Barriers and Facilitators to Accessing Psychosocial Support Following Miscarriage: A Scoping Review Protocol

Background and Aims: Miscarriage is the most common complication in early pregnancy and is associated with adverse mental health outcomes. Expectant parents want emotional support during this devastating life event, yet few receive the support they desire. Access to support may be affected by individual, societal, and systemic factors. This study aims to map international English literature about the barriers and facilitators to accessing psychosocial support. As miscarriage can have enduring psychological impacts, it is pertinent to uncover factors impacting access to psychosocial support, as this may reduce the psychological impact of miscarriage and promote wellbeing. Methods: Any peer-reviewed English literature that explores barriers and facilitators to accessing psychosocial support in an adult population experiencing miscarriage will be considered for inclusion in the review, including perceptions from partners and health professionals. Literature that assesses other forms of pregnancy loss (e.g., ectopic pregnancy, molar pregnancy, termination of pregnancy, stillbirth, neonatal death) is out of scope. To ensure methodological rigour and transparency, the planned scoping review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search of PubMed/MEDLINE, PsycINFO, Web of Science, and CINAHL will be conducted to identify relevant literature. Results: The final scoping review will present the results of the search, study inclusion, and data analysis. Quantitative data will be presented in tabular format, stratified by geographical location and definition of miscarriage. Qualitative data will be coded and synthesized using descriptive qualitative content analysis. Barriers and facilitators will be presented visually using a socio-ecological model framework whilst recommendations to minimize barriers and enhance facilitators will be tabulated. Conclusion: The planned review is the first of its kind to identify barriers and facilitators to accessing psychosocial support following miscarriage. Outcomes have the potential to advance understanding about access to psychosocial support, which could enhance miscarriage care and alter the psychological trajectory of people impacted by miscarriage.