A descriptive cross sectional study on mental health outcome and perceived care needs following miscarriage in a tertiary care hospital in Sri Lanka

Introduction Miscarriage increases women's risk for psychiatric disorders such as depression, anxiety and stress and can also lead to a threat to life. Hospital environment and provision of appropriate clinical information to the client is an important determinant in prevention of psychological distress. The aim of our study was to describe the psychosocial consequences of miscarriages, its correlates and perceived needs in the care provided by the hospital. Method A descriptive cross sectional study was carried out in the Colombo South Teaching Hospital in 405 consecutive women admitted with first trimester miscarriages to the Gynaecology wards. An intervieweradministered study specific questionnaire was used to collect information on demographic details and Depression Anxiety Stress Scale (DASS) was used to assess psychosocial consequences. Results Out of the 405 women studied, 55.7% met the cut-off scores for depression, 66.6% for anxiety and 50.2% for stress. The symptoms of depression, anxiety and stress were severe in 14%, 40% and 18% respectively. Women who have taken treatment for subfertility had significantly higher depressive (p=0.01) and anxiety symptoms (p=0.02). The attending doctors not listening to concerns, not explaining the condition and not explaining the treatment methods were significantly associated with symptoms of depression, anxiety and stress. (p=0.02). Discussion Anxiety was the most common psychological condition detected following miscarriage followed by depression and inadequacies of service provision at the hospital have contributed significantly to the experience of emotional distress. Provision of correct information, validation of distress and psychological debriefing, may be useful in enabling women to adjust emotionally following miscarriage.