“Your womb, your choice!” Making an informed decision regarding the timing of pregnancy following miscarriage

Abstract

AbstractThe ideal interpregnancy interval (IPI) following a miscarriage is controversial as the World Health Organization (WHO) advise women to delay pregnancy for at least six months. Subsequent research has found that IPI less than six months is beneficial for both mother and baby. The impact of this guidance on the decision-making process for couples/women in this predicament is unknown.Views of women regarding the optimum IPI following miscarriage were investigated using a thematic framework applied to discussion threads from a popular online forum, Mumsnet (https://www.mumsnet.com). A systematic search of all online information was also undertaken to identify all relevant patient information regarding conceiving another pregnancy after a miscarriage. The findings from the search were tabulated and analysed in relation to the themes identified from the discussion threads on Mumsnet. Ninety-four discussion threads were included. Women saw no reason to wait if they felt ready. Women posted about their frustrations at the multiple sources of conflicting advice they received, at the lack of professional sympathy and felt that being told to wait before trying to conceive after a miscarriage was outdated advice. However, these findings were not corroborated by the patient information currently available online. All web-based patient information gave consistent advice – to wait for at least one normal period before trying to conceive again after a miscarriage and to try for another pregnancy when they felt physically mentally and emotionally ready. None advised waiting for six months. This study highlights that sometimes despite contradictory clinical advice, women are keen to make their own decisions regarding reproductive choice. These decisions are often empowered by peer support and advice which women trust over inconsistent information received from healthcare professionals. In this case, health information appears to have been updated in response to women’s choice rather than the other way around.Research highlightsA knowledge gap exists in relation to the views of women regarding the ideal interpregnancy interval following miscarriage.This study provides insights into the views and beliefs of women regarding the IPI following miscarriageThe dominant themes emerging from the study were: there is an array of conflicting advice being provided; there is no requirement to wait following a miscarriage; and the right time is when a couple feels physically, mentally and emotionally ready to try for another pregnancy.Current web-based information for patients does not endorse the WHO’s guidance of waiting for at least six months before trying to conceive again after a miscarriage.