Economic and health‐related quality of life impacts of receiving recurrent miscarriage care in Ireland: Exploratory analysis drawing on results from a national care experience survey

Abstract

Undergoing miscarriage is a significant life event and having recurrent miscarriage (RM) can magnify psychological effects, including anxiety and depression, following a miscarriage. There is limited published evidence on impacts of RM on employment, personal finances, quality of life and use of health care services.This study examines the impact on quality of life, work experiences and personal finances of people receiving RM care.We conducted a cross‐sectional study using an anonymous national survey of people who experienced ≥2 consecutive first‐trimester miscarriages and received care for RM in Ireland in a 10‐year period. Questions encompassed sociodemographic information, details of RM care and workplace presenteeism (SPS‐6), health‐related quality of life (HRQOL) (SF‐12), healthcare utilisation and out‐of‐pocket expenses.Of the 135 participants included in analysis, 79% were aged 33–44 years. Participants scored low on the SF‐12 mental component (38.7), with 50% well below population norm. Participants needed time off work for investigations (66%), receiving results (62%), early reassurance scans (77%) and attending support services (18%). Participants spent, on average, 82 h off work attending RM care appointments. 70% experienced decreased productivity at work. Participants travelled 36.54 km, on average, attending RM care appointments, costing on average €372/participant for transport, parking and fuel. Other out‐of‐pocket expenses included further investigations, scans and services: total cost averaged €7930 per participant, plus costs for care of children/dependents while attending appointments of €245/participant.Implementing care standards, clinical guidelines and interventions supporting women/couples with RM, with appropriate funding, is needed to mitigate psycho‐social impacts and prevent high patient costs.