Hospital-based interventions at and following miscarriage: literature to inform a research-practice initiative.

BACKGROUND

It is estimated that up to one in five pregnancies will result in miscarriage, the spontaneous loss of pregnancy up to 20 weeks gestation. Miscarriage is such a common form of reproductive loss that it is often under acknowledged by the community, including health professionals. Dissatisfaction with care following miscarriage is well noted despite evidence that the care provided in hospital can have a significant effect on the experience of and the emotional and physical recovery from a miscarriage.

AIMS

The aim of this literature review was to determine any evidence-based guidelines for hospital-based medical and psychosocial services following a miscarriage.

METHODS

A search was made of medical and psychosocial databases for key terms. Further searches were then carried out using references. Articles were critically analysed and implications for service delivery derived.

RESULTS

Indications for service delivery at the time of miscarriage and follow up are clear from the reported experiences of women and the psychological sequelae of miscarriage. However, there is little evidence to support the efficacy of follow up postdischarge. There are implications for service delivery and research in six domains: staff care, assessment, information, phone follow up, risk assessment and care during subsequent pregnancies.

CONCLUSIONS

Further research is needed to establish the impact on women and staff of routine follow-up care after a miscarriage.