Effect of supportive care on the psychosocial health status of women who had a miscarriage

The impact of midwife/nurse-led psychosocial interventions on parents experiencing perinatal bereavement: An integrative review

BACKGROUND

Perinatal loss is a traumatic event associated with a high risk of parents experiencing negative psychological outcomes. Despite most parents being in regular contact with midwives and nurses during the perinatal period, there is a lack of evidence which hampers these professionals from using effective psychosocial interventions with parents.

AIM

This study aims to synthesise the existing evidence on the types of psychosocial interventions delivered by midwives/nurses for parents with perinatal bereavement, their impacts on bereaved parents' mental health and the experiences of midwives and nurses in delivering psychosocial interventions for parents experiencing perinatal loss.

DESIGN

An integrative review of the literature.

METHODS

Whittemore and Knafl's five-stage integrative review framework guided this review. A systematic literature search of the Medline, PsycINFO, Embase, CINAHL and ASSIA, Cochrane Library and ProQuest databases was conducted from inception to January 2023, with no language or geographical limiters set due to the paucity of research published in this subject area. Two researchers independently screened and reviewed each study's data extraction and methodological quality using the Joanna Briggs Institute and Mixed Method Appraisal Tool. Results were analysed and synthesised using narrative synthesis.

RESULTS

A total of 21 studies met the inclusion criteria. From these, we identified nine types of psychosocial interventions for perinatal bereavement that can be delivered by midwives and nurses. The positive impacts of midwife/nurse-led psychosocial interventions on grief, anxiety, depression posttraumatic stress disorder and other psychosocial outcomes amongst parents experiencing perinatal loss have been demonstrated. In addition, we identified the useful components of these interventions and the experiences of midwives and nurses in delivering psychosocial interventions, thereby highlighting barriers such as lack of knowledge and skills, stressful working environments and inadequate emotional support.

CONCLUSION

Our findings demonstrate that midwife/nurse-led psychosocial interventions have the potential to improve grief, anxiety, depression, posttraumatic stress disorder symptoms and other psychosocial outcomes for parents experiencing perinatal loss. Thus, future research should consider training, workload, time cost and emotional support for midwives/nurses when developing midwife/nurse-led psychosocial interventions for parents with perinatal loss.

REGISTRATION NUMBER

CRD42022369032.

TWEETABLE ABSTRACT

Midwife/nurse-led psychosocial interventions have the potential to improve mental health amongst parents experiencing perinatal loss.

The Relationship Between Psychological Pain, Spiritual Well-Being, and Social Support in Turkish Women Undergoing Therapeutic or Elective Abortion

This study was conducted to determine the relationship between psychological pain, spiritual well-being, and social support among Turkish women undergoing therapeutic or elective abortion. The cross-sectional study was conducted with 342 women who were hospitalized in the gynecology and obstetrics service of a city hospital between March 2021 and December 2022 in Turkey. The mean psychological pain, spiritual well-being and perceived social support scores of women undergoing therapeutic/elective abortion were 26.96 ± 11.21, 110.72 ± 13.09 and 64.09 ± 15.62, respectively. There were a significant negative correlation between psychological pain with spiritual well-being and social support. According to linear regression analysis, spiritual well-being, social support, age, employment status, economic level, history of abortion, number of abortion, current abortion type, and gestational week were statistically significant predictive factors of psychological pain. Therefore, healthcare providers can provide individualized psychosocial-spiritual care and counseling services that decrease psychological pain in women after therapeutic or elective abortion.

Experiences of miscarriage: the voice of parents and health professionals

The death of a child in the intrauterine stage has legal, psychological, spiritual, and health-related connotations that condition the woman's experience. To understand better the processes set in motion around early pregnancy loss, this ethnographic study explores the experiences of miscarriage in a group of 15 women. The following themes are analyzed: Experience of losing the child, spirituality, health care, and the need to physically recognize the child. The study shows that the need women have to honor the child who did not live may be conditioned by the perception of an uncertain loss and by the absence of a place to honor him/her. Attitudes among professionals are revealed that could be perceived as gender-related abuse. The care of women places emphasis on physical aspects, underlining the lack of comprehensive care during the grieving process.

Navigating miscarriage in Jordan: understanding emotional responses and coping strategies

BACKGROUND

Miscarriages account for 20% of clinically confirmed pregnancies and up to 50% of all pregnancies and is considered one of the most heartbreaking events experienced by women. The current study aimed to explore participants' perceptions and practices and how they link with the negative emotions of miscarriage.

METHODS

In this cross-sectional study a web-based questionnaire was used to gather data from 355 women living in Jordan who had experienced a previous miscarriage. The questionnaire consisted of four sections, including socio-demographic information, experience with miscarriage, emotions after the experience, and self-care practices. Participants were recruited through social media platforms from April to August 2022. Data were analyzed using SPSS, and descriptive statistics, chi-square test, and binomial regression were performed to examine the results.

RESULTS

The results show that the majority of participants were in the age group of 22-34 years and a larger percentage of participants hold a Bachelor's degree and were employed. All participants had experienced a previous miscarriage with 53.8% having one, 27.0% having two, and 19.2% having three or more miscarriages. In addition, most miscarriages did not have an explanation for their cause (77.5%), but vaginal bleeding was the most reported symptom (55.2%) and surgical management was predominant (48.7%). Most participants reported adequate emotional support from partners and family (63.7% and 62.3%, respectively). Almost half (48.7%) of the respondents felt like they had lost a child and those who did not receive any social support had a higher association with the same feeling (p = 0.005). Of the participating women, 40.3% decided to postpone another pregnancy while 20.0% planned for a subsequent pregnancy. The feeling of shame regarding the miscarriage was the main driver for women to get pregnant again (Odd ration [OR] 2.98; 95% confidence interval (CI) 1.31-6.82; p = 0.01).

CONCLUSIONS

The findings highlight the emotional impact of miscarriage on women and the need for proper support and self-care practices.

Posttraumatic Stress Disorder Symptoms and Related Factors in Women with Early Pregnancy Loss

Aim: Women may experience emotions such as fear, anxiety, stress, anger or guilt after pregnancy loss, and it can lead to posttraumatic stress disorder if the women cannot cope with these emotions. This study aimed to identify posttraumatic stress disorder symptoms and related factors in women with early pregnancy loss. Material and Methods: The sample of this descriptive study consisted of 132 women hospitalised with early pregnancy loss in an Obstetrics and Gynecology service of a state hospital (

Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks

Threatened miscarriage is one of the most common complications causing pregnancy loss, and it affects approximately 20% of confirmed pregnancies. More and more women are seeking treatment with complementary and alternative medicine (CAM) for this common complication, and it has been reported that women have had successful pregnancies after threatened miscarriage when being treated with CAM, which mainly includes Chinese herbal medicines, acupuncture, and nutritional supplements as well as psychological interventions and other approaches. However, many experts are concerned about the safety and adverse events of certain CAM approaches in women with threatened miscarriage. Therefore, this review focuses on the status of CAM for threatened miscarriage and presents the potential therapeutic efficacy and safety of CAM based on some clinical and experimental studies. We thus hope to provide some instructive suggestions for the application of CAM for treating threatened miscarriage in the future.