Supportive care for women with recurrent pregnancy loss: preferences of Japanese women

Abstract

Women who had miscarriage/stillbirth are likely to have anxiety, depression, grief, and guilt. Tender loving care (TLC) is important to ease women's stress with recurrent pregnancy loss (WWRPL), but it is still an ill-defined concept. This study aimed to clarify the specific contents of TLC preferred and experienced by the WWRPL. Women who visited outpatient clinics in two hospitals in Okayama and Hiroshima to receive treatments for recurrent pregnancy loss (RPL) (n = 146) from June-September 2019 were studied. Awareness of TLC, preferences and experience regarding 26 supportive care options, the number of doctors consulted, and frequency of ultrasound examinations were assessed using a questionnaire survey. Responses from 142 were analysed, and < 10% were aware of TLC. Six categories were developed based on the supportive care options, and category-wise, testing, guidance and advice, and a friendly atmosphere was highly preferred. Out of 26, 14 supportive care options were preferred by > 70% of WWRPL. Sufficient tests to find the cause of RPL (97.2%), provide medical information and necessary explanations (96.5%), explain the pregnancy condition (95.8%) and an environment where you can ask questions freely (95.8%) were highly preferred. First, three options of the above four had the highest experience rates as well. History of > 4 miscarriages/stillbirths was significantly associated (p < 0.05) with the preferences related to sensitivity and empathy. The majority preferred to consult one doctor (43%) and perform ultrasound examinations once a week (54.9%). In conclusion, preferences for TLC ranged widely among WWRPL. It is necessary to identify the background and requirements of each patient and provide tailor-made care, paying attention to highly requested care options. WWRPL preferred a patient-centred care plan incorporating emotional support, psychological care, sensitivity and empathy involving one doctor with an ultrasound examination performed once a week in the first trimester of their subsequent pregnancies.