A Systematic Review and Meta-Synthesis of Qualitative Studies on Women's Experiences of Initial Miscarriage Care at the First Point of Clinical Contact.

OBJECTIVE

Miscarriage is a common pregnancy complication, yet women's experiences of care at the first point of clinical contact remain insufficiently understood. This systematic review and qualitative meta-synthesis examined how women experience and evaluate initial miscarriage care and what needs and priorities they identify during this early stage.

DATA SOURCES: CINAHL, Scopus, and PubMed were systematically searched for qualitative and mixed methods studies published between January 2015 and December 2024 following a preregistered protocol on the Open Science Framework and PRISMA 2020 guidance.

STUDY SELECTION: Eligibility criteria were developed using the SPIDER framework and included studies reporting women's experiences of care at first clinical contact for miscarriage (e.g., emergency departments, early pregnancy assessment units, outpatient triage) and published in English. Of 1,091 records identified (1,035 after deduplication), 45 full-text articles were assessed for eligibility, and 10 studies, predominantly from high-income settings, met the inclusion criteria. Studies were appraised for methodological quality using the Joanna Briggs Institute checklist.

DATA EXTRACTION: Data relevant to women's experiences, needs, and priorities during early miscarriage care were extracted from the 10 studies involving 232 women (nurses and nurse managers interviewed alongside parents in one review were not counted, consistent with this review's inclusion criteria) and synthesized thematically.

DATA SYNTHESIS: Four themes were developed: Emotional Shock and Vulnerability, Communication and Information Gaps, Clinical Prioritization Versus Emotional Needs, and Navigating Discharge and Ongoing Uncertainty. Across studies, initial miscarriage services were found to prioritize physical management while frequently overlooking emotional and informational support.

CONCLUSION

This review offers a focused synthesis of women's experiences at the earliest stages of miscarriage care, revealing a persistent gap between clinical and emotional responsiveness. The findings provide new evidence to inform more compassionate, woman-centered early miscarriage pathways that integrate timely clinical care with clear communication and psychosocial support.