Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study

Women's grief after miscarriage is substantial and important. Women who experience early miscarriage do not constitute a homogenous group. The aim of this study is to measure whether a structured follow-up visit to a midwife (group 1) at 21-28 days after early miscarriage could reduce the women's grief, measured using the perinatal grief scale Swedish short version (PGS) after a further 3 months (i.e. 4 months after the miscarriage), compared to a regular follow-up visit to a midwife (group 2).

We performed an open randomized study of women who experienced early miscarriage (n = 88). The midwife's attitude in group 1 came from Swanson science theory of midwifery. In group 2, the women were offered only the ordinary type of consultation at a regular visit. A questionnaire with the PGS was used in both groups. Four months after the miscarriage, a second questionnaire with the same perinatal grief scale was sent by post.

There was a 30% greater reduction in grief in group 1 than that in group 2, when comparing the first and second measurements (not significant). The biggest differences were in the subscales active grief and difficulty in coping. Women with the subdiagnosis missed abortions had, as a group, significantly higher PGS scores at both visits, especially in active grief and difficulty in coping, regardless of the type of follow-up visit.

A structured follow-up visit did not, in comparison with a regular follow-up visit, imply any significant reduction in grief as measured using the PGS scale. However, the subgroup missed abortion had more extensive grief than the other women with miscarriage. Structured follow-up visits are not imperative for all women with early miscarriage.