New TCD research on pregnancy loss in rural Ireland

The importance of support networks to mediate the impact of pregnancy loss and minimise the risk of disenfranchised grief has been highlighted in new research undertaken by Trinity College's School of Social Work and Social Policy.

An estimated 15-20 per cent of pregnancies end in miscarriage or preterm loss. Hospital social workers have an important role to play in mediating the impact of pregnancy loss. A small-scale qualitative study undertaken by TCD researchers to explore women's experience of the care delivered in rural Irish hospitals at the time of, and following a pregnancy loss points to the need for tailored support services to ease the impact of grief.

Seven out of eight of the women who participated in the research, described how their pregnancy loss was not openly acknowledged, publicly mourned or socially supported. This type of bereavement can be referred to as 'disenfranchised grief', according to TCD Assistant Professor in Social Work, Dr Trish Walsh, who supervised the research.

The research findings also point to the need for honest and sensitive communication from hospital staff in breaking bad news and providing information to women experiencing pregnancy loss. Lack of privacy in hospital wards and communal waiting areas and the need for routine follow-up psychosocial support to deal with feelings of grief were also highlighted by participants in the research.

Key recommendations from the study include the need for all Irish hospitals, rural and urban, to offer support services following pregnancy loss, both during admission and following discharge from hospital. The research also highlights the need for non-religious follow-up services, staff training in the emotional aspects of pregnancy loss and a tiered model of care, encompassing information, support, psycho-education and for some, counselling interventions.

"Hospital practices, even in smaller rural settings, can be improved by developing modest but explicit policies which counteract this sense of disenfranchisement, offer follow-up emotional support and address problems within the hospital environment," commented Dr Walsh.

"At a time when our healthcare services are being rationalised and staff numbers cut, it is of vital importance that we don't forget how central psychosocial supports can be in helping people come to terms with loss and how the absence or provision of supports in themselves affect the patient's overall experience of the hospital system. Minor changes to practice can make the world of difference."

The research was conducted by Senior Social Worker Aileen Mulvihill, supervised by Dr Trish Walsh, Assistant Professor in Social Work, Trinity College Dublin, and has recently been published in the British Journal of Social Work.