Abstract
OBJECTIVE: To describe women's experiences with expectant management of spontaneous abortions. DESIGN: Descriptive survey using questionnaires with fixed-choice and open-ended questions. The latter were analyzed for themes, using qualitative methods. SETTING: Urban and suburban private primary care family practices. PARTICIPANTS: A convenience sample of family practice patients (59 of 80 eligible) pregnant for less than 12 weeks who had spontaneous abortions without surgery. Response rate was 84.7%; 50 questionnaires were received from the 59 women. METHOD: Women were asked about their physical experiences, including amount of pain and bleeding; emotional effects; their satisfaction with medical care; and their suggestions for improving care. MAIN FINDINGS: The mean worst pain experienced during a spontaneous abortion on an 11-point scale was 5.9. Bleeding varied, but was often very heavy. Satisfaction rate was 92.9% with family physician care and 84.6% with hospital care. Women described the emotional effect of "natural" spontaneous abortions and made recommendations for improving care. CONCLUSIONS: A better understanding of the physical and emotional experiences of the women in this study might help physicians better prepare and support patients coping with expectant management of spontaneous abortions.
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- Ben-Baruch G., Schiff E., Moran O., Menashe Y., Mashiach S., Menczer J. Curettage vs. nonsurgical management in women with early spontaneous abortions. The effect on fertility. J Reprod Med. 1991 Sep;36(9):644–646. [PubMed] [Google Scholar]
- Borkan J., Reis S., Hermoni D., Biderman A. Talking about the pain: a patient-centered study of low back pain in primary care. Soc Sci Med. 1995 Apr;40(7):977–988. doi: 10.1016/0277-9536(94)00156-n. [DOI] [PubMed] [Google Scholar]
- Chipchase J., James D. Randomised trial of expectant versus surgical management of spontaneous miscarriage. Br J Obstet Gynaecol. 1997 Jul;104(7):840–841. doi: 10.1111/j.1471-0528.1997.tb12030.x. [DOI] [PubMed] [Google Scholar]
- Friedman T. Women's experiences of general practitioner management of miscarriage. J R Coll Gen Pract. 1989 Nov;39(328):456–458. [PMC free article] [PubMed] [Google Scholar]
- Jurkovic D., Ross J. A., Nicolaides K. H. Expectant management of missed miscarriage. Br J Obstet Gynaecol. 1998 Jun;105(6):670–671. doi: 10.1111/j.1471-0528.1998.tb10184.x. [DOI] [PubMed] [Google Scholar]
- Karlson E. W., Daltroy L. H., Liang M. H., Eaton H. E., Katz J. N. Gender differences in patient preferences may underlie differential utilization of elective surgery. Am J Med. 1997 Jun;102(6):524–530. doi: 10.1016/s0002-9343(97)00050-8. [DOI] [PubMed] [Google Scholar]
- Mansur M. M. Ultrasound diagnosis of complete abortion can reduce need for curettage. Eur J Obstet Gynecol Reprod Biol. 1992 Mar 23;44(1):65–69. doi: 10.1016/0028-2243(92)90315-p. [DOI] [PubMed] [Google Scholar]
- Nielsen S., Hahlin M. Expectant management of first-trimester spontaneous abortion. Lancet. 1995 Jan 14;345(8942):84–86. doi: 10.1016/s0140-6736(95)90060-8. [DOI] [PubMed] [Google Scholar]
- Seidl M. M., Stewart D. E. Alternative treatments for menopausal symptoms. Qualitative study of women's experiences. Can Fam Physician. 1998 Jun;44:1271–1276. [PMC free article] [PubMed] [Google Scholar]
- Speraw S. R. The experience of miscarriage: how couples define quality in health care delivery. J Perinatol. 1994 May-Jun;14(3):208–215. [PubMed] [Google Scholar]
- Wiebe E., Janssen P. Management of spontaneous abortion in family practices and hospitals. Fam Med. 1998 Apr;30(4):293–296. [PubMed] [Google Scholar]
- Zaccardi R., Abbott J., Koziol-McLain J. Loss and grief reactions after spontaneous miscarriage in the emergency department. Ann Emerg Med. 1993 May;22(5):799–804. doi: 10.1016/s0196-0644(05)80794-2. [DOI] [PubMed] [Google Scholar]