Women’s experiences of health care utilization in cases of early pregnancy loss: A scoping review

Freeman, Angela; Neiterman, Elena; Varathasundaram, Shya

doi:10.1016/j.wombi.2020.07.012

Cited by 21 publications

(24 citation statements)

References 52 publications

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“…Finally, the results of this review suggested that it appears to be extremely distressing for parents to be in areas where privacy is lacking, for example, waiting in shared facilities with evident symptoms of miscarriage. These results mirrored another systematic reviews that highlighted the lack of private amenities accessible to women in the hospital environment [11]. Our ndings highlights the importance for women to access private toilets in particular when experiencing miscarriage as this seems to be particularly distressing for them.…”

Section: Discussionsupporting

confidence: 83%

“…Parents expressed the importance of acknowledging miscarriage as a signi cant loss [56] and recognising both the emotional and physical implications it [57]. These ndings are in line with other systematic reviews conducted on the experience of parents' hospital journeys [11,58]. The four interventions included in the review have shown that providing emotional support following miscarriage can contribute to the reduction of psychological morbidities in both men and women [23,38,40,41].…”

Section: Discussionsupporting

confidence: 57%

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Factors Affecting the Emotional Wellbeing of Women and Men Who Experience Miscarriage in Hospital Settings: A Scoping Review

Galeotti

Mark

et al. 2021

Preprint

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Background - Miscarriage can be a devastating event for women and men that can lead to short- and long-term mental illness. 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 OpenGray. 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.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 57%

Factors Affecting the Emotional Wellbeing of Women and Men Who Experience Miscarriage in Hospital Settings: A Scoping Review

Galeotti

Mark

et al. 2021

Preprint

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“…As this first point of contact, healthcare providers are a crucial first step in supporting parents as they navigate this loss. However, research has consistently documented significant gaps in the psychosocial elements of miscarriage care, including lack of empathy, treating miscarriage as routine and trivial, failing to attend to grief and loss, and lack of clarity in communication about the miscarriage and next steps (1,4,(41)(42)(43)(44).…”

Section: Current Challenges In Miscarriage Carementioning

confidence: 99%

“…In light of the overwhelming amount of evidence indicating the sub-par quality of existing approaches to miscarriage care, researchers are calling for new methods of care and new interdisciplinary team members to improve care across all levels of the biopsychosocial spectrum (42,50). Current recommendations for enhancing psychosocially-oriented, patient-centered care include: (1) attending to the emotional significance of the loss, (2) providing more information to parents regarding miscarriage management and impact on fertility, (3) engaging patients and their partners in shared decision-making, (4) implementing screening to identify needs for additional mental health support and (5) developing a referral system and resource list to connect parents with this support (1,(50)(51)(52)(53).…”

Section: A Family-oriented Multidisciplinary Approach To Miscarriage Carementioning

confidence: 99%

A Multidisciplinary, Family-Oriented Approach to Caring for Parents After Miscarriage: The Integrated Behavioral Health Model of Care

Hiefner

Villareal

2021

Front. Public Health

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Miscarriage is increasingly gaining recognition, both in scientific literature and media outlets, as a loss that has significant and lasting effects on parents, though often disenfranchised and overlooked by both personal support networks and healthcare providers. For both men and women, miscarriage can usher in intense grief, despair, and difficulty coping, and for women in particular, there is evidence of increased prevalence of depression, anxiety, and post-traumatic stress. Additionally, miscarriage can contribute to decreased relationship satisfaction and increased risk of separation, all while stigma and disenfranchisement create a sense of isolation. Despite this increased need for support, research indicates that many parents experience their healthcare providers as dismissive of the significance of the loss and as primarily focusing only on the physical elements of care. Research exploring the barriers to providers engaging in more biopsychosocial-oriented care has identified time constraints, lack of resources, lack of training in addressing loss, and compassion fatigue as key areas for intervention. This paper will review the biopsychosocial elements of miscarriage and discuss a multidisciplinary, family-oriented approach that can be implemented in healthcare settings to ensure a high quality and holistic level of care for individuals, couples, and families experiencing pregnancy loss.

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“…Miscarriage refers to a spontaneous demise of pregnancy before the fetus reaches viability [ 10 ]. Approximately 25% of pregnancies end in miscarriage, most occurring within early pregnancy (<13 weeks) [ 11 ]. Although the causes of miscarriage have not been fully explained, previous studies have shown a negative association of advanced maternal age (≥35 years), tobacco use, psychological problems, BMI, and other unhealthy lifestyles with miscarriage [ 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study

Zhang¹,

Liu²,

Han³

et al. 2021

JMIR Public Health Surveill

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Background The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. Objective This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. Methods In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19–specific information. Results Among all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. Conclusions Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.

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Women’s experiences of health care utilization in cases of early pregnancy loss: A scoping review

Cited by 21 publications

References 52 publications

Factors Affecting the Emotional Wellbeing of Women and Men Who Experience Miscarriage in Hospital Settings: A Scoping Review

Factors Affecting the Emotional Wellbeing of Women and Men Who Experience Miscarriage in Hospital Settings: A Scoping Review

A Multidisciplinary, Family-Oriented Approach to Caring for Parents After Miscarriage: The Integrated Behavioral Health Model of Care

Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study

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