Versorgung und Nachbetreuung von Aborten – Empfehlungen für Public-health-Maßnahmen

About 25% of all women of reproductive age experience at least one miscarriage in their lifetime. For affected parents, miscarriage can often have unrecognized physical and psychological effects, which is why adequate aftercare is crucial. The aim of the research is to identify possible interface problems in the German health care system, to collect experiences of after-care services, to determine individual needs and to generate public health measures for practice.

To determine needs, a qualitative study was conducted using guideline-based telephone or video interviews with 10 women from different regions of Germany who had suffered one miscarriage or several miscarriages. These were analyzed following Mayring’s qualitative content analysis.

Women who miscarried require more emphatic approach towards the situation of those affected in the context of aftercare and an interdisciplinary service in inpatient and outpatient settings, including the partner’s perspective. Support groups and low-threshold online aftercare services are predominantly utilised. Outpatient therapy sessions were preferred to online forms of therapy. Risk counseling and support provided by gynaecologists and fertility clinics for subsequent pregnancies is predominantly rated positively. Further needs such as intersectoral information provision, the nationwide expansion of special postnatal courses for orphaned mothers and access to rehabilitation clinics as well as the destigmatisation of miscarriages were identified in the field of aftercare.

Approaches to public health measures for practice are generated from the analyzed interface problems and the needs derived from them. These recommendations require optimization of aftercare strategies, such as increased medical education and intersectoral provision of information on potential support services. Training and further education in the various professional groups, a more sensitive approach on part of the authorities, and improvements to statutory cost regulations in German social security law are necessary. In addition, further studies are required to record the perspectives not only of women but also of men and service providers.