Second Trimester Miscarriage

1.1 Introduction

Second trimester miscarriage is often under reported and lacks recognition in both clinical practice and the literature. There are varied definitions for second trimester miscarriage and terms used to describe miscarriage in current literature. Miscarriage is defined by The World Health Organisation (WHO) (2001) as the premature expulsion of an embryo or fetus from the uterus up to 23 weeks of pregnancy and weighing less than 500g. Internationally there are different views on how second trimester miscarriage is distinguished from miscarriage and stillbirth. In Australia and America pregnancy loss before 20 weeks is considered a miscarriage and a stillbirth is defined as fetal death after 20 weeks (The American College of Obstetrics

Here I cared for women who experienced miscarriage and early pregnancy loss on a daily basis. I also on occasion cared for women following a stillbirth or early neonatal death. During this time I assisted in the planning and organisation of the annual remembrance service. I was struck by the large number of bereaved parents who attended and the appreciation they showed to the staff that looked after them. The experience I gained here encouraged me to apply for the Higher Diploma in Midwifery. During my time as a student midwife I cared for a number of bereaved parents and while it was a challenging experience I found it to be very rewarding also. Student midwives are offered the opportunity to complete a one week elective placement during their training program. I elected to spend a week with the clinical midwife specialist in bereavement and gained a wealth of knowledge from observing her practice during that week. Following the completion of the Higher Diploma in Midwifery I worked in the labour ward of the National Maternity Hospital. I thoroughly enjoyed this experience and spent over three years working very happily in the labour ward. Towards the end of my third year in the labour ward I successfully applied for the position of research assistant and worked with the bereavement team to complete the research project ‘An exploration of the prevalence and patterns of care for women presenting with Mid-trimester Loss at the National Maternity Hospital’ (Cullen et al., 2016). The current study is a follow on study. Throughout the process of completing this project I worked closely with the bereavement team and this further developed my interest in this area. One outcome of this study was a recommendation for further research examining mid-trimester loss (or second trimester miscarriage)