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A Swedish study of midwives' and nurses' experiences when women are diagnosed with a missed miscarriage during a routine ultrasound scan
Division of Reproductive and Perinatal Health Care, Department of Women’s and Children’s Health, Karolinska Institutet, SE 171 77, Stockholm, Sweden.
School of Life Sciences, University of Skovde, P.O. Box 408, SE 541 28, Skovde, Sweden.
2010 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 1, no 2, p. 67-72Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to describe midwives' and nurses' experiences when women are diagnosed with a missed miscarriage during a routine ultrasound scan in pregnancy weeks 18-20.

STUDY DESIGNS: A qualitative content analysis with an inductive approach and 13 semi-structured interviews were used for data collection from these three domains: midwives at an ultrasound department, midwives at a maternity clinic and nurses at a gynecological ward. Content analysis resulted in six codes, four categories and one primary theme.

MAIN OUTCOME MEASURES: The four categories identified were: the interviewees' experiences of women's reactions, support from the midwife and nurse, the interviewees' experiences of men's reactions and communication between care providers and women. The main theme focused on the interviewees' noting that women had a premonition that something was wrong with their pregnancy. This could for example have been in the form of minor bleeding or the fact that pregnancy symptoms had receded and there were no movements by the fetus. The midwives carried out a follow-up with assessment.

CONCLUSIONS: Women need confirmation of their premonitions of a missed miscarriage so that a diagnosis can be made as early as possible in their pregnancy. Women and their partners who have suffered a missed miscarriage need extended support on an individual basis in addition to follow-up assistance as assessed by the midwives.

Place, publisher, year, edition, pages
2010. Vol. 1, no 2, p. 67-72
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Identifiers
URN: urn:nbn:se:uu:diva-362139DOI: 10.1016/j.srhc.2010.01.002PubMedID: 21122599OAI: oai:DiVA.org:uu-362139DiVA, id: diva2:1253169
Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2019-02-01Bibliographically approved
In thesis
1. Experiences of Miscarriage
Open this publication in new window or tab >>Experiences of Miscarriage
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Experiences are unique and both men and women experience grief, anxiety, depressive symptoms after a miscarriage.

The overall aim was to describe and measure experiences among women and men after a miscarriage.

Study one was a qualitative study with interviews with Swedish midwives' and nurses' experiences of women's reactions after routine ultrasonographic diagnosis of a missed miscarriage.

Study two concerned validation of "The revised impact of miscarriage scale" for Swedish conditions and a comparison of Swedish and American women's and men's experiences of miscarriage.

Study three was a longitudinal study of Swedish women's and men's emotions.

Study four was a longitudinal study, on women's feelings in relation to diagnosis and treatment.

Scales about experiences, grief, and depressive symptom were used.

The results showed that midwives perceived that the women had had a premonition of symptoms of a missed miscarriage and a follow-up was performed. The degree of consistency showed that the questionnaire can be used in a Swedish setting. The Swedish and American women and men scored similarly in two factors, and the women's experiences were more pronounced than the men's. Grief and depressive symptoms became reduced over time, while experiences persisted. No previous children, miscarriage or infertility treatment prior to miscarriage made the experience worse especially grief reaction. There was no difference between the two diagnosis groups in experiences one week after the miscarriage and their experience improved after four months. Women treated with misoprostol had more depressive symptoms than women treated with misoprostol and subsequent vacuum aspiration.

In conclusion, care providers can confirm women's premonition of a missed miscarriage so a diagnosis can be set early in the pregnancy and they can do an individual follow-up. The high consistency between the countries in two factors show that RIMS is reliable for both women and men. Grief and depressive symptoms become reduced, while experiences persist. Previous miscarriage, lack of previous children and an infertility diagnosis can lead to negative feelings as grief. A diagnosis of miscarriage has a limited influence on experiences, and a shorter duration of treatment and treatment with misoprostol and subsequent vacuum aspiration led to a fewer depressive symptom.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 75
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1497
Keywords
Miscarriage, spontaneous abortion, missed abortion, pregnancy loss, gender, measurement, emotion, care, stress
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-362136 (URN)978-91-513-0454-0 (ISBN)
Public defence
2018-11-27, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2018-11-01 Created: 2018-10-02 Last updated: 2019-04-29

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