Exploring parents’ experiences and holistic needs following late miscarriage: a narrative systematic review

Giannatiempo, Francesca; Hollins Martin, Caroline; Patterson, Jenny; Welsh, Nicola

Abstract

Up to 2% of all pregnancies result in pregnancy loss between 14 + 0 and 23 + 6 weeks’ gestation, which is defined as ‘late miscarriage’. Lack of consensus about definition of viability paired with existing multiple definitions of perinatal loss make it difficult to define the term ‘late miscarriage’. Parents who experience late miscarriage often have had reassuring scan-milestones, which established their confidence in healthy pregnancy progression and identity formation, which socially integrates their baby into their family. The clinical lexicon alongside the lack of support offered to parents experiencing late miscarriage may disclaim their needs, which has potential to cause adverse psychological responses.

Aim
To review what primary research reports about parents’ experiences and their perceived holistic needs following late miscarriage.

Methods
A narrative systematic review was carried out. Papers were screened based on gestational age at time of loss (i.e. between 14 + 0 and 23 + 6 weeks’ gestation). The focus was set on experience and holistic needs arising from the loss rather than its clinical care and pathophysiology. Studies were selected using PRISMA-S checklist, and quality assessed using the Critical Appraisal Skills Program (CASP) tool. Thematic analysis was used to guide the narrative synthesis of findings.

Results
Six studies met the inclusion criteria. Three main themes emerged: communication and information-giving; feelings post-event; and impact of support provision.

Conclusion
Literature about the experience of late miscarriage is scarce, with what was found reporting a lack of compassionate and individually tailored psychological follow-up care for parents following late miscarriage. Hence, more research in this arena is required to inform and develop this area of maternity care provision.

• Journal Article Type: Article
• Acceptance Date: Dec 17, 2023
• Online Publication Date: Jan 7, 2024
• Deposit Date: Jan 5, 2024
• Publicly Available Date: Mar 11, 2024
• Print ISSN: 0264-6838
• Publisher: Routledge
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1080/02646838.2023.2297905
• Keywords: Late miscarriage, second trimester pregnancy loss, perinatal loss, systematic review, perinatal bereavement
• Public URL: http://researchrepository.napier.ac.uk/Output/3445548