Toward Optimal Emotional Care During the Experience of Miscarriage: An Integrative Review of the Perspectives of Women, Partners, and Health Care Providers

Abstract

Introduction Miscarriage is frequently associated with significant emotional impact, causing psychological distress, trauma, and grief. Unfortunately, women and partners frequently report dissatisfaction with care around miscarriage, and health care providers report feeling ill‐prepared and underequipped to provide emotional support. This integrative review synthesizes the individual perspectives of the woman experiencing the miscarriage, the partner, and the different health care provider roles involved in the care to better understand what future research is necessary to improve the experiences of bereaved parents and their health care providers. Methods Electronic databases were searched for studies that covered emotional care around miscarriage from the perspective of women, partners, or health care providers. The review included studies published in English between 2015 and 2022, using either quantitative or qualitative methods. Thematic analysis was carried out, and conclusions from these articles were integrated into themes and subthemes. Results A total of 60 studies met the inclusion criteria. Two main themes were identified for women: (1) a need for more information and (2) a need for acknowledgment of their loss. Two main themes were likewise identified for partners: (1) a need for more information and (2) a need for recognition. Three main themes were identified for health care providers: (1) a need for additional training, (2) components of quality care, and (3) perceived barriers to providing care. Discussion There is broad overlap in the needs identified by bereaved parents and their health care providers, as well as general agreement regarding the barriers to providing effective care. Five areas of future research priority were identified to understand how best to meet these needs: empirical evaluation of strategies to meet identified needs, investigation of setting‐specific needs, integrated consideration of all relevant roles, investigation of the care needs of diverse groups, and an investigation of the predictors of emotional impact.

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Mifepristone and misoprostol in the management of early pregnancy loss

“…Prior to engaging in any activity to assist with the com-pletion of the process of emptying the uterus, the needs and desires of the patient should be considered. 3 Following an initial assessment of the patient to determine that they are hemodynamically stable and not at risk for infection, the approach to next steps needs to include a discussion with the patient to assess their preferences related to their care. These preferences may include a desire for privacy, fear of pain, need for expediency, economic considerations, previous experience with induced abortion or miscarriage management, ability to manage symptoms independently, and risk of complications.…”

“…Multiple resources are available to help guide the conversation with the patient about what is the best approach to resolve the miscarriage. 3…”