{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:40:29Z","timestamp":1784734829795,"version":"3.55.0"},"reference-count":67,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["ILP\u2010HSR\u20102019\u2010011"],"award-info":[{"award-number":["ILP\u2010HSR\u20102019\u2010011"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Maternity services underwent much change during the COVID\u201019 pandemic. Research on the impact on miscarriage care and experiences during this time is sparse. Within a national evaluation of recurrent miscarriage care, we qualitatively explored stakeholder views and experiences of recurrent miscarriage services in Ireland. This study describes the impact of the COVID\u201019 pandemic on those experiences and perceptions of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>People with professional and lived experience of recurrent miscarriage and service engagement were actively involved in this qualitative study from idea generation to analysis and reporting. We recruited women and men with two or more consecutive first\u2010trimester miscarriages, and people involved in the management\/delivery of recurrent miscarriage services and supports. We used purposive sampling to ensure that perspectives across disciplinary or lived experience, geographical, and health service administrative areas, were included. We conducted semi\u2010structured interviews, virtually all due to COVID\u201019 restrictions, between June 2020 and February 2021. These were audio\u2010recorded, and data were transcribed, and subsequently analyzed using reflexive thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We interviewed 42 service providers and 13 women and 7 men with experience of recurrent miscarriage. We actively generated two central themes during data analysis. The first\u2014\u2018Disconnected\u2019\u2014describes how many women navigated miscarriage diagnosis and management and care in subsequent pregnancies alone; many felt that this resulted in increased trauma. At the same time, men struggled with not being present to support their partners and described feeling disconnected. The second theme highlighted \u2018The perceived dispensability of recurrent miscarriage services and supports\u2019. Some service providers felt that service reduction and redeployment demonstrated a lack of value in the service. Virtual clinics facilitated access to services, but a preference for in\u2010person care was highlighted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our analysis provides rich insights into the significant impacts that the COVID\u201019 pandemic has had on the way recurrent miscarriage care is provided and experienced, with important implications for early pregnancy, miscarriage and recurrent miscarriage care. Services have undergone significant changes and, while these may be temporary, how services should be delivered in the future requires consideration, particularly given the deficits in care and care experiences highlighted prepandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Members of the multidisciplinary RE:CURRENT Project Research Advisory Group (including four parent advocates, two of whom are co\u2010authors on this article) were actively involved throughout the study, including the generation of topic guides and the refining of themes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13791","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T06:29:20Z","timestamp":1686378560000},"page":"1768-1782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["\u2018An extra level of kind of torment\u2019: Views and experiences of recurrent miscarriage care during the initial phases of COVID\u201019 in Ireland\u2014A qualitative interview study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5182-1349","authenticated-orcid":false,"given":"Rebecca","family":"Dennehy","sequence":"first","affiliation":[{"name":"Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology University College Cork Cork Ireland"},{"name":"INFANT Research Centre University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-8118","authenticated-orcid":false,"given":"Marita","family":"Hennessy","sequence":"additional","affiliation":[{"name":"Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology University College Cork Cork Ireland"},{"name":"INFANT Research Centre University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Ui","family":"Dhubhgain","sequence":"additional","affiliation":[{"name":"RE:CURRENT Research Advisory Group, Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology University College Cork Cork Ireland"},{"name":"Miscarriage Association of Ireland Carmichael Centre Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Con","family":"Lucey","sequence":"additional","affiliation":[{"name":"RE:CURRENT Research Advisory Group, Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keelin","family":"O\u2032Donoghue","sequence":"additional","affiliation":[{"name":"Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology University College Cork Cork Ireland"},{"name":"INFANT Research Centre University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00079-6"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100947"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2021-0441"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16844"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04816-7"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04724-w"},{"key":"e_1_2_11_8_1","article-title":"COVID\u201019: challenging Ireland to move from mastership to midwifeship","author":"Devane D","year":"2020","journal-title":"Medical Anthropology Quarterly Rapid Response Blog Series"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2022.103356"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.2021.29.4.216"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2021.103092"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2022.06.007"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04637-8"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04602-5"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03283-2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2021.103116"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-051965"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248488"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2021.04.012"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10020304"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2326"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102779"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.07.011"},{"key":"e_1_2_11_24_1","article-title":"Birth partners are not a luxury","author":"Black B","year":"2020","journal-title":"BMJ Opin"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.03.011"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002967"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000629"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.10.010"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00836-3"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00682-6"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04292-5"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-061550"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.2196\/38866"},{"key":"e_1_2_11_34_1","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun V","year":"2021"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13607"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/10497323221101709"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.11.311"},{"key":"e_1_2_11_38_1","volume-title":"Timeline and Detail of Public Health Restrictive Measures Advised by NPHET in Response to the COVID\u201019 Pandemic","author":"NPHET Policy Unit","year":"2021"},{"key":"e_1_2_11_39_1","unstructured":"Government of Ireland.Government publishes roadmap to ease COVID\u201019 restrictions and reopen Ireland's society and economy.2020. Accessed December 19 2022.https:\/\/www.gov.ie\/en\/press-release\/e5e599-government-publishes-roadmap-to-ease-covid-19-restrictions-and-reope\/"},{"key":"e_1_2_11_40_1","unstructured":"Department of the Taoiseach.Ireland placed on Level 5 of the plan for living with COVID\u20101919 (19 October 2020). October 19 2020. Accessed December 19 2022.https:\/\/www.gov.ie\/en\/press-release\/66269-ireland-placed-on-level-5-of-the-plan-for-living-with-covid\/"},{"key":"e_1_2_11_41_1","unstructured":"Department of the Taoiseach.Ireland placed on Level 3 of the plan for living with COVID\u20101919 (27 November 2020). November 27 2020. Accessed December 19 2022.https:\/\/www.gov.ie\/en\/press-release\/5b068-ireland-placed-on-level-3-of-the-plan-for-living-with-covid-with-special-measures-for-a-safe-christmas\/"},{"key":"e_1_2_11_42_1","unstructured":"Department of the Taoiseach.Ireland placed on Level 5 Restrictions of the plan for living with COVID\u201019\u2014with a number of specific adjustments (22 December 2020). December 22 2020. Accessed December 19 2022.https:\/\/www.gov.ie\/en\/press-release\/a1f21-ireland-placed-on-level-5-restrictions-of-the-plan-for-living-with-covid-19-with-a-number-of-specific-adjustments\/"},{"key":"e_1_2_11_43_1","unstructured":"Department of the Taoiseach.Briefing on the government's response to COVID\u201019\u2014Wednesday 10 February 2021. February 10 2021. Accessed December 19 2022.https:\/\/www.gov.ie\/en\/publication\/e69b6-briefing-on-government-measures-in-response-to-covid-19-wednesday-10th-february\/"},{"key":"e_1_2_11_44_1","unstructured":"O\u2032DonoghueK McKernanJ.Institute of Obstetricians and Gynaecologists Royal College of Physicians of Ireland. Version 5.0. Royal College of Physicians of Ireland;2021. Accessed December 19 2022.https:\/\/rcpi-live-cdn.s3.amazonaws.com\/wp-content\/uploads\/2021\/11\/COVID19-pregnancy-040521.pdf"},{"key":"e_1_2_11_45_1","unstructured":"O\u2032DonoghueK McKernanJ.Institute of Obstetricians and Gynaecologists Royal College of Physicians of Ireland. Version 4.0.Royal College of Physicians of Ireland;2020."},{"key":"e_1_2_11_46_1","unstructured":"Health Service Executive.COVID\u201019 guidance on visitations to acute hospitals including Children's Hospitals Rehabilitation Services and other Healthcare Settings providing a similar intensity of care. V2.2. Health Service Executive. June 11 2021."},{"key":"e_1_2_11_47_1","unstructured":"Health Protection Surveillance Centre.Infection prevention and control precautions for possible or confirmed COVID\u201019 in a pandemic setting. V1.1. May 8 2020. Accessed December 19 2022.https:\/\/www.lenus.ie\/bitstream\/handle\/10147\/627507\/Interim%20Infection%20Prevention%20and%20Control%20Precautions%20for%20Possible%20or%20Confirmed%20COVID-19%20in%20a%20Pandemic%20Setting%281%29.pdf?sequence=5&isAllowed=y"},{"key":"e_1_2_11_48_1","unstructured":"AIMS Ireland.Covid restrictions\u2014continuing effects Autumn2020. Accessed December 1 2022.http:\/\/aimsireland.ie\/coiid-restrictions-continuing-effects\/"},{"key":"e_1_2_11_49_1","unstructured":"FinnM. Hundreds gather to protest at ongoing maternity restrictions.Independent. October 6 2021. Accessed December 13 2022.https:\/\/www.independent.ie\/irish-news\/hundreds-gather-to-protest-at-ongoing-maternity-restrictions-40923947.html"},{"key":"e_1_2_11_50_1","unstructured":"PollakS O\u2032HalloranM. Women protest outside maternity hospitals over Covid restrictions.The Irish Times. May 11 2021. Accessed December 13 2022.https:\/\/www.irishtimes.com\/news\/health\/women-protest-outside-maternity-hospitals-over-covid-restrictions-1.4562257"},{"issue":"1","key":"e_1_2_11_51_1","first-page":"P713","article-title":"A national evaluation of recurrent miscarriage care services","volume":"116","author":"Hennessy M","year":"2023","journal-title":"Ir Med J"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_11_53_1","unstructured":"ESHRE Recurrent Pregnancy Loss Guideline Development Group.Recurrent Pregnancy Loss: Guideline of European Society of Human Reproduction and Embryology. Update 2022;2023. Accessed December 19 2022.https:\/\/www.eshre.eu\/Guidelines-and-Legal\/Guidelines\/Recurrent-pregnancy-loss"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13452"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732319870270"},{"issue":"11","key":"e_1_2_11_56_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0267415","article-title":"Making maternity and neonatal care personalised in the COVID\u201019 pandemic: results from the babies born better survey in the UK and the Netherlands","volume":"17","author":"Berg LMM","year":"2022","journal-title":"PLoS One"},{"key":"e_1_2_11_57_1","unstructured":"O\u2032DonoghueK CotterR.On the Implementation of the National Standards for Bereavement Care Following Pregnancy Loss and Perinatal Death. National Women and Infants Health Programme Health Service Executive.2021. Accessed December 19 2022.https:\/\/www.hse.ie\/eng\/about\/who\/acute-hospitals-division\/woman-infants\/bereavement-care\/hse-national-standards-for-bereavement-care.pdf"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13284"},{"key":"e_1_2_11_59_1","unstructured":"Health Service Executive.National miscarriage misdiagnosis review. Health Service Executive.2011. Accessed December 16 2022.https:\/\/www.hse.ie\/eng\/services\/publications\/hospitals\/miscarriagereview.html"},{"issue":"1","key":"e_1_2_11_60_1","first-page":"65","article-title":"Barriers and facilitators to knowledge translation in the field of pregnancy loss: findings from a qualitative survey with a range of knowledge users","volume":"130","author":"Hennessy M","year":"2023","journal-title":"Br J Obstet Gynaecol"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00954-5"},{"key":"e_1_2_11_62_1","unstructured":"Scottish Government.A Fairer Greener Scotland: programme for Government 2021\u201322. Scottish Government.2021. Accessed December 16 2022.https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/strategy-plan\/2021\/09\/fairer-greener-scotland-programme-government-2021-22\/documents\/fairer-greener-scotland-programme-government-2021-22\/fairer-greener-scotland-programme-government-2021-22\/govscot%3Adocument\/fairer-greener-scotland-programme-government-2021-22.pdf"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077800410383121"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011382"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09347-1"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04585-3"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2017.11.002"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.06.011"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.13791","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T08:34:01Z","timestamp":1700123641000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.13791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":67,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/hex.13791"],"URL":"https:\/\/doi.org\/10.1111\/hex.13791","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,9]]},"assertion":[{"value":"2023-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}