32 Grief and Loss Across the Lifespan
worry about the health and well-being of themselves and their fetuses, the
more likely they will have problems. Mindfulness, yoga, and other medita-
tion techniques assist pregnant women in reducing stress (Beddoe, Paul
Yang, Kennedy, Weiss, & Lee, 2009) (see also the websites http://www.noetic
.org/education/self-study/mindful-motherhood-course and http://www.mindful
.org/mindful-magazine/mindful-pregnancy).Social Aspects of Pregnancy
Societal messages about pregnancy and the reinforcement of various behaviors
during a woman’s youth such as playing house and babysitting can influence
her feelings and behavior regarding the pregnancy. The lessons learned are
culturally derived and generally fit that woman’s ethnic, racial, religious, and
generational contexts. In some countries, women avoid medical care because it
is believed merely to cause problems (and indeed, in countries where women
are lacerated or flogged during labor to scare away bad sprits, or told to confess
if they are having difficult labors, this suspicion may make sense) (Evans, 2013).
Yet even in Westernized nations, cultural heritage and religion will influence
expectations, attitudes and practices regarding pregnancy, beliefs about the
fetus, and childbirth (Schott & Henley, 1996). Societal messages in the United
States in postcolonial times through the 1950s dictated that pregnant women
should avoid any physical labor and should be coddled and focus inward,
scripting women’s behavior in the early part of the 20th century. When these
societal messages changed, pregnant women expected to work until the onset
of labor, give birth, and continue with work as soon as physical recovery was
complete (as in agricultural societies and recent U.S. feminist culture). Women
who elect to step outside the norms of their culture are likely to be ostracized
(Schott & Henley, 1996), providing feedback to other pregnant women about
desired behaviors. An example of this is the relatively rapid change in U.S.
culture that allowed pregnant women to drink alcohol while pregnant in the
1970s, then saw alcohol consumption in pregnancy as a public health problem
that might warrant criminal prosecution (Golden, 2000, 2011).
Similarly, early-stage pregnancy was socially ignored until the 1970s when
it became ever more imbued with notions of “life” and value (Freidenfelds,
2013). Cultural components play an active role here. Some social environments
(consider poor, developing countries) give very clear messages that pregnancy
loss levels are high and that it is best to avoid giving much thought to a preg-
nancy until very close to delivery. Other social environments (especially cur-
rent U.S. culture) encourage early pregnancy testing, visualizing the fetus on
ultrasound and often even naming the fetus from the moment one is aware
of its existence. Again, failure to adhere to the given norms brings sanctions
from family members, friends and pregnancy-care providers. When messages
about norms are in conflict or discrepant, this seems to make the emotions and
lessons even more complex and challenges coping capacities (McCoyd, 2009a).
Emotion work (Hochschild, 1979) is socially guided and is consciously
used by pregnant women motivated to maintain a sense of health, cope with
negative events, manage pain, and achieve the desired birth (Carter & Guittar,
2014). Emotion work involves women bringing their emotions and emotional