Part Three: When Not All Goes Well

The chapters in this section address the more problematic areas of motherhood: miscarriage and abortion, postnatal depression, and abusive parenting.

Miscarriages are frequent. Rates vary according to the woman's age, number of previous miscarriages, and whether or not unreported miscarriages are included. In what may be a conservative estimate, 15 per cent of all pregnancies end in miscarriage in the first trimester (British Medical Journal ). The loss of a pregnancy has a powerful impact on a woman and on her family. If the woman has other young children, they are often not informed, yet they will pick up something of the parents’ sadness and of their unconscious reactions. The child has then to make sense as best she or he can of his parents’ responses to this unknown but distressing event. Sometimes, its effects can be surmised in analysis when the child has become an adult.

One may see miscarriage as motivated by conscious or unconscious death wishes. But even when it is the result of medical complications, it may nevertheless trigger fears and phantasies that may be felt by the woman, consciously or unconsciously, to have had the power to cause the loss of the pregnancy.

Voluntary terminations of pregnancy are also very frequent: in 2009, the Department of Health have recorded 189,100 abortions in England and Wales. In the USA Remeikis (2001), in her review on

the psychoanalytic literature on the subject, reports there are one and a half million abortions in the United States each year.

Dinora Pines wrote on women's lifecycle, including miscarriage and abortion. In her book A Woman's Unconscious Use of her Body (1993) she collected her clinical papers on the female reproductive cycle. She describes how her patients in childhood internalised the relationship with their mother, and how their experiences as adults were shaped by an ‘interaction between Fantasy and Reality’ (p. 59). Her paper on miscarriage and abortion, reprinted in this volume (Chapter 9), highli