"It's just one of those things people don't seem to talk about." women's experiences of social support following miscarriage: A qualitative study 11 Medical and Health Sciences 1117 Public Health and Health Services

Background: Miscarriage is a common event which is estimated to occur in approximately one in four confirmed pregnancies (Collins et al, Grief Matters Aust J Grief Bereave- 17:44, 2014, St John et al, Aust J Adv Nurs- 23:8, 2006). Social networks play an important role in supporting women following this event and positive support experiences can play a role in buffering women's experiences of grief, loss and psychological distress following miscarriage (Rowlands et al, J Reprod Infant Psychol- 28:274-86, 2010, Stratton et al, Aust New Zeal J Obstet Gynaecol- 48:5-11). Methods: Women were recruited through existing networks known to the researcher, miscarriage support organisations and snowball sampling methods. Fifteen women living in Australia completed semi-structured interviews either in person or by telephone regarding their experiences of social support following miscarriage, and their recommendations for how this could be improved. Results: Women reported both positive and negative social support experiences following miscarriage. Women's partners were identified as their central support figures for most women in this study, and women also identified other women who had previously experienced miscarriage as helpful and supportive. Conversely, women also expressed they felt there was a vast silence surrounding miscarriage, with others being commonly uncomfortable discussing the event leading to feelings of loneliness and isolation. Many women also felt the societal tradition of not disclosing pregnancy until after the first trimester contributed to the stigma surrounding miscarriage, and lead to poorer support experiences. Conclusions: Raising awareness of the psychological impact of miscarriage appears imperative to assist the community to support women experiencing this loss, as well as reducing the secret and hidden nature of the experience. The recommendations provided may assist well-meaning friends and family in providing appropriate support for their loved ones experiencing miscarriage. Yet as many people in the wider community are uncomfortable with others' grief, providing the recommended supports in the context of miscarriage would likely remain highly challenging.