Wong Joanne, Frayne Jacqueline, Smith Sarah, Bilardi Jade, Temple-Smith Meredith
Medical School, Department of General Practice, The University of Western Australia, Perth, Australia.
King Edward Memorial Hospital for Women, Perth, Australia.
BMC Pregnancy Childbirth. 2025 Aug 21;25(1):871. doi: 10.1186/s12884-025-08004-1.
Miscarriage, defined as the unintended loss of pregnancy before 20 weeks affects 1 in 4 pregnancies in Australia. Despite its prevalence, the emotional impact is often overlooked, and can lead to many women experiencing psychological distress including depression, anxiety, and post-traumatic stress disorder (PTSD). Healthcare professionals play a vital role in providing support, however, many women experiencing miscarriage report dissatisfaction with their care, primarily due to the lack of emotional support. This study explores the perspectives of both women and General Practitioners-in-Training (GPiTs) to improve communication and provide actionable solutions for better miscarriage care during consultations.
A qualitative study was undertaken. Recruitment occurred with consumers from pregnancy loss support networks, and GPiTs from the national General Practice training organisation in Australia. Online focus groups were conducted to discuss personal experiences, challenges and needs related to the miscarriage consultation. The data was transcribed, analysed using NVivo and coded using an inductive thematic approach. The research team identified key themes and reached a consensus on the findings.
Three key themes were developed: Emotional care: Both women and GPiTs highlighted the need for improved emotional support, including acknowledgment of the loss, addressing guilt, and offering follow-up care. Women valued inclusivity and informed choices, while GPiTs reported challenges due to limited training. Provision of clear information: Women preferred simple, clear explanations and written materials regarding miscarriage management. GPiTs recognised the importance of empathetic communication when conveying sensitive information. Training and skills: GPiTs highlighted the need for early, formal training in miscarriage counselling whilst women emphasised the importance of education for all healthcare providers involved in miscarriage care.
This study highlights the need to integrate emotional care into all miscarriage consultations. Additionally, early training to support and deliver a consistent approach in a sensitive manner, covering both the physical and emotional aspects of miscarriage is needed. This is essential to improve the quality of care provided, and ensure better support for women during this emotionally challenging time.
流产定义为妊娠20周前意外终止妊娠，在澳大利亚，每4次怀孕中就有1次受其影响。尽管其发生率很高，但其对情绪的影响常常被忽视，这可能导致许多女性出现心理困扰，包括抑郁、焦虑和创伤后应激障碍（PTSD）。医疗保健专业人员在提供支持方面发挥着至关重要的作用，然而，许多经历流产的女性对她们所接受的护理表示不满，主要原因是缺乏情感支持。本研究探讨了女性和全科医生培训生（GPiTs）的观点，以改善沟通，并为咨询期间更好地护理流产提供可行的解决方案。
进行了一项定性研究。从流产损失支持网络招募消费者，并从澳大利亚国家全科医学培训组织招募全科医生培训生。开展了在线焦点小组讨论，以探讨与流产咨询相关的个人经历、挑战和需求。对数据进行转录，使用NVivo进行分析，并采用归纳主题法进行编码。研究团队确定了关键主题，并就研究结果达成共识。
形成了三个关键主题：情感护理：女性和全科医生培训生都强调需要改善情感支持，包括承认流产损失、消除内疚感以及提供后续护理。女性重视包容性和知情选择，而全科医生培训生报告称由于培训有限面临挑战。提供清晰信息：女性更喜欢关于流产管理的简单、清晰的解释和书面材料。全科医生培训生认识到在传达敏感信息时进行共情沟通的重要性。培训和技能：全科医生培训生强调在流产咨询方面需要早期、正规的培训，而女性则强调对所有参与流产护理的医疗保健提供者进行教育的重要性。
本研究强调有必要将情感护理纳入所有流产咨询中。此外，需要进行早期培训，以支持并以敏感的方式提供一致的方法，涵盖流产的身体和情感方面。这对于提高所提供护理的质量以及确保在这个情感上具有挑战性的时期为女性提供更好的支持至关重要。
