A systematic review and thematic synthesis of women’s coping strategies for early to late miscarriage

Abstract

Background Miscarriage is a common adverse pregnancy outcome that can have long-term negative impacts on women. Coping strategies can indicate how someone attempts to manage their response to a stressor and may provide an indication of how to support them after a traumatic event. Despite emerging qualitative research on miscarriage experiences, there has been no comprehensive synthesis focusing on how women cope with miscarriage. Aim This study aims to explore women’s experiences of coping with a miscarriage without a known cause occurring up to 24 weeks gestation. Methods A double-blinded systematic review and thematic synthesis of qualitative papers was conducted. A search of seven databases, supplemented with a manual search was carried out. Articles published in academic journals between 2014 and 2024 were included. Papers were critically appraised using two tools, analysed thematically and critically discussed through a thematic synthesis.Findings Nine studies conducted across eight countries published between 2016 and 2024 were included. Four themes were identified: Denying or Commemorating the Lost Child, Changed Outlook after the Loss, Seeking a Cause or Meaning, and Social Interactions as a Source of Support or Pain. These themes demonstrate that women cope with miscarriage in diverse ways but with some similarities across different contexts. Conclusions The impact of miscarriage is felt by women cross-culturally. Coping strategies after miscarriage are both highly individualised and deeply interconnected with social attitudes. Maternity and healthcare professionals should consider how their support and response has the potential to empower or further impact the experience of miscarriage.