Negotiating the transition: caring for women through the experience of early miscarriage
Abstract
Aim. To explore women’s experiences of having an early miscarriage in a hospital gynaecological unit. Background. Miscarriage is a global health issue affecting significant numbers of women and is usually considered a distressing experience. This distress is often interpreted as being characteristic of grief. Nurses and other health professionals in hospital and community settings are therefore expected to provide appropriate care to meet the physical and emotional needs of the woman. Design. A qualitative, ethnographic study of a hospital gynaecological unit in the UK. Methods. The primary method was 20 months of part‐time participant observation. Data were also collected through documentary analysis of key documents in the setting and formal interviews. These were with eight women who had an early miscarriage and 16 health professionals (nurses, doctors, ultrasonographers) working in the unit. Results. Three clear phases emerged in the women’s experience of miscarriage and hospital admission; first signs and confirmation, losing the baby and the aftermath. These were interpreted as being components of a process of transition. The hospital admission emerged as vital in these early phases in which the importance of nurses and other health professionals providing sensitive, engaged care to meet the emotional and physical needs of the woman was identified. Conclusions. The hospital setting emerged as highly influential in shaping the care that was given to women and influencing their experiences. Transition models were felt to be more appropriate than grief and bereavement models in guiding the psychological care given to women. Relevance to clinical practice. The experience of hospital admission and the actions of nurses and other health professionals is influential in how women negotiate the transition through miscarriage.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Current care for bereaved parents after a baby dies is inconsistent.
“Current care for bereaved parents after a baby dies is inconsistent [11, 12]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [12]
Cites
Delmont, S., & Mason, J. (1997) · British Journal of Sociology · doi:10.2307/591613 · Cited by 4,245 · see citing works
McLeod, J. (1999) · SAGE Publications Ltd eBooks · doi:10.4135/9781849209588.n8 · Cited by 3,964 · see citing works
Social Research: Issues, Methods and Process.
Langford, I. H., & May, T. (1994) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348595 · Cited by 2,159 · see citing works
Experiencing Transitions: An Emerging Middle-Range Theory
Meleis, A. I., Sawyer, L. M., Im, E., Messias, D. K. H., & Schumacher, K. L. (2000) · Advances in Nursing Science · doi:10.1097/00012272-200009000-00006 · Cited by 1,698 · see citing works
Ethnography: Principles in Practice.
Gibbons, J. A., Hammersley, M., & Atkinson, P. (1986) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2070079 · Cited by 1,605 · see citing works
Qualitative Methods in Health Research
Pope, C. J., & Mays, N. (2006) · doi:10.1002/9780470750841.ch1 · Cited by 1,287 · see citing works
What's Wrong with Ethnography?
Feagin, J. R., & Hammersley, M. (1993) · Social Forces · doi:10.2307/2579903 · Cited by 652 · see citing works
Empirical Development Of a Middle Range Theory of Caring
Swanson, K. M. (1991) · Nursing Research · doi:10.1097/00006199-199105000-00008 · Cited by 635 · see citing works
Grief Counselling and Grief Therapy: A Handbook for the Mental Health Practitioner
Worden, J. W. (1991) · Cited by 518 · see citing works
Bereavement: Studies of grief in adult life
Fowler, J. (1987) · Nurse Education Today · doi:10.1016/0260-6917(87)90110-9 · Cited by 503 · see citing works
Qualitative Research in Health Care
Webster, J. A. (2005) · Nursing Older People · doi:10.7748/nop.16.10.43.s21 · Cited by 335 · see citing works
Miscarriage as a traumatic event: A review of the literature and new implications for intervention
Lee, C. W., & Slade, P. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00579-x · Cited by 253 · see citing works
Major Depressive Disorder in the 6 Months After Miscarriage
Neugebauer, R. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540290035029 · Cited by 202 · see citing works
Men's passage to fatherhood: an analysis of the contemporary relevance of transition theory
Draper, J. (2003) · Nursing Inquiry · doi:10.1046/j.1440-1800.2003.00157.x · Cited by 189 · see citing works
The Psychiatric Consequences of Spontaneous Abortion
Friedman, T., & Gath, D. (1989) · British Journal of Psychiatry · doi:10.1192/bjp.155.6.810 · Cited by 184 · see citing works
Effects of Caring, Measurement, and Time on Miscarriage Impact and Women's Well-Being
Swanson, K. M. (1999) · Nursing Research · doi:10.1097/00006199-199911000-00004 · Cited by 157 · see citing works
Grief, Mourning and Death Ritual
Katz, J. S., Hockey, J., & Small, N. (2001) · Medical Entomology and Zoology · Cited by 149 · see citing works
Emotion, attachment, and bereavement: A conceptual commentary.
Shaver, P. R., & Tancredy, C. M. (2001) · American Psychological Association eBooks · doi:10.1037/10436-003 · Cited by 128 · see citing works
GUILT AND EMPTINESS: WOMEN'S EXPERIENCES OF MISCARRIAGE
Adolfsson, A., Larsson, P. ‐., Wijma, B. E., & Berterö, C. (2004) · Health Care For Women International · doi:10.1080/07399330490444821 · Cited by 125 · see citing works
THE RELATIONSHIP OF ATTACHMENT THEORY AND PERINATAL LOSS
Margaret Robinson, L. B. (1999) · Death Studies · doi:10.1080/074811899201073 · Cited by 124 · see citing works
Cumming, G., Klein, S., Bolsover, D., Lee, A., Alexander, D., Maclean, M., & Jurgens, J. (2007) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2007.01452.x · Cited by 121 · see citing works
Predicting Depressive Symptoms after Miscarriage: A Path Analysis Based on the Lazarus Paradigm
Swanson, K. M. (2000) · Journal of Women s Health & Gender-Based Medicine · doi:10.1089/152460900318696 · Cited by 117 · 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
Investigation of the cause of miscarriage and its influence on women's psychological distress
Nikčević, A. V., Tinkel, S. A., Kuczmierczyk, A. R., & Nicolaides, K. H. (1999) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1999.tb08402.x · Cited by 80 · see citing works
Rethinking ethnography: reconstructing nursing relationships
Manias, E., & Street, A. F. (2001) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2001.01660.x · Cited by 77 · see citing works
Contexts and evolution of women's responses to miscarriage during the first year after loss
Swanson, K. M., Connor, S., Jolley, S. N., Pettinato, M., & Wang, T.-J. T. (2007) · Research in Nursing & Health · doi:10.1002/nur.20175 · Cited by 73 · see citing works
The health system and emotional care: Validating the many meanings of spontaneous pregnancy loss.
Corbet-Owen, C., & Kruger, L. (2001) · Families Systems & Health · doi:10.1037/h0089469 · Cited by 62 · see citing works
The Miscarriage Experience: More Than Just a Trigger to Psychological Morbidity?
Maker, C., & Ogden, J. (2003) · Psychology and Health · doi:10.1080/0887044031000069343 · Cited by 58 · see citing works
A ‘good enough’ nurse: supporting patients in a fertility unit
Allan, H. T. (2001) · Nursing Inquiry · doi:10.1046/j.1440-1800.2001.00090.x · Cited by 58 · see citing works
Research‐based Practice with Women Who Have Had Miscarriages
Swanson, K. M. (1999) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.1999.tb00514.x · Cited by 55 · see citing works
Pregnancy loss and the death of a baby. Guidelines for professionals.
Kroll, D. (1996) · PubMed · Cited by 43 · see citing works
From Hazard to Blessing to Tragedy: Representations of Miscarriage in Twentieth-Century America
Reagan, L. J. (2003) · Cited by 37 · see citing works
(1980) · Postgraduate Medical Journal · doi:10.1136/pgmj.56.662.885-c · Cited by 33 · see citing works
The management of miscarriage: Results from a survey at one hospital
Moohan, J. M., Ashe, R. G., & Cecil, R. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408863 · Cited by 32 · see citing works
Loss and bereavement in childbearing
Silverton, L. I. (1995) · Midwifery · doi:10.1016/0266-6138(95)90076-4 · Cited by 31 · see citing works
Williams, D. (1999) · Futures · doi:10.1016/s0016-3287(99)00017-8 · Cited by 30 · see citing works
Psychological reactions to pregnancy loss
Broquet, K. (1999) · Primary Care Update for OB/GYNS · doi:10.1016/s1068-607x(98)00176-0 · Cited by 27 · see citing works
Tsartsara, E., & Johnson, M. P. (2002) · Clinical Effectiveness in Nursing · doi:10.1016/s1361-9004(02)00028-6 · Cited by 21 · see citing works
Understanding Pregnancy Loss: Perspectives and issues in care
Moulder, C. (1998) · DigitalGeorgetown (Georgetown University Library) · doi:10.1007/978-1-349-14674-1 · Cited by 18 · see citing works
Nikčević, A. V., Kuczmierczyk, A. R., Tunkel, S. A., & Nicolaides, K. H. (2000) · Journal of Reproductive and Infant Psychology · doi:10.1080/713683047 · Cited by 17 · see citing works
Rethinking ethnography: reconstructing nursing relationships
Manias, E., & Street, A. F. (2001) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2001.01660.x · Cited by 15 · see citing works
MIDWIFERY PRACTICE: Core Topics 2
Alexander, J., Levy, V., & Roth, C. (1997) · doi:10.1007/978-1-349-14529-4 · Cited by 10 · see citing works
Understanding the experience and emotional consequences of miscarriage–editorial
Siade, P., & Cecil, R. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408861 · Cited by 8 · see citing works
Nazarko, L. (1992) · Nursing Standard · doi:10.7748/ns.7.12.44.s54 · Cited by 2 · see citing works
Making an impact on return to practice.
Miller, E. (2004) · PubMed · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ellis, A., Chebsey, C., Storey, C., Bradley, S., Jackson, S., Flenady, V., Heazell, A., & Siassakos, D. (2016) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-016-0806-2 · Cited by 322 · see citing works
“Current care for bereaved parents after a baby dies is inconsistent [11, 12], and parents are more likely to develop prolonged psychological problems if professional support is not given [13].”
BackgroundUnderstanding 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
Emond, T., de Montigny, F., & Guillaumie, L. (2019) · Journal of Clinical Nursing · doi:10.1111/jocn.14780 · Cited by 70 · 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
Malm, M.-C., Rådestad, I., Erlandsson, K., & Lindgren, H. (2011) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2011.02.002 · Cited by 33 · see citing works
Midwives' experiences of caring for women with early pregnancy loss in an Irish maternity hospital
Nash, M., Barry, M., & Bradshaw, C. (2018) · British Journal of Midwifery · doi:10.12968/bjom.2018.26.12.796 · Cited by 29 · see citing works
Creating and maintaining compassionate relationships with bereaved parents after perinatal death
Quinn, C. (2016) · British Journal of Midwifery · doi:10.12968/bjom.2016.24.8.562 · Cited by 3 · see citing works
- Authors
- Murphy, F., & Merrell, J.
- Affiliations
- Swansea University (GB)
- Corresponding author
- Murphy, Fiona
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2009-05-11
- Volume
- 18
- Issue
- 11
- Pages
- 1583-1591
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W1992777966
- Cited by
- 68
- References
- 45
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 8 · 2021: 3 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 8 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 3 · 2012: 4
- FWCI
- 4.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- early pregnancy loss, women's experiences, transition model, psychological care, nurse-patient relationship, emotional needs, hospitalization
- MeSH terms
- Abortion, Spontaneous, Bereavement, Female, United Kingdom, Humans, Pregnancy, Negotiating
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review