Abstract
BACKGROUND: Recurrent miscarriage (RM) and infertility are separately associated with psychological distress and adverse pregnancy outcomes. The dual experience is devastating for women/couples but is not considered in clinical guidance for RM or fertility care. OBJECTIVE: The aim of this study is to explore healthcare professional (HCP) views on the provision of care to women and couples with RM and infertility in the ROI, as well as the experiences of women who use these services. SETTING AND PARTICIPANTS: We recruited HCPs working in RM and fertility services and women with lived experience of two or more miscarriages who had undergone fertility care. Purposive sampling was used to include perspectives from multiple disciplines, lived experiences and geographical locations. DESIGN: We conducted semi-structured interviews, virtually and in-person, between December 2022 and May 2023. These were audio-recorded, and the data were transcribed for subsequent reflexive thematic analysis. RESULTS: We interviewed 16 HCPs and 17 women with lived experience. We actively generated four central themes during data analysis. 'Exploring all avenues'-stigmatisation and misinformation around RM and infertility impacted on seeking care. 'Exhausting all resources'-there were physical, emotional and financial implications with this dual experience. 'Separateness'-women felt remote from others and removed from services. 'No woman is an island'-supports came from multiple sources in various guises but were limited. CONCLUSION: The experience of RM and infertility is complex, with a profound impact on the lives of women and their partners. Alongside financial and psychological supports, there is a need for greater education and awareness of miscarriage and fertility. PATIENT/PUBLIC CONTRIBUTION: Our research group includes and collaborates with people with lived experience. Women were recruited through direct approach and social media, and their participation was voluntary with no financial remuneration. The experiences of women and their families offer keen insights into services and highlight areas requiring improvement and development.