Many Women in England Report Poor Support After Early Pregnancy Loss

Women in England who experience early pregnancy loss frequently report dissatisfaction with both their medical care and the follow-up support they receive afterwards, according to a cross-sectional online survey published in BMC Women’s Health. The study, led by Erica Jane Cook with colleagues including Jane Williams, Amy Ridge and Faye Powell, surveyed 512 women who had lost a pregnancy before thirteen weeks gestation within the previous three years. Overall, only 42.4 percent of participants, corresponding to 203 women, said they were satisfied with the care they received, while a striking 70.1 percent, or 330 women, reported dissatisfaction with follow-up support.

Early pregnancy loss is defined in the study as the loss of a pregnancy at less than thirteen weeks gestation. The authors note in their background that it affects approximately fifteen percent of all recognised pregnancies and can have a profound impact on women’s well-being. Previous evidence, they write, indicates that women often experience dissatisfaction with the care they receive, particularly where aftercare support is insufficient, and that this can adversely affect psychological outcomes. The new survey was designed to provide a current picture of women’s experiences and satisfaction with early pregnancy loss healthcare and follow-up support, and to examine how these experiences relate to psychological well-being and the overall impact of the loss.

Methodologically, the study was a descriptive cross-sectional online survey. Participants completed a self-administered Qualtrics questionnaire made up predominantly of closed-ended questions, using Likert-scale and multiple-choice formats, covering pregnancy history, experiences and satisfaction with healthcare, follow-up support and demographics. Alongside these questions, the questionnaire incorporated three validated psychological measures: the Reproductive Loss Impact Scale, or RMIS, for the psychological impact of pregnancy loss; the Hospital Anxiety and Depression Scale, or HADS, for anxiety and depression; and the PTSD Checklist for DSM-5, or PCL-5, for post-traumatic stress symptoms.

The psychological findings were substantial. Clinically significant post-traumatic stress symptoms were reported by 44.5 percent of participants, amounting to 204 women. Moderate-to-severe anxiety was reported by 40.4 percent, or 181 women, and moderate-to-severe depression by 20.8 percent, or 93 women. The participants had a mean age of 33.72 years with a standard deviation of 4.95. The authors also report that psychological outcomes differed according to selected socio-demographic and pregnancy-related factors, suggesting that the burden of early pregnancy loss is not distributed evenly across women.

A central association reported in the study links care quality to mental health: lower healthcare satisfaction was associated with poorer psychological well-being. Because the design is cross-sectional, the data capture women’s experiences and symptoms at a single point in time and cannot establish whether dissatisfaction with care causes worse psychological outcomes, or whether women who feel worse rate their care more negatively. The authors nonetheless frame the pattern as evidence that the emotional dimension of early pregnancy loss care deserves far greater attention within health services.

One of the starkest numbers in the survey concerns access to formal mental health support. Only 6.0 percent of participants, just 28 women, said they had been offered or referred for mental health support following their loss. Set against the high rates of post-traumatic stress, anxiety and depression symptoms reported by the same group, this figure points to what the authors describe as substantial gaps in the provision of emotional support and follow-up care after early pregnancy loss.

In their conclusions, the researchers argue that more consistent, compassionate and accessible care pathways are needed to ensure that women’s physical and psychological needs are recognised and addressed after early pregnancy loss. They emphasise that dissatisfaction is concentrated not only in immediate clinical encounters but also in the period afterwards, when follow-up support appears frequently to fall short of what women expect or need.

The authors are careful about what their findings can and cannot establish. As a descriptive cross-sectional survey of women in England who experienced an early pregnancy loss within the previous three years, the study reflects the experiences of those who chose to participate in online research rather than a random sample of all affected women. The authors call for future research to evaluate approaches to follow-up support that may improve women’s experiences and psychological well-being following early pregnancy loss, rather than claiming that any particular intervention has already been shown to work. For clinicians and service planners, however, the survey offers a detailed, quantified snapshot of where women currently perceive the gaps: in satisfaction with care, in follow-up support, and in the small proportion who are connected to mental health services after losing a pregnancy.

Subject of Research: Women's satisfaction with healthcare and follow-up support after early pregnancy loss in England

Article Title: Women’s satisfaction with early pregnancy loss healthcare and follow-up support: a cross-sectional study in England

Article References: Cook, E. J., Williams, J., Ridge, A., & Powell, F. (2026). Women’s satisfaction with early pregnancy loss healthcare and follow-up support: a cross-sectional study in England. BMC Women's Health. https://doi.org/10.1186/s12905-026-05023-8

Image Credits: AI Generated

DOI: 10.1186/s12905-026-05023-8

Keywords: early pregnancy loss, cross-sectional study, patient satisfaction, follow-up support, psychological well-being, PTSD symptoms, anxiety, depression, mental health referral, England, women's health, online survey