Development and evaluation of a miscarriage follow-up clinic

Abstract

Miscarriage is the most common complication of pregnancy. There is a growing recognition that early pregnancy loss can be associated with high levels of psychological distress, yet routine follow-up care for women and their partners is not existent in the UK. This paper describes the development and evaluation of a miscarriage follow-up clinic, which was established in order to provide information, support and care to couples in whom a routine ultrasound examination in the first trimester of pregnancy revealed a pregnancy failure. Three stages in the development of the clinic are described: during the initial stage, the psychological outcomes and desirability of follow-up care after missed miscarriages were established. Drawing on the results of the first stage of the project and on the empirical research in the field, a miscarriage follow-up clinic was established. Both medical and psychological interventions were offered as part of routine miscarriage follow-up care. A controlled evaluation of such integrated care suggested that the combination of psychological counselling, medical investigations of the cause of miscarriage and a consultation, was superior in bringing about reduction in women's distress over and above benefits obtained solely through medical care. Recommendations for routine provision of miscarriage follow-up care for women and the form it should take are outlined.