Women need to feel able to make an informed choice on the best way of treating their miscarriage a study published in the March issue of the British Journal of General Practice (BJGP) has found.

The study aimed to assess the personal and social impact of different management methods (surgical, medical and expectant)* on women's experience of first trimester miscarriage. Women's views varied significantly and the study found there was no 'best way' to treat miscarriage.

Interviews were held with 72 women and a set of themes emerged including: intervention; pain and bleeding; experience of caring; finality; and the 'baby'. One of the key issues for women was clinical intervention in the physiological process of miscarriage. Most women questioned whether such an approach was necessary, this finding being consistent with many other studies of women's views where medical treatment is often seen negatively. In contrast, a minority welcomed medical intervention.

Dr Lindsay Smith, GP in Somerset and lead researcher, said: "The major finding of this qualitative study was the widely divergent views of women in a number of areas, in terms of women's subjective responses to what they had experienced. There is clearly no 'one best way' to treat miscarriage that suits all individuals. This points to the current stress on the importance of people being able to make 'choices', a value now very strongly culturally embedded in consumerist societies and a choice that may well be different from their professional carers. Thus, many women strongly expressed their desires for an informed choice among methods. This must include full information on the possible outcomes of each method."

*Surgical management involved general anaesthetic and a short operation to empty the womb; medical management involved giving drugs to encourage the womb to contract and empty itself; expectant management involved waiting for the womb to empty spontaneously.

Smith L, Frost J, Levitas R, Bradley H, Garcia J. "Women's experiences of three early miscarriage management options - a qualitative study". BJGP March 2006; 56: 198-205.

The BJGP is published monthly and distributed to over 24,000 RCGP members, associates, and subscribers in more than 40 countries worldwide. Its primary purpose is to publish first-rate, peer reviewed research papers on topics relevant to primary care.

The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the "voice" of GPs on issues concerned with education; training; research; and clinical standards. Founded in 1952, the RCGP has over 23,000 members who are committed to improving patient care, developing their own skills and promoting general practice as a discipline.

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