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Longitudinal study of emotional experiences, grief and depressive symptoms in women and men after miscarriage
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.ORCID iD: 0000-0003-0180-0280
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.ORCID iD: 0000-0003-4729-9962
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration. Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynecology, St Olav’s Hospital, Trondheim, Norway.ORCID iD: 0000-0002-8311-4956
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2018 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 64, p. 23-28Article in journal (Refereed) Published
Abstract [en]

Objective: Although miscarriage is common and affects up to 20 % of pregnant women, little is known about these couples’ short term and long term experiences after miscarriage.The aim of the present study was to study emotional experience, grief and depressive symptoms in women and men,one week and four months after miscarriage. Research design /setting:Women, (n=103), and their male partner (n=78), were recruited at the gynecological clinic after miscarriage. Control women were recruitedfrom the general population.Three validated questionnaires concerning psychological wellbeing and mental health, RIMS, PGS and MADRS-S were answered by the participants one week and four months after the miscarriage. Findings: It was shown that for women, the emotional experiences of miscarriage, grief and depressive symptoms were more pronounced than for their male partners. Grief and depressive symptoms were reduced with time, which was not the case for the emotional experiences of miscarriage. Previous children was favorable for emotional experience while previous miscarriage or infertility treatment made the emotional experience worse. Conclusion: Grief and depressive symptoms is reducedover time while emotional experiences such as isolation, loss of baby and a devastating event persist for longer time than four months. Lack of previous children, previous miscarriageand infertility diagnosis could increase negative emotional experiencesafter miscarriage, this was especially pronounced for grief reaction.The questionnaires could be used both clinically and in research to understand the emotional experiences after miscarriage.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 64, p. 23-28
Keywords [en]
Spontaneous abortion, grief, emotion, RIMS, PGS, MADRS-S
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychology (excluding Applied Psychology) Nursing
Identifiers
URN: urn:nbn:se:uu:diva-351713DOI: 10.1016/j.midw.2018.05.003ISI: 000439641700004PubMedID: 29864578OAI: oai:DiVA.org:uu-351713DiVA, id: diva2:1210835
Funder
VINNOVAAvailable from: 2018-05-29 Created: 2018-05-29 Last updated: 2018-10-16Bibliographically 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: 2018-11-01

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Volgsten, HelenaJansson, CarolineSkoog Svanberg, AgnetaDarj, ElisabethStavreus-Evers, Anneli

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