The World Health Organisation defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The miscarriage process itself affects the physical well-being: abdominal cramps, blood loss and falling pregnancy hormones. The mental well-being is undermined by the psychological trauma of loss and the heartbreaking experience of ending a pregnancy without a baby to hold. The social well-being is impacted because people in the patient’s social circle who have not experienced a miscarriage themselves may find it hard to empathise with what has occurred and how upsetting it may be; this may lead to unrealistic expectations of her recovery and/or avoidance of the issue, making the woman feel particularly isolated.
There usually are culturally appropriate accounts produced by individuals and societies about why miscarriages happen; these accounts may be used to excuse or blame women for miscarrying. In some villages in the Western part of Nigeria, miscarriage is attributed to spirits where traditional birth attendants have been known to advice the women to avoid movements in the midday and at nights because those are the times the evil spirits that can harm a pregnancy also move around. In Orba and Nsukka towns of Enugu state in the Eastern part of Nigeria, pregnant women are encouraged to eat a lot of ewedu, a vegetable believed to prevent miscarriage. The Journal of Medicinal Food has revealed Ewedu to be a good source of Iron while the African Journal of Biotechnology states that it may arrest threatened miscarriage specifically due to malnutrition or infections. In a study conducted in tertiary care centres in South-Eastern Nigeria, it was found that there was a drop in coital frequency in about 72% of the male partners of pregnant women; a significant predictor of reduced coital frequency was the belief that sex in pregnancy could cause miscarriage.
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