Women’s experiences of early pregnancy loss services during the pandemic: A qualitative investigation
Open accessAbstract
PROBLEM: Early pregnancy losses [EPL] are common, varied, and require different courses of management and care. BACKGROUND: In the UK, women who suspect or suffer a pregnancy loss are usually provided specialist care in early pregnancy assessment units [EPAUs]. Their configuration has recently been evaluated, but recommendations for change in-line with best practice for optimum outcomes were unable to be implemented due to the COVID-19 pandemic health system shock. AIM: To compare women's experiences of EPAUs during the pandemic to themes previously found in qualitative work undertaken with women who utilised EPAUs before the pandemic. METHODS: We conducted semi-structured virtual interviews, with women (N = 32) who suffered an early pregnancy loss during the pandemic; analysing transcripts using Template Analysis, based on findings about women's (pre-pandemic) experiences of EPAU from The VESPA Study. FINDINGS: We report on seven key themes: Barriers to Accessing Services; Communication & Information; Retention of Relational Care; Involvement in Care Decisions; Staffs' Attitude or Approach; Efficiency of Service Delivery; Sensitive Patient Management. DISCUSSION: Sensitive patient management and woman-staff interactions in EPAU settings remain a fundamental issue. Women also reported their experiences of EPAUs were comparatively worse during the pandemic. CONCLUSIONS: Women valued the care provided by EPAUs and found services to be efficient, despite pandemic-related restrictions. However, psychological recognition surrounding EPL and appropriate, sensitive, relational care and support continue to be areas in need of improvement. Our recommendation is to implement the improvements suggested by VESPA as a priority to ameliorate present sub-optimal experiences and prevent further deterioration.
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Major changes in healthcare services, such as cancellation of appointments and exams, and restrictions on contact with the baby after death, further intensified women's suffering during the pandemic.
“Major changes in healthcare services, such as the cancellation of appointments and exams (56), and restrictions on contact with the baby after death, further intensified women’s suffering during this period (57, 58).”
From Experiences and long-term repercussions of perinatal grief in women after perinatal bereavement: a meta-ethnography (2025) · cites this paper as [56]
The Discussion (p. 9) reports that women’s experiences of early pregnancy loss services deteriorated during the pandemic and says some deterioration could be linked to pandemic restrictions. The paper does not report restrictions on contact with a baby after death or link that specific restriction to women’s suffering. The cancellation of appointments and exams is cited separately to reference 56, not to this source. (LLM, conf=0.82)
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- Authors
- George-Carey, R., Memtsa, M., Kent-Nye, F. E., Magee, L. A., Oza, M., Burgess, K., Goodhart, V., Jurković, D., & Silverio, S. A.
- Affiliations
- Royal Free London NHS Foundation Trust (GB)
- King's College London (GB)
- The Ectopic Pregnancy Trust (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Silverio, Sergio A.
- ORCID
- Venue
- Women and Birth
- Publisher
- Elsevier BV
- Published
- 2024-03
- Volume
- 37
- Issue
- 2
- Pages
- 394-402
- ISSN
- 1871-5192 (ISSN-L)
- OpenAlex
- W4390617251
- Cited by
- 19
- References
- 23
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7
- FWCI
- 7.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Women and Birth (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Liverpool John Moores University (submittedVersion)
- Funders
- National Institute for Health and Care Research Applied Research Collaboration South London
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
- Keywords
- early pregnancy loss, COVID-19 pandemic, women's experiences of care, relational care, staff-patient communication, service delivery efficiency
- MeSH terms
- Abortion, Spontaneous, Female, Humans, Male, Maternal Health Services, Pregnancy, Qualitative Research, Pandemics
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