study aimed to investigate coping strategies of women who suffered a miscarriage during the COVID-19 pandemic in North Carolina. This was a secondary analysis involving in-depth interviews with 18 women who experienced miscarriage(s) between March 30, 2020, and February 24, 2021. Of the 18 women, six had more than one miscarriage during the time frame. Participants described how both the miscarriage and the pandemic influenced their mental health and coping processes. Directed content analysis was applied using 14 coping strategies based on the COPE Inventory. After applying the 14 coping strategies, 11 were retained and eight new categories were inductively derived from the data. The final 19 coping strategies were organized into five broader coping themes: Problem-focused Coping, Social Coping, Emotion-focused Coping, Maladaptive Coping, and Meaning-focused Coping. Findings reveal that the most frequently reported strategies were seeking emotional social support followed by seeking instrumental social support. Participants also described significant challenges in coping due to social distancing restrictions, limited access to mental health resources, and extensive feelings of isolation. The COPE Inventory did not fully capture the depth and complexity of coping described by participants, accounting for the emergence of eight additional categories. This expansion highlights the diverse ways women sought to cope with and care for their emotional and mental well-being while navigating the challenges of the COVID-19 pandemic.