Views of health professionals on the impact of early miscarriage on women's mental health and the accessibility of services and support.

Aim: To explore health professionals' views on the impact of early miscarriage on mental health and accessibility of services and support available to women.

Methods: Semi-structured interviews were conducted with 10 health professionals from an urban tertiary hospital and a community setting, followed by semi-inductive thematic analysis.

Results: Three overarching themes were identified: (1) extent and nature of psychological impact, (2) barriers to accessing mental health support and (3) facilitators of change or improvement. Early miscarriage was regarded as a "loss" that affected not only the women but their partners and other family/whānau members. Establishing how women felt about the pregnancy was regarded as important in directing both the scope of the consultation and subsequent guide to support services. Inequitable access to services and support was identified. Cost of counselling, geographic location and fragmented care were cited as barriers to accessing support. Improved clinical pathways and channels for inter-professional communication, as well as more accessible counselling, were regarded as key areas for service improvement.

Discussion: This study highlights that, although health professionals appropriately recognise early miscarriage as a significant loss, access to support is inequitable and fragmented. Early miscarriage care is an area of unmet need and, given the high incidence of early miscarriage and its impact on mental health, urgent action around service provision is needed.