An exploration of how women in the UK perceive the provision of care received in an early pregnancy assessment unit: an interpretive phenomenological analysis

Abstract

ObjectiveThe objective of the study was to explore how women experience care within an early pregnancy assessment unit (EPAU) and how they are helped to understand, reconcile and make sense of their loss and make informed decisions about how their care will be managed following a first trimester miscarriage.DesignThis was a single centre, prospective qualitative study. An interpretive phenomenological analysis approach was used to interpret the participants’ meanings of their experiences. It is an ideographic approach that focuses in depth on a small set of cases to explore how individuals make sense of a similar experience.SettingAn EPAU in a large teaching hospital in the Midlands that provides care to women in their early pregnancy, including those experiencing pregnancy loss.ParticipantsA purposive sample of 10 women were recruited to this study. All of the women were either miscarrying at the time of this study or had miscarried within the previous few weeks.ResultsSix superordinate themes in relation to women’s experiences of miscarriage were identified: (1) the waiting game, (2) searching for information, (3) management of miscarriage: no real choice, (4) the EPAU environment, (5) communication: some room for improvement and (6) moving on.ConclusionsThis study found that improvements are required to ensure women and their partners receive a streamlined, informative, supportive and continuous package of care from the point they first see their general practitioner or midwife for support to being discharged from the EPAU. The provision of individualised care, respect for women’s opinions and appropriate clinical information is imperative to those experiencing miscarriage to help them gain a degree of agency within an unfamiliar situation and one in which they feel is out of their control.

Delivering unexpected news via obstetric ultrasound: A systematic review and meta‐ethnographic synthesis of expectant parent and staff experiences

“…Twenty‐four were in expectant parents and four were in HCPs. These were published between 1994 25 and 2018 26,27 and included 637 participants (581 expectant parents/56 staff). HCPs were obstetricians, 26,28 nurses and midwives 29 and sonographers 30 .…”

“…Seven studies reported ethnicity data. In two, all participants were White, 38,40 in two, >90% of participants were White 10,36 and in three, >10% of participants were from a non‐White ethnic group 27,37,39 . Most studies used qualitative interviews (n = 23) and five used mixed methods 25,30,31,39,40 .…”

“…However, parental expectations were less positive when there were concerning symptoms such as bleeding 29 . Some parents in these situations waited anxiously for scans to confirm the viability of their pregnancy and overestimated the diagnostic capabilities of ultrasound 27 …”

“…Parents progressed from their initial shock to consider the decisions and provisions that would need to be made 25,27,32‐34,36‐39,41,42,44,45,47,49 . Feelings of anxiety were common 33,36,39,47 .…”

“…They did not want to be asked to make decisions immediately 25,37,38 but they needed follow‐up appointments and test results quickly 36,47 . Parents were keen to understand the opinions of their HCPs 36,44 but wanted HCPs to support them to make their own choices 25,27,37 . When parents had experienced a miscarriage or still‐birth, management options were often limited 27,45 .…”