Social work intervention for women experiencing early pregnancy loss in the emergency department
Abstract
Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant. Many women experience EPL as an ambiguous loss and are at risk for disenfranchised grief. Compassionate, patient-centred care has been identified by women as an essential and often missing aspect of ED care and can have a profound impact on the overall well-being of women after EPL. Social workers play a critical role in the ED given that they prioritize the psychosocial well-being of patients in a system that is structured to primarily address trauma care. In an effort to reduce the psychological impact and complicated grief reactions of women experiencing EPL, specific recommendations for social work intervention to address the individual needs of women experiencing EPL in the ED are presented. These include acknowledging the loss, providing psychoeducation, honouring the loss, assessing resources, referral and additional information, and building capacity in the ED.
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Compassionate and patient-centred care has been identified by women who suffer pregnancy loss as an essential aspect which plays a crucial role in their long-term emotional recovery.
“Compassionate and patient-centred care has been identified by women who suffer pregnancy loss as an essential aspect which plays a crucial role in their long-term emotional recovery (Palmer & Murphy-Oikonen, 2019).”
From Integrative Review of Emotional Care Following Perinatal Loss (2021) · cites this paper as Palmer & Murphy-Oikonen, 2019
Cites
Psychology Research and Behavior Management
(2020) · Psychology Research and Behavior Management · doi:10.2147/prbm · Cited by 703 · see citing works
Ambiguous Loss Theory: Challenges for Scholars and Practitioners
BOSS, P. G. (2007) · Family Relations · doi:10.1111/j.1741-3729.2007.00444.x · Cited by 458 · see citing works
National Association of Social Workers ( NASW )
Ripsch, J. (2014) · Encyclopedia of Special Education · doi:10.1002/9781118660584.ese1650 · Cited by 366 · see citing works
Abortion and mental health: Evaluating the evidence.
Major, B., Appelbaum, M. I., Beckman, L. J., Dutton, M. A., Russo, N. F., & West, C. M. (2009) · American Psychologist · doi:10.1037/a0017497 · Cited by 320 · see citing works
Grief therapy and the reconstruction of meaning: From principles to practice
Neimeyer, R. A., Burke, L. A., Mackay, M. M., & van Dyke Stringer, J. G. (2010) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-009-9135-3 · Cited by 310 · see citing works
The Context and Process of Theory Development: The Story of Ambiguous Loss
BOSS, P. G. (2016) · Journal of Family Theory & Review · doi:10.1111/jftr.12152 · Cited by 253 · see citing works
Posttraumatic stress disorder after pregnancy loss
Engelhard, I. M., van den Hout, M. A., & Arntz, A. (2001) · General Hospital Psychiatry · doi:10.1016/s0163-8343(01)00124-4 · Cited by 245 · see citing works
Perinatal Loss and Parental Grief: The Challenge of Ambiguity and Disenfranchised Grief
Lang, A., Fleiszer, A. R., Duhamel, F., Sword, W., Gilbert, K. R., & Corsini-Munt, S. (2011) · OMEGA - Journal of Death and Dying · doi:10.2190/om.63.2.e · Cited by 239 · see citing works
Farren, J. A., Jalmbrant, M., Ameye, L., Joash, K., Mitchell‐Jones, N., Tapp, S., Timmerman, D., & Bourne, T. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011864 · Cited by 220 · see citing works
Psychological effects of stillbirth
Cacciatore, J. (2013) · Seminars in Fetal and Neonatal Medicine · doi:10.1016/j.siny.2012.09.001 · Cited by 188 · cited 4× · see citing works
“Cacciatore (2013) explains how honouring the loss can decrease the mother’s shame response through the “recognition of her motherhood” (p.81).”
BackgroundInfluentialHunter, A., Tussis, L., & MacBeth, A. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.07.004 · Cited by 153 · see citing works
Robinson, G. E. (2013) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2013.08.012 · Cited by 142 · see citing works
Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss.
Krosch, D., & Shakespeare‐Finch, J. (2016) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000183 · Cited by 134 · see citing works
Stress Reduction Through Psychoeducation
Daele, T. V., Hermans, D., Audenhove, C. V., & den Bergh, O. V. (2011) · Health Education & Behavior · doi:10.1177/1090198111419202 · Cited by 127 · see citing works
Does Psychoeducation Help Prevent Post Traumatic Psychological Distress?
Wessely, S. C., Bryant, R. A., Greenberg, N. L., Earnshaw, M., Sharpley, J. G., & Hughes, J. H. (2008) · Psychiatry · doi:10.1521/psyc.2008.71.4.287 · Cited by 127 · see citing works
The Scope and Impact of Perinatal Loss: Current Status and Future Directions.
Bennett, S. M., Litz, B. T., Lee, B. S., & Maguen, S. (2005) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.36.2.180 · Cited by 115 · see citing works
The influence of medical and psychological interventions on women's distress after miscarriage
Nikčević, A. V., Kuczmierczyk, A. R., & Nicolaides, K. H. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.04.004 · Cited by 91 · see citing works
van den Berg, M. M. J., Dancet, E. A. F., Erlikh, T., van der Veen, F., Goddijn, M., & Hajenius, P. J. (2017) · Human Reproduction Update · doi:10.1093/humupd/dmx030 · Cited by 88 · see citing works
Chojenta, C., Harris, S., Reilly, N., Forder, P., Austin, M.-P., & Loxton, D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0095038 · Cited by 81 · see citing works
When a Baby Dies: Ambiguity and Stillbirth
Cacciatore, J., DeFrain, J., & Jones, K. L. C. (2008) · Marriage & Family Review · doi:10.1080/01494920802454017 · Cited by 76 · see citing works
A Randomized Trial of a Bereavement Intervention for Pregnancy Loss
Johnson, O. P., & Langford, R. W. (2015) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/1552-6909.12659 · Cited by 74 · see citing works
Recovering from stillbirth: the effects of making and sharing memories on maternal mental health
Crawley, R., Lomax, S., & Ayers, S. (2013) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2013.795216 · Cited by 73 · see citing works
Understanding the experience of miscarriage in the emergency department
MacWilliams, K., Hughes, J., Aston, M., Field, S., & Moffatt, F. W. (2016) · Journal of Emergency Nursing · doi:10.1016/j.jen.2016.05.011 · Cited by 71 · see citing works
Lisy, K., Peters, M. D. J., Riitano, D., Jordan, Z., & Aromataris, E. (2016) · Birth · doi:10.1111/birt.12217 · Cited by 70 · see citing works
Caring for families experiencing stillbirth: evidence-based guidance for maternity care providers
Peters, M. D. J., Lisy, K., Riitano, D., Jordan, Z., & Aromataris, E. (2015) · Women and Birth · doi:10.1016/j.wombi.2015.07.003 · Cited by 69 · see citing works
Pregnancy Loss: What It Means to Women Who Miscarry and Their Partners
Abboud, L. N., & Liamputtong, P. (2002) · Social Work in Health Care · doi:10.1300/j010v36n03_03 · Cited by 64 · see citing works
Meta-analysis to obtain a scale of psychological reaction after perinatal loss: focus on miscarriage
Adolfsson, A. (2011) · Psychology Research and Behavior Management · doi:10.2147/prbm.s17330 · Cited by 63 · see citing works
Stratton, K., & Lloyd, L. (2008) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2007.00806.x · Cited by 58 · see citing works
Predicting grief intensity after recent perinatal loss
Hutti, M. H., Myers, J., Hall, L. A., Polivka, B. J., White, S., Hill, J., Kloenne, E., Hayden, J., & Grisanti, M. M. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.07.016 · Cited by 53 · see citing works
Nursing praxis, compassionate caring and interpersonal relations: An observational study
Fry, M., MacGregor, C., Ruperto, K., Jarrett, K., Wheeler, J., Fong, J., & Fetchet, W. (2013) · Australasian Emergency Nursing Journal · doi:10.1016/j.aenj.2013.02.003 · Cited by 49 · see citing works
Evidence-based Intervention with Women Pregnant after Perinatal Loss
Côté‐Arsenault, D., Schwartz, K., Krowchuk, H. V., & McCoy, T. P. (2014) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000024 · Cited by 46 · see citing works
Pregnancy Loss in Rural Ireland: An Experience of Disenfranchised Grief
Mulvihill, A., & Walsh, T. (2014) · British Journal of Social Work · doi:10.1093/bjsw/bct078 · Cited by 46 · see citing works
The meaning of rituals after a stillbirth: A qualitative study of mothers with a stillborn baby
Tseng, Y., Hsu, M., Hsieh, Y., & Cheng, H. (2018) · Journal of Clinical Nursing · doi:10.1111/jocn.14142 · Cited by 43 · see citing works
Goodwin, P., & Ogden, J. (2007) · Psychology and Health · doi:10.1080/14768320600682384 · Cited by 39 · see citing works
Evans, L., Lloyd, D. M., Considine, R., & Hancock, L. (2002) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.0004-8666.2002.00155.x · Cited by 38 · see citing works
Doohan, I. S., & Saveman, B. (2014) · International Emergency Nursing · doi:10.1016/j.ienj.2014.08.008 · Cited by 37 · see citing works
Health Professionals' Practices and Attitudes About Miscarriage
Engel, J., & Rempel, L. A. (2015) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000207 · Cited by 35 · see citing works
Elangovan, C., Singh, S., Gardner, P. A., Snyderman, C. H., Tyler‐Kabara, E. C., Habeych, M. E., Crammond, D. J., Balzer, J. R., & Thirumala, P. D. (2015) · Journal of Neurosurgery Pediatrics · doi:10.3171/2015.7.peds14403 · Cited by 34 · see citing works
McLean, A., & Flynn, C. A. (2012) · Qualitative Social Work · doi:10.1177/1473325012464099 · Cited by 33 · see citing works
Toward a Theoretical Framework for Perinatal Bereavement
Brownlee, K. (2004) · The British Journal of Social Work · doi:10.1093/bjsw/bch063 · Cited by 33 · see citing works
Mahan, C. K., & Calica, J. (1997) · Social Work in Health Care · doi:10.1300/j010v24n03_12 · Cited by 32 · see citing works
Health Care Provider Support and Grief after Perinatal Loss: A Qualitative Study
Ujda, R. M., & Bendiksen, R. (2000) · Illness, Crisis & Loss · doi:10.1177/105413730000800304 · Cited by 30 · see citing works
The Use of Rituals in Grieving for a Miscarriage or Stillbirth
Brin, D. J. (2004) · Women & Therapy · doi:10.1300/j015v27n03_09 · Cited by 29 · see citing works
Moore, M., Ekman, E., & Shumway, M. (2012) · Social Work in Health Care · doi:10.1080/00981389.2011.610872 · Cited by 27 · see citing works
Meaning Reconstruction among Women following Stillbirth: A Loss Fraught with Ambiguity and Doubt
Golan, A., & Leichtentritt, R. D. (2016) · Health & Social Work · doi:10.1093/hsw/hlw007 · Cited by 27 · see citing works
A Collaborative Framework for Managing Pregnancy Loss in the Emergency Department
Bacidore, V., Warren, N., Chaput, C. J., & Keough, V. A. (2009) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.2009.01075.x · Cited by 27 · see citing works
Moore, M., Cristofalo, M. A., Dotolo, D. G., Torres, N. I., Lahdya, A., Ho, L. A., Vogel, M. T., Forrester, M., Conley, B., & Fouts, S. O. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.02.014 · Cited by 26 · see citing works
A Review of the Management of Loss of Pregnancy in the Emergency Department
Punches, B. E., Johnson, K. D., Gillespie, G. L., Acquavita, S. A., & Felblinger, D. M. (2018) · Journal of Emergency Nursing · doi:10.1016/j.jen.2017.11.001 · Cited by 25 · see citing works
Johnson, O., & Langford, R. W. (2010) · Critical Care Nursing Quarterly · doi:10.1097/cnq.0b013e3181e65f3b · Cited by 23 · see citing works
Death of a Child in the Emergency Department
O’Malley, P. J., Barata, I. A., Snow, S. K., Shook, J. E., Ackerman, A. D., Chun, T. H., Conners, G. P., Dudley, N. C., Fuchs, S. M., Gorelick, M. H., et al. (2014) · Journal of Emergency Nursing · doi:10.1016/j.jen.2014.05.003 · Cited by 21 · see citing works
The Silent Birth: A Feminist Perspective
Cacciatore, J. (2009) · Social Work · doi:10.1093/sw/54.1.91 · Cited by 20 · cited 1× · see citing works
“Social workers could be instrumental in “helping women find their voices after the death of a baby” (Cacciatore, 2009, p. 93), which is important to normalizing their grief experience and lessening the burden of disenfranchised grief (Price, 2008).”
BackgroundSampson, J. M., Yeats, J. R., & Harris, S. M. (2012) · Contemporary Family Therapy · doi:10.1007/s10591-012-9214-6 · Cited by 19 · see citing works
The effect of psychoeducation on anxiety and pain in patients with mastalgia
Öztürk, A. B., Özenli, Y., Ozturk, S. B., Önel, S., Soker, G., & Şeydaoğlu, G. (2014) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2014.989260 · Cited by 17 · see citing works
Miscarriage in Australia: The geographical inequity of healthcare services
Edwards, S., Birks, M., Chapman, Y. B., & Yates, K. (2016) · Australasian Emergency Nursing Journal · doi:10.1016/j.aenj.2016.02.001 · Cited by 17 · see citing works
Miscarriage: Emotional burden and social suffering for women in Pakistan
Batool, S. S., & Azam, H. (2016) · Death Studies · doi:10.1080/07481187.2016.1203376 · Cited by 17 · see citing works
Zavotsky, K. E., Mahoney, K., Keeler, D., & Eisenstein, R. M. (2012) · Journal of Emergency Nursing · doi:10.1016/j.jen.2012.08.006 · Cited by 15 · see citing works
Palliative Social Work in the Emergency Department
Lawson, R. M. (2012) · Journal of Social Work in End-of-Life & Palliative Care · doi:10.1080/15524256.2012.685427 · Cited by 15 · see citing works
Park, J., Tahk, S.-J., Bae, S. H., & Son, Y. (2013) · International Journal of Nursing Practice · doi:10.1111/ijn.12067 · Cited by 14 · see citing works
TheWhyof Practice: Utilizing PIE to Analyze Social Work Practice in Australian Hospitals
Nilsson, D., Joubert, L., Holland, L., & Posenelli, S. (2013) · Social Work in Health Care · doi:10.1080/00981389.2012.737901 · Cited by 14 · see citing works
Women and Reproductive Loss: Client-Worker Dialogues Designed to Break the Silence
Price, S. K. (2008) · Social Work · doi:10.1093/sw/53.4.367 · Cited by 13 · see citing works
Journey Interrupted: A Phenomenological Exploration of Miscarriage
Watson, M. A., Jewell, V., & Smith, S. L. (2018) · The Open Journal of Occupational Therapy · doi:10.15453/2168-6408.1439 · Cited by 13 · see citing works
A Women's Health Model for Pregnancy Loss: A Call for a New Standard of Care
Layne, L. L. (2006) · Feminist Studies · doi:10.2307/20459106 · Cited by 12 · see citing works
Educating Emergency Department Nurses About Miscarriage
Merrigan, J. L. (2017) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000391 · Cited by 11 · see citing works
Social Work and the HIV Care Continuum: Assisting HIV Patients Diagnosed in an Emergency Department
Edmonds, A. T., Moore, E., Valdez, A., & Tomlinson, C. (2015) · Social Work · doi:10.1093/sw/swv011 · Cited by 11 · see citing works
Health Promotion: Healing Through Loss
Olson, K. J. (2012) · Journal of Emergency Nursing · doi:10.1016/j.jen.2011.12.013 · Cited by 10 · see citing works
Maintaining patient dignity and offering support after miscarriage
Bryant, H. (2008) · Emergency Nurse · doi:10.7748/en2008.02.15.9.26.c8178 · Cited by 10 · see citing works
Catlin, A. J. (2017) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000399 · Cited by 10 · see citing works
Death of a Child in the Emergency Department
Shook, J. E., Ackerman, A. D., Chun, T. H., Conners, G. P., Dudley, N. C., Fuchs, S. M., Gorelick, M. H., Lane, N., Moore, B. R., Wright, J. L., et al. (2014) · Journal of Emergency Nursing · doi:10.1016/j.jen.2014.05.002 · Cited by 9 · see citing works
Murphy, C., Jaman, A., Craike, M., Haynes, J., & Austin, D. (2016) · Advances in Mental Health · doi:10.1080/18387357.2015.1051175 · Cited by 8 · see citing works
Neonatal Death in the Emergency Department: When End-of-Life Care Is Needed at the Beginning of Life
Fry, J. T., & Henner, N. (2016) · Clinical Pediatric Emergency Medicine · doi:10.1016/j.cpem.2016.04.001 · Cited by 4 · see citing works
New Normal Project: An Intervention for Grief and Loss
Vaterlaus, J. M. (2014) · International Journal of Systemic Therapy · doi:10.1080/08975353.2014.881699 · Cited by 3 · see citing works
Childhood Traumatic Stress and the Emergency Department Visit
Berkowitz, S. J., & Fein, J. A. (2013) · Clinical Pediatric Emergency Medicine · doi:10.1016/j.cpem.2013.01.007 · Cited by 1 · see citing works
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1 of the 73 references couldn’t be matched to a known paper.
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Integrative Review of Emotional Care Following Perinatal Loss
Furtado-Eraso, S., Escalada-Hernández, P., & Marín-Fernández, B. (2021) · Western Journal of Nursing Research · doi:10.1177/0193945920954448 · Cited by 51 · see citing works
“Compassionate and patient-centered care has been identified by women who suffer pregnancy loss as an essential aspect which plays a crucial role in their long-term emotional recovery (Palmer & Murphy-Oikonen, 2019).”
BackgroundRoberts, L. R., Nick, J. M., Sarpy, N. L., Peters, J., & Tamares, S. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00149 · Cited by 27 · see citing works
Dunn, M. B. (2023) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2023.100513 · Cited by 9 · see citing works
Follistatin-like 3, an activin A binding protein, is involved in early pregnancy loss
Xu, Y., Xie, J., Wan, L., Wang, M., Xu, Y., Wang, H., & Dong, M. (2019) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2019.109577 · Cited by 9 · see citing works
“Perinatal loss, a devastating cyclone”: A situation‐specific nursing theory
Furtado‐Eraso, S., Fernández, B. M., & Escalada‐Hernández, P. (2024) · Journal of Nursing Scholarship · doi:10.1111/jnu.12996 · Cited by 4 · see citing works
Navigating grief and pregnancy loss through online story telling
Jones, A. E., Scoresby, K. J., & Duong, C. C. (2022) · Qualitative Social Work · doi:10.1177/14733250221108634 · Cited by 4 · see citing works
“The Dark Farewell to the Light of Life”: A Qualitative Study About Prenatal Loss
Öztürk, G. K., & Elmas, S. (2022) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221131599 · Cited by 2 · see citing works
“Many women experience feelings of guilt after loss in the prenatal period and fear that these losses will be repeated in their future pregnancies (Palmer & Murphy-Oikonen, 2019).”
BackgroundGregory, K. A., Amambua, C. T., Jaskowiak, M. A., & Jeanmougin, C. (2026) · International Emergency Nursing · doi:10.1016/j.ienj.2026.101763 · Cited by 1 · see citing works
Lived experiences of women with spontaneous abortion at a district hospital, South Africa
Lockett, M., & Mash, R. J. (2024) · South African Family Practice · doi:10.4102/safp.v66i1.5917 · Cited by 1 · see citing works
“22 Being more person-centred within the emergency department can have a positive impact in reducing the adverse effects of spontaneous abortions.”
BackgroundCalled to the Crisis: The Experiences of Hospital-Based Social Workers Providing on-Call Services
Fox, M., Hopkins, D., & Crehan, S. (2021) · The British Journal of Social Work · doi:10.1093/bjsw/bcab202
La muerte perinatal, un ciclón devastador
Eraso, S., Marin, B., & Hermández, P. (2024) · doi:10.64628/aao.6vs7vnyq6
- Authors
- Palmer, A. D., & Murphy-Oikonen, J.
- Affiliations
- Lakehead University (CA)
- Corresponding author
- Murphy-Oikonen, Jodie
- Venue
- Social Work in Health Care
- Publisher
- Informa UK Limited
- Published
- 2019-02-18
- Volume
- 58
- Issue
- 4
- Pages
- 392-411
- ISSN
- 0098-1389 (ISSN-L)
- 1541-034X
- OpenAlex
- W2915364587
- Cited by
- 11
- References
- 73
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Work in Health Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- early pregnancy loss, miscarriage, social work intervention, emergency department, complicated grief, disenfranchised grief, ambiguous loss, psychosocial well-being, patient-centered care, psychoeducation, referral, women's health
- MeSH terms
- Abortion, Spontaneous, Emergency Service, Hospital, Female, Grief, Humans, Referral and Consultation, Social Work
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