From the shadow of pregnancy loss to a new pregnancy: couples' perspectives and medical care priorities.

Research question

What are couples' perspectives on a new pregnancy after a recent pregnancy loss, and what do they need from medical care?

Design

Qualitative interview study of 20 couples recruited from the Copenhagen Pregnancy Loss (COPL) Research Programme (a prospective study of over 3000 couples in Denmark seeking acute care for pregnancy loss before 22 weeks of gestation). Couples who had experienced one or two pregnancy losses participated in joint semi-structured interviews 1-12 weeks after the loss (median 3 weeks). Data were analysed inductively using reflexive thematic analysis following Braun and Clarke's approach. Researcher reflexivity and iterative discussions enhanced analytic credibility and transparency.

Results

An overarching theme was developed from the data: 'stepping out of the shadow of pregnancy loss towards a new pregnancy'; this described couples' efforts to move forwards while navigating emotional uncertainty. Four themes captured their experiences: (i) 'focusing on a new pregnancy as a way to cope with and heal from loss'; (ii) 'recognizing that emotional readiness is fluid and never fully attainable'; (iii) 'approaching a new pregnancy with cautious optimism while managing co-existing, conflicting emotions'; and (iv) 'seeking medical care and support to plan and prepare for a future pregnancy'. Couples valued empathetic, individualized discussions about future pregnancy during follow-up, rather than being told they can 'just try again' at the time of pregnancy loss.

Conclusions

This study offers insight into how couples navigate the transition from pregnancy loss to planning another pregnancy. Findings highlight the need for follow-up care integrating emotional readiness with reproductive planning, delivered through compassionate family-centred care to improve trust, continuity and patient experience.