Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review

Abstract

Background Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner’s miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research. Aims The aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings. Methods A systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity organisation websites, Google, and OpenGrey. A Mixed Methods appraisal tool (MMAT) and AACODS checklist were used to assess the quality of primary studies. Results Thirty studies were included in this review representing qualitative (N = 21), quantitative (N = 7), and mixed-methods (N = 2) research from eleven countries. Findings indicated that women and men’s emotional wellbeing is influenced by interactions with health professionals, provision of information, and the hospital environment. Parents’ experiences in hospitals were characterised by a perceived lack of understanding among healthcare professionals of the significance of their loss and emotional support required. Parents reported that their distress was exacerbated by a lack of information, support, and feelings of isolation in the aftermath of miscarriage. Further, concerns were expressed about the hospital environment, in particular the lack of privacy. Conclusion Women and men are dissatisfied with the emotional support received in hospital settings and describe a number of hospital-related factors as exacerbators of emotional distress. Implications for practice This review highlights the need for hospitals to take evidence-informed action to improve emotional support services for people experiencing miscarriage within their services.

A assistência multiprofissional no apoio integral as mulheres acometidas pelo aborto espontâneo: uma revisão sistemática

“…Partindo dessa percepção, foi visto que, os profissionais de saúde desempenham um papel fundamental na formação da experiência de aborto espontâneo de homens e mulheres e influenciam no seu bem-estar emocional. Estar exposto à perda perinatal diariamente pode levar os profissionais de saúde a ver esse problema como de responsabilidade médica (Galeotti et al, 2022).…”

“…Além disso, se destacou a necessidade da assistência também aos homens, por parte da equipe de saúde, considerando que eles frequentam o hospital com suas parceiras, e também faz parte do planejamento familiar, porém, muitas vezes eles podem se sentir excluído. Outro pronto, considerável para minimizar o sofrimento da família foi fornecer níveis suficientes de informação, mostrou poder reduzir o sofrimento associado ao aborto espontâneo (Galeotti et al, 2022).…”

“…Uma necessidade também identificada por parte das mulheres foi á necessidade de tempo para processar a notícia do aborto antes de passar para as opções de tratamento, também a importância de quartos e banheiros separados das demais puérperas, para que assim, evite situações as quais lhe abalam mais ainda, em contato com outras mães e seus bebês. Dessa maneira, é fundamental comunicar-se com empatia, sem usar termos médicos e comentários insensíveis, e dar o tempo adequado para processar as informações e dar-lhes oportunidades de fazer perguntas (Galeotti et al, 2022).…”

Psychologic Sequelae in Early Pregnancy Complications

“…15 Hence, hospitals need to take evidence-informed actions to promote psychological support for people experiencing miscarriage. 16 Depression and anxiety were more frequent among women with miscarriage history. 17 Women with previous miscarriages were more vulnerable to experiencing excessive worry (OR value = 2.01, 95% CI: 1.24 to 3.24), as well as sadness and/or drooped spirits (OR value = 1.75, 95% CI: 1.11 to 2.76) during subsequent pregnancies.…”

Assessment and management of vaginal bleeding in early pregnancy

“…The clinician should explain everything clearly in layman's terms, not withhold information, provide privacy, and above all acknowledge the loss and associated pain. 16 A grief counselor or a local support group also may be considered helpful. Adequate social support and strategies to strengthen one's sense of control and self-efficacy can have a positive impact on psychosocial wellbeing of patients who have experienced pregnancy loss beyond medical management.…”