Health care support following miscarriage in Australia: a qualitative study. How can we do better?

Abstract

Miscarriage occurs in one in four pregnancies in Australia and commonly results in adverse psychosocial sequelae, such as clinically significant levels of depression and anxiety. Women also commonly report a lack of support, understanding and acknowledgement of their loss. Research has shown that poor health care support experiences serve to exacerbate adverse psychosocial outcomes. This study explored the support experiences of women affected by miscarriage and their views on what support is needed, when it is needed and who should provide it, as well as their recommendations for improvement. Sixteen Australian women were purposively sampled to participate in qualitative semi-structured interviews. Interview data was analysed using content analysis. Approximately half the women reported positive experiences with healthcare providers, but, despite this, almost all pointed to areas where support was lacking. Insensitive comments and lack of emotional awareness were common. Participants suggested areas for increased clinician support, including mentioning the possibility of miscarriage earlier in routine pregnancies, offering more information before and at the time of miscarriage, providing emotionally sensitive care and offering follow up and psychological support. Women wanted healthcare providers to be proactive in offering support, information and emotionally sensitive care at the time of miscarriage, rather than having to seek it out themselves. Suggestions to improve support after miscarriage included mentioning the possibility of miscarriage earlier, offering more information about miscarriage and psychological support options.