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“Being Sure”: Women's Experience with Inevitable Miscarriage

Limbo, Rana PhD, RN, PMHCNS-BC, CPLC, FAAN; Glasser, Jo K. PhD, MBA, MS; Sundaram, Maria E. MSPH

MCN: The American Journal of Maternal/Child Nursing: May/June 2014 - Volume 39 - Issue 3 - p 165–174
doi: 10.1097/NMC.0000000000000027
Feature: CE Connection

Purpose: To extend understanding of women's experience of miscarriage by exploring their approach to decisions about what to do after learning a miscarriage was likely.

Study Design and Methods: Using dimensional analysis, a technique generic to grounded theory, we analyzed interview transcripts of 23 women who experienced miscarriage (before 14 weeks gestation) at a midwestern medical center. We explored women's experiences by focusing on (1) how they came to know they were having a miscarriage and (2) how they decided what to do next. Both are key, yet relatively unexplored, constructs of early miscarriage.

Results: Being Sure emerged as the central process for women as they made decisions about what was happening to them, and about their treatment options. Participants needed to be sure that they were having a miscarriage (that the pregnancy was truly over), and also be sure that they were choosing the right treatment option for them (surgical, medical, or expectant management).

Clinical Implications: Nurses caring for women in the throes of an inevitable miscarriage can use the information in this article to support women in their quest toward Being Sure. Helping women thusly encompasses assisting women to understand their symptoms, come to terms with the inevitability of the pregnancy loss, and be comfortable with which treatment they choose for the miscarriage.

The loss of a pregnancy after 12 weeks is particularly difficult. One aspect of this loss oftentimes is the need for treatment to remove uterine contents. This requires that patients and families make choices they may not want to make.

Rana Limbo is Associate Director, Resolve Through Sharing, Gundersen Health System, La Crosse, WI. The author can be reached via e-mail at

Jo K. Glasser is Research Scientist (retired), Gundersen Health System, La Crosse, WI.

Maria E. Sundaram is Research Epidemiologist, Marshfield Clinic, Marshfield, WI.

The first author declares an employee relationship with Gundersen Medical Foundation.

The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

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