Miscarriage communication in Australia: insights from women and general practice trainees

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.