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

Abstract Background Early pregnancy loss (EPL; loss < 13 weeks gestation) is a common pregnancy complication affecting approximately 15% of all recognised pregnancies, which can have a profound impact on the well-being of women. Evidence reveals that women often experience dissatisfaction with the care they receive, particularly in terms of insufficient aftercare support, which can adversely impact psychological outcomes. This study aimed to provide a current understanding of women’s experiences and satisfaction with early pregnancy loss healthcare and follow-up support and to understand to what extent these experiences relate to psychological well-being and the overall impact of their loss. Methods A descriptive cross-sectional online survey was conducted among women in England who had experienced an EPL within the previous three years. Participants completed a self-administered Qualtrics questionnaire comprising closed-ended, predominantly Likert-scale and multiple-choice questions assessing pregnancy history, experiences and satisfaction with healthcare, follow-up support, and demographics, alongside validated measures of the psychological impact of pregnancy loss (RMIS), anxiety and depression (HADS), and post-traumatic stress symptoms (PCL-5). Results A total of 512 women participated ( M age = 33.72 years, SD = 4.95). Overall, 42.4% ( n = 203) were satisfied with the care they received, and lower healthcare satisfaction was associated with poorer psychological well-being. Clinically significant PTSD symptoms were reported by 44.5% ( n = 204) of participants, moderate-to-severe anxiety by 40.4% ( n = 181), and moderate-to-severe depression by 20.8% ( n = 93). Psychological outcomes also differed according to selected socio-demographic and pregnancy-related factors. Overall, 70.1% ( n = 330) of women were dissatisfied with follow-up support, while only 6.0% ( n = 28) were offered or referred for mental health support. Conclusions These findings highlight substantial gaps in the provision of emotional support and follow-up care following early pregnancy loss. More consistent, compassionate, and accessible care pathways are needed to ensure that women’s physical and psychological needs are recognised and addressed. Future research should evaluate approaches to follow-up support that may improve women’s experiences and psychological well-being following early pregnancy loss.