Bakgrund Missfall drabbar ca 20% av alla kvinnor med bekräftade graviditeter i Sverige. Den vanligaste orsaken till missfall är kromosomavvikelser hos fostret. Riskfaktorer för missfall är bland annat om kvinnan har diabetes mellitus eller en sköldkörtelsjukdom som inte är medicinskt välinställd. Även livsstilsrelaterade riskfaktorer föreligger. Vid missfall kan kvinnan uppleva en känsla av att sakna kontroll och hjälplöshet. Ett missfall kan upplevas traumatiskt och förlusten kan påverka kvinnan under en längre tid. Viktiga omvårdnadsåtgärder som lyfts upp är information om vem kvinnan kan kontakta och allmän information, samt även att vara lyhörd som sjuksköterska. Syfte Syftet var att belysa kvinnors upplevelse av omvårdnad vid missfall.​ Metod En litteraturöversikt som inkluderat 7 kvalitativa artiklar samt 3 artiklar med mixad metod. Litteratursökningen genomfördes i databaserna Cinahl complete och PubMed. Resultat Resultatet presenteras i tre huvudteman: Vårdmiljön skapar oro och ovisshet, Vikten av omvårdnadsinformatik och Vikten av psykosocialt stöd. Resultatet visar bland annat på att kvinnor upplevde att väntan på svar kring diagnostiseringen av missfallet skapade ångest och oro, medan snabb hantering och behandling värdesattes. Även en bristande medkänsla från sjuksköterskor i samband med missfall framkom och bristande information kring missfall samt att många kvinnor kände att de lämnades frågandes efter ett missfall. Slutsats Trots vissa positiva upplevelser av omvårdnad vid missfall, såsom tydlig information och emotionellt stöd från sjuksköterskor, var de negativa upplevelserna övervägande. Kvinnor upplevde en otrygg vårdmiljö, bristande bemötande och bristande information. Kvinnor efterfrågade mer information samt tydlig och direkt kommunikation samt uppföljning. Den känslomässiga hanteringen av förlusten upplevdes lättare om sjukvårdspersonal hade ett bemötande med medkänsla då det upplevdes som tröstande. / Background Miscarriage affetcs around 20% of all women with confirmed pregnancies in Sweden. The most common cause of miscarriage is chromosomal abnormalities in the fetus. Various diseases can consitute risk factors, such as diabetes mellitus or thyroid disease that’s not medicaly well-controlled. Lifestyle-related risk factors also exist. During a miscarriage, the women can experience a sense of lacking control and helplessness. A miscarriage can be perceived as traumatic and the loss can impact the woman for an extended period. Essential nursing measures that were highlighted include providing information about who the women can contact and general information. Additionally, being attentive as a nurse is important. Aim The aim was to enlighten women’s experience of nursing care in the context of miscarriage. Method A literature review including 7 qualitative atricles and 3 articles with mixed method. The literature search was conducted in the databases Cinahl complete and PubMed. Results The results are presented in three main themes: The healthcare environment creates anxiety and uncertainty, The importance of nursing informatics and The importance of psychosocial support. The findings indicated, among other things, that women experience anxiety and worry during the wait for diagnostic results of the miscarriage, quick handling and treatment was valued. A lack of compassion from nurses in connection with miscarriage was evident, leaving many women with unanswered questions after a miscarriage.​ Conclusions Despite some positive experiences of care during miscarriage, such as clear information and emotional support from nurses, the negative experiences were dominant. Women perceived an insecure care environment, inadequate treatment och lack of information. Women sought more information as well as clear and direct communication and follow-up. The emotional handling of the loss was perceived easier if the nurses approached it with compassion, as it was found to be comforting.

Spontaneous abortion, or miscarriage, is an event that affects approximately one in four women during their reproductive years. Despite the psychological and physiological trauma associated with the loss of pregnancy, few evidence-based practice recommendations exist to guide nursing care of women experiencing first trimester miscarriage. The purpose of this integrative review of literature was to examine research related to women's health care experiences of first trimester miscarriage and discuss common themes relating to nursing care. Inclusion criteria consisted of peer review research articles published after 2001 and available in the English language and women that experienced miscarriage during the first 12 weeks of pregnancy. Current literature was collected from Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE- EBSCOhost and PsycINFO databases using combinations of various key words. Six qualitative studies and one quasi-experimental study met the inclusion criteria and were reviewed. The results indicated that nursing care of women experiencing miscarriage should include therapeutic communication, psychological support, and provision of information and follow-up care. While there is little research reviewing nursing interventions related to first trimester miscarriage, these themes may help guide the development of further research reviewing the efficacy and effectiveness of specific nursing interventions.

Grand Tour Question Ø What are the impacts of miscarriage on African American men? Pettie Tour Question Ø What are African American malesʼ most effective means of dealing with and healing after experiencing a miscarriage? Purpose of the Study Ø To investigate the effects and perceptions of miscarriages in the African American community from the male perspective. Ø In 2008, my wife and I lost our first child that we were expecting. This experience revealed the degree to which social stigma and gender specific traditions inhibit disclosure, healthy discourse and closure concerning reproductive loss. I plan to utilize historical, social, spiritual and scientific tools to construct a relevant and helpful resource for Black men coping with such a profound loss. Data Collection Ø I utilized the extensive resources available in the Social Science Data Library and Paley Library of Temple University. Implications for Future Study Ø The research presented provides a platform to test the “Dual construction” method introduced. Testimonials can be compiled through interviews of African American men who have experienced reproductive loss. These recounts could be recorded for a possible documentary on the subject that could exponentially expand the discourse among African American men and the pain and pressures that they may share. An organization specifically geared towards the needs of African American men as revealed through the findings of this thesis. Conclusions Ø The therapeutic truth of candid communication is a much-needed component in the effort to advance the dialogue about miscarriage among African American men. The Dual Construction Method of learning more about the self in order to help rebuild it after traumatic events is a strategy conceived with the needs of African American men in mind. The intellectual, cultural and testimonial fortification that the Dual Construction Method can provide is a foundation that can expand the discourse about miscarriage exponentially. The lost seeds of human procreation must be watered with waves of relevant empowering information as old as the Nile River in order to properly grow and/or be grieved. / African American Studies

Implantation requires complex molecular and cellular events involving coagulation, angiogenesis and immunological processes that need to be well regulated for a pregnancy to establish and progress normally.  The overall aim of this thesis was to study different models associated with atypical angiogenesis, impaired implantation and/or placentation, such as recurrent miscarriage (RM), oocyte donation (OD) and preeclampsia. Histidine-rich glycoprotein (HRG), a serum protein with angiogenic potential has been previously shown to have an impact on implantation and fertility.  In two retrospective case-control studies, women suffering from RM (Study I) and gestational hypertensive disorders (GHD) (Study IV) have been compared to healthy control women, regarding carriership of HRG genotypes (HRG A1042G and C633T SNP, respectively).  According to the findings of this thesis, heterozygous carriers of the HRG A1042G SNP suffer from RM more seldom than homozygous carriers (Study I).  Additionally, the presence of the HRG 633T allele was associated with increased odds of GHD (GHD IV).  Studies II and III comprised a national cohort of relatively young women with optimal health status conceiving singletons with donated oocytes versus autologous oocytes (spontaneously or via IVF).  We explored differences in various obstetric (Study II) and neonatal (Study III) outcomes from the Swedish Medical Birth Register.  Women conceiving with donated oocytes had a higher risk of GHD, induction of labor and cesarean section, as well as postpartum hemorrhage and retained placenta, when compared to autologously conceiving women.  OD infants had higher odds of prematurity and lower birthweight and length when born preterm, compared to neonates from autologous oocytes.  With regard to the indication of OD treatment, higher intervention but neverthelss favourable neonatal outcomes were observed in women with diminished ovarian reserve; the risk of GHD did not differ among OD recipients after adjustment. In conclusion, HRG genetic variation appears to contribute to placental dysfunction disorders.  HRG is potential biomarker that may contribute in the prediction of the individual susceptibility for RM and GHD.  Regarding OD in Sweden, the recipients-despite being of optimal age and health status- need careful preconceptional counselling and closer prenatal monitoring, mainly due to increased prevalence of hypertensive disorders and prematurity.

Abstract Objectives: The objective of this study was to determine if an association exists between prior induced and prior spontaneous pregnancy termination (PIPT and PSPT) and preterm birth (PTB) of first live births in Virginia. Methods: Data was collected by linking maternal data from Virginia’s live birth and fetal death registries. All first live, singleton births occurring in Virginia from 2000-2007 were analyzed. Logistic regression models that controlled for various demographic, medical and obstetric history factors were used to determine associations among prior pregnancy termination types. Results: Compared with women who had no history of previous pregnancy terminations, women who had 1 (OR = 1.1, 95% CI 1.31, 1.53), 2 (OR = 1.2, 95% CI 1.12, 1.24) and 3 or more (OR = 1.4, 95% CI 1.07, 1.13) total prior pregnancy terminations had an increased odds of experiencing PTB. Increased odds of PTB were found for women who had 2 (OR = 1.1, 95% CI 1.05, 1.18) and 3 or more (OR = 1.3, 95% CI 1.39, 1.61) PIPTs. Women who reported 1, 2, 3 or more PSPT had PTB odds-ratios of 1.4 (95% CI 1.37, 1.50), 1.7 (95% CI 1.48, 1.98) and 3.0 (95% CI 2.09, 4.22) times, respectively. Conclusion: Two or more PIPT and one or more PSPT were found to be a significant risk factor for PTB of a first live birth in Virginia, and women having 3 or more PSPT had three times the odds of experiencing this outcome. Health practitioners should take this data into account to target research, education and action strategies to those high risk groups of women associated with obtaining induced terminations and to those women more susceptible to spontaneous termination of pregnancy.

Introduction Radiologic Technologists exposed to continuous low dose radiation may have an increased risk for spontaneous abortions. Although the federally mandated radiation dose limit to the developing fetus of an occupational worker is 5mSv, well below the documented threshold of 100mSv, some studies have suggested an increased risk for spontaneous abortions in occupationally exposed females. The effects of exposure to low levels of radiation are difficult to discern from the usual occurrence and are limited in the literature because of the large sample size needed to achieve statistical power. This study contains data from 152,439 self-reported pregnancies and possesses the appropriate sample size to assess the risk of spontaneous abortions incident to radiologic technologists who maintain fetal radiation dose levels within federal guidelines. Methods This non-experimental retrospective designed study uses data from the United States Radiologic Technologist Study (USRTS). The USRTS began in 1982 as a joint effort between the American Registry of Radiologic Technologists (ARRT),UniversityofMinnesotaand the National Cancer Institute to study the radiation effects from low-dose occupational exposure. This longitudinal study follows more than 90,000 current and former technologists through periodic surveys and contains a sufficient sample size to overcome statistical power concerns. The provided data included the order and outcome of each self-reported pregnancy as well as the year of each live birth. The data were therefore manipulated to provide a likely gestational interval for both a reported live birth and spontaneous abortion. After calculating the spontaneous abortion rate for the final sample, a binary logistic regression was performed to determine if levels of estimated fetal radiation dose are associated with predicting the odds of a reported spontaneous abortion. A linear regression analysis was then performed to assess the relationship between the calculated odds ratios of a reported spontaneous abortion as a function of estimated fetal radiation dose, specifically to determine the significance of the linear relationship Results The overall spontaneous abortion incidence to the cohort reporting at least one live birth or spontaneous abortion was 14.8%, lower than the reported national incidence of 15-20%. Using up to 1mSv as the reference fetal radiation dose category, the odds ratios of a spontaneous abortion for 1-2mSv, 2-3mSv, 3-4mSv and 4-5mSv were calculated as 1.57, 1.82, 2.11 and 2.15 respectively. This increase in odds was linear with estimated fetal radiation dose as demonstrated by the significant regression equation (F=29.93, p = .01) and an R2 of 0.9089. Conclusions By demonstrating an increased risk at levels of radiation as low as natural background, and further demonstrating the risk increases linearly with radiation dose, the Linear Non-Threshold Theory appears to be the more likely risk model for predicting spontaneous abortions in lieu of the belief that a 100mSv threshold must first be exceeded for a radiation induced spontaneous abortion to occur. Application of this model demonstrates the risk of a spontaneous abortion is twice as likely in occupational workers whose fetal radiation doses are closer to the maximum allowable limit of 5mSv compared with those who maintain fetal radiation doses below 1mSv.

Introdução: O aborto é assunto bastante polêmico e ainda muito estigmatizado pela sociedade brasileira. Seja aborto espontâneo ou provocado, apresenta repercussões emocionais ambivalentes para as mulheres que o vivenciam. Este estudo trata do tema aborto em um contexto plural e multifacetado, com o objetivo de identificar e analisar a vivência e o significado do aborto provocado enquanto fenômeno existencial concreto na vida da mulher, e comparar com mulheres que tiveram o aborto espontâneo. Método: Trata-se de estudo quali-quantitativo em que foram entrevistadas mulheres com diagnóstico de aborto atendidas em dois hospitais públicos da cidade de São Paulo no período de julho de 2008 a março de 2010. Para fins de análise qualitativa foram incluídas as 11 mulheres que provocaram aborto e para análise quantitativa, foi realizado estudo caso controle comparando-se com 22 que sofreram aborto espontâneo. As 11 mulheres que provocaram aborto foram entrevistadas em profundidade e os dados analisados qualitativamente com embasamento teórico Fenomenológico-Existencial. Resultados: As mulheres do grupo com aborto provocado, em relação ao grupo com aborto espontâneo, apresentaram menor escolaridade sendo mais freqüente o nível fundamental (82% vs. 36%, P=0,04); menor renda familiar (mediana, R$1000 vs. R$1400, P=0,04); menor renda pessoal (mediana, R$200 vs. R$333, P=0,04), maior frequência de sentimentos negativos na suspeita (82% vs. 22%, P=0,004) e na confirmação (72% vs. 22%, P=0,03) da gravidez. Na análise qualitativa fenomenológica, foram revelados nos discursos das mulheres cinco temáticas: percepção do conflito, a culpa como recurso de enfrentamento, identidade parental, relações afetivas fragilizadas e significado do aborto provocado (desamparo, sofrimento e dor). Um tema único e maior prevaleceu no discurso de todas as mulheres que provocaram o aborto as relaçoes afetivas fragilizadas e a culpa, entendendo-se este tema como a essência da vivência das mulheres que provocaram o aborto. Conclusão: Este estudo permitiu lançar um novo olhar, um recorte da vivência de mulheres menos favorecidas que se utilizaram de serviços públicos de saúde em momento de sofrimento diante da experiência do aborto provocado, e os sentimentos de relacionamentos fragilizados associados à culpa ressaltam como significados da vivência dessas mulheres / Introduction: The abortion subject is very controversial and still much stigmatized by the Brazilian society. Is miscarriage or induced abortion, shows ambivalent has emotional repercussions for women who experience. This study addresses the abortion issue in a plural and multifaceted context, aiming to identify and analyze the experience and meaning of abortion as the concrete existential phenomenon in women\'s lives, and to compare with women who had spontaneous abortion. Method: This is a qualitative and quantitative study based upon interviews with women diagnosed as abortion treated at two hospitals in São Paulo in the period July 2008 to March 2010. For purposes of qualitative analysis were included the 11 women who had an abortion and for quantitative analysis was conducted case-control study compared yourself to 22 who suffered miscarriage. The 11 women who had induced abortion were interviewed in depth and analyzed qualitatively with theoretical background Existential-Phenomenological. Results: The women in group with induced abortion in compared to those with spontaneous abortion, had less education and are more frequent in primary level (82% vs. 36%, P=0,04); lower family income (median $580 vs. $812, P = 0.04), lower personal income (median, $115 vs. $193, P = 0.04), higher frequency of negative feelings in the suspicion (82% vs. 22%, P = 0.004) and confirmation (72% vs. 22%, P = 0.03) of pregnancy. In phenomenological qualitative analysis, were revealed in the discourses of women at five themes: the perception of conflict, guilt as a means of coping, parental identity, vulnerable emotional relationships and meaning of abortion (abandonment, pain and suffering). The single theme and more prevalent in discourse of all women who had an induced abortion - the guilt and vulnerable affective relationships, understanding of this as the essence of the experience of women who had an induced abortion. Conclusion: This study has generated a new look, a clipping of the experience of disadvantaged women who used public health services in moment of suffering in the face of experience of abortion, and feelings of guilt associated with vulnerable relationships stand out as meanings of experiences of these women

Einleitung: Fehlgeburten können nachhaltige seelische Folgen für die Betroffenen haben. Ihre Folgen für eine nachfolgende Schwangerschaft sind bislang kaum untersucht worden. Untersuchungsmethoden: In einer prospektiven Längsschnittuntersuchung werden 342 Frauen nach Frühabort (bis 16. Schwangerschaftswoche) jeweils wenige Wochen, 6 und 12 Monate nach dem Schwangerschaftsverlust postalisch über standardisierte Erhebungsinstrumente zu ihren Verarbeitungsmustern befragt. Bei 108 Frauen trat im Untersuchungszeitraum eine neue Schwangerschaft ein, sie wurden jeweils in jedem Schwangerschaftstrimenon befragt. Über standardisierte Symptomskalen werden schwangerschaftsbezogene Ängste, State-Ängste und Trait-Angst (STAI) sowie Depressivität dieser Schwangeren erhoben und mit der Symptomatik von jeweils 69 (1. Trimenon), 82 (2. Trimenon) und 97 (3. Trimenon) anamnestisch nicht durch frühere Schwangerschaftsverluste belasteten Schwangeren verglichen. Ergebnisse: Im ersten Trimenon einer neuen Schwangerschaft sind Frauen nach Frühaborten signifikant stärker belastet durch schwangerschaftsbezogene Ängste und – vor dem Überschreiten des kritischen Zeitpunktes der zurückliegenden Fehlgeburt(en) – auch durch situative Ängste als anamnestisch nicht belastete Schwangere. Sie haben darüber hinaus ein erhöhtes Risiko für Blutungen in der Frühschwangerschaft. Muster einer depressiven und pessimistisch-traurigen Verarbeitung der Fehlgeburt sagen ausgeprägtere Angst- und depressive Symptome im ersten Trimenon einer nachfolgenden Schwangerschaft vorher. Schlussfolgerungen: Frauen nach Frühabort sind hinsichtlich psychischer Befindensstörungen in einer neuen Schwangerschaft besonders gefährdet. Es lassen sich Risikofaktoren bestimmen, anhand derer besonders gefährdete Frauen schon unmittelbar nach der Fehlgeburt erkannt werden und einer entsprechenden Behandlung zugeführt werden können. / Background: It is well known that miscarriages have enduring mental consequences for the persons affected and may also have implications for the course of a new pregnancy. So far, however, not many studies investigated the physical and mental stress of pregnant women with previous miscarriages. Methods: In this study, 342 women who had early miscarriages were interviewed in writing a couple of weeks, half a year and one year after the prenatal loss. 108 of these women became pregnant during the research period and answered further questionnaires in each trimenon of the pregnancy. In addition, the data of a comparative group was collected consisting of 69 (first trimenon), 82 (second trimenon) and 97 (third trimenon) women without any previous miscarriages. The symptoms (anxiety and depression) of any new pregnancy were collected by using standardised data collection instruments and specific methods for recording specific pregnancy-related anxieties, subjective pregnancy problems and complications during the pregnancy. Results: In the first trimenon of a pregnancy, those women who had previous miscarriages are more stressed by pregnancy-related and – before the critical moment of the previous miscarriage – situational (State) anxieties than those women without any anamnesis of miscarriage. Furthermore they show a higher risk of bleedings in early pregnancy. The women''s health during the first trimenon of a new pregnancy can be predicted based on coping processes after the miscarriage. Women who show depressive or pessimistic-anxious coping styles after the prenatal loss, have a higher risk of anxieties and depressive disorders in their new pregnancy. Conclusions: The results are discussed in relation to the care to women after a miscarriage and during a new pregnancy.

Introdução: O aborto é assunto bastante polêmico e ainda muito estigmatizado pela sociedade brasileira. Seja aborto espontâneo ou provocado, apresenta repercussões emocionais ambivalentes para as mulheres que o vivenciam. Este estudo trata do tema aborto em um contexto plural e multifacetado, com o objetivo de identificar e analisar a vivência e o significado do aborto provocado enquanto fenômeno existencial concreto na vida da mulher, e comparar com mulheres que tiveram o aborto espontâneo. Método: Trata-se de estudo quali-quantitativo em que foram entrevistadas mulheres com diagnóstico de aborto atendidas em dois hospitais públicos da cidade de São Paulo no período de julho de 2008 a março de 2010. Para fins de análise qualitativa foram incluídas as 11 mulheres que provocaram aborto e para análise quantitativa, foi realizado estudo caso controle comparando-se com 22 que sofreram aborto espontâneo. As 11 mulheres que provocaram aborto foram entrevistadas em profundidade e os dados analisados qualitativamente com embasamento teórico Fenomenológico-Existencial. Resultados: As mulheres do grupo com aborto provocado, em relação ao grupo com aborto espontâneo, apresentaram menor escolaridade sendo mais freqüente o nível fundamental (82% vs. 36%, P=0,04); menor renda familiar (mediana, R$1000 vs. R$1400, P=0,04); menor renda pessoal (mediana, R$200 vs. R$333, P=0,04), maior frequência de sentimentos negativos na suspeita (82% vs. 22%, P=0,004) e na confirmação (72% vs. 22%, P=0,03) da gravidez. Na análise qualitativa fenomenológica, foram revelados nos discursos das mulheres cinco temáticas: percepção do conflito, a culpa como recurso de enfrentamento, identidade parental, relações afetivas fragilizadas e significado do aborto provocado (desamparo, sofrimento e dor). Um tema único e maior prevaleceu no discurso de todas as mulheres que provocaram o aborto as relaçoes afetivas fragilizadas e a culpa, entendendo-se este tema como a essência da vivência das mulheres que provocaram o aborto. Conclusão: Este estudo permitiu lançar um novo olhar, um recorte da vivência de mulheres menos favorecidas que se utilizaram de serviços públicos de saúde em momento de sofrimento diante da experiência do aborto provocado, e os sentimentos de relacionamentos fragilizados associados à culpa ressaltam como significados da vivência dessas mulheres / Introduction: The abortion subject is very controversial and still much stigmatized by the Brazilian society. Is miscarriage or induced abortion, shows ambivalent has emotional repercussions for women who experience. This study addresses the abortion issue in a plural and multifaceted context, aiming to identify and analyze the experience and meaning of abortion as the concrete existential phenomenon in women\'s lives, and to compare with women who had spontaneous abortion. Method: This is a qualitative and quantitative study based upon interviews with women diagnosed as abortion treated at two hospitals in São Paulo in the period July 2008 to March 2010. For purposes of qualitative analysis were included the 11 women who had an abortion and for quantitative analysis was conducted case-control study compared yourself to 22 who suffered miscarriage. The 11 women who had induced abortion were interviewed in depth and analyzed qualitatively with theoretical background Existential-Phenomenological. Results: The women in group with induced abortion in compared to those with spontaneous abortion, had less education and are more frequent in primary level (82% vs. 36%, P=0,04); lower family income (median $580 vs. $812, P = 0.04), lower personal income (median, $115 vs. $193, P = 0.04), higher frequency of negative feelings in the suspicion (82% vs. 22%, P = 0.004) and confirmation (72% vs. 22%, P = 0.03) of pregnancy. In phenomenological qualitative analysis, were revealed in the discourses of women at five themes: the perception of conflict, guilt as a means of coping, parental identity, vulnerable emotional relationships and meaning of abortion (abandonment, pain and suffering). The single theme and more prevalent in discourse of all women who had an induced abortion - the guilt and vulnerable affective relationships, understanding of this as the essence of the experience of women who had an induced abortion. Conclusion: This study has generated a new look, a clipping of the experience of disadvantaged women who used public health services in moment of suffering in the face of experience of abortion, and feelings of guilt associated with vulnerable relationships stand out as meanings of experiences of these women

Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively. Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss. Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type. We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage. Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative. / On the day of the public defence of the doctoral thesis the status of article III was In Press and article IV was In Press.