Women Attending Hospital in Malawi for Miscarriage: A Qualitative Study of Perceptions of Miscarriage

Aims: To investigate women’s perceptions of miscarriage and its complications.
Study Design: A qualitative design was used with data collected through semi-structured interviews.
Place and Duration of Study: Gynaecology ward of the Queen Elizabeth Central Hospital, Blantyre, Malawi, during February and March 2012.
Methodology: Sample: We included 30 patients (aged between 18 and 39) admitted to the gynaecology ward for surgery following miscarriage. Inclusion criteria were: (a) diagnosis of miscarriage (b) aged over 18. Semi-structured interviews were conducted through a translator and lasted an average of 30 minutes (range 14 – 46minutes).
Results: 14 of the women interviewed knew what a miscarriage was. Perceived causes included contraceptives, prohibited medicines, hard labour, stress, HIV, malaria, witchcraft, traditional medicines, lack of child spacing and abuse by their male partners. Women obtained knowledge from their own experience of miscarriage and through the shared experiences of female family members and friends. Women were found to have concerns about death from miscarriage; facing stigmatising attitudes of community and health workers; and the treatment they would receive in hospital, particularly the surgical procedure.
Conclusions: The women had poor knowledge of the causes and symptoms of miscarriage. They were concerned about the treatment that they would receive in the hospital and how their miscarriage would be perceived by both the hospital staff and within their communities. Women who have miscarriages should be encouraged to discuss this with female friends and relatives to improve knowledge on miscarriage and help dispel the stigma surrounding it. Providing information on the treatment they would receive whilst in hospital may help to allay women’s concerns. Incorporating education about miscarriage into the school syllabus may help to improve women’s awareness and understanding.