| "Tell me about your thoughts and feelings when you knew you were pregnant." |
| "Tell me about your thoughts and feelings when you had your miscarriage." |
| "Tell me about your thoughts and feelings after miscarriage." |
| "Tell me about your family members' thoughts and feelings after your miscarriage." |
| "Tell me about the healthcare providers and their care." |
| "Tell me about information and follow-up appointment after miscarriage." |
Table 1: The table shows the open-ended questions used in the semi structed interviews
| RIMS factors | RIMS questions |
| Isolation and guilt | I felt much alone in my loss. |
| My (our) miscarriage destroyed my zest for life. | |
| I feel my (partner's) body has betrayed me. | |
| Through my (our) miscarriage, I have experienced a loss of pride in myself. | |
| I feel guilt about my (our) miscarriage. | |
| I feel very isolated by my (our) miscarriage. | |
| Loss of a baby | Through miscarriage, I feel I lost a part of myself. |
| I feel there will always be a place in my heart for the miscarried baby. | |
| Through miscarriage, I feel that I have lost a person. | |
| I get irritated when my (our) miscarried baby is called a fetus. | |
| I dwell on the fact that my child will only exist in my memory. | |
| Devastating events | My (our) miscarriage was a horrendous, devastating event. |
| Miscarriage equals one big loss of control. | |
| Miscarriage is like going from one extreme of happiness to the other total unhappiness. | |
| Miscarriage is a nightmare. | |
| My (our) miscarriage represents a major setback for me. |
Table 2: The table presents the Revised Impact of the Miscarriage Scale (RIMS) factors and questions for both women and men. RIMS factors, isolation and guilt, loss of baby, and devastating events and 16 included questions with answers options: The answer options are revised and coded. (1) Definitely true for me (very good), (2) Quite true for me (good), (3) Rarely true for me (average), (4) Definitely not true for me (poor).
| Sociodemographic characteristics | |
| Born in Burundi (b) | 11 (100) |
| Parents born in Burundi (b) | 11 (100) |
| Partner born in Burundi (b) | 11 (100) |
| Partner parents born in Burundi (b) | 11 (100) |
| Woman's age (a) | 32 (19–48) |
| Married (b) | 11 (100) |
| Cohabitating (b) | 0 (0) |
| Unmarried (b) | 0 (0) |
| Vocational training (b) | 0 (0) |
| Primary school or no schooling (b) | 7 (63.6) |
| Secondary school (b) | 4 (36.4) |
| University (b) | 0 (0) |
| Working as a farmer (b) | 11 (100) |
| Lifestyle factors | |
| Smoking (b) | 0 (0) |
| Never drinking alcohol (b) | 10 (91.0) |
| Sometimes drinking alcohol (b) | 1 (9.1) |
| Body Mass Index, underweight (b) | 5 (45.5) |
| Body Mass Index, normal weight (b) | 6 (54.5) |
| Exercise (b) | 1 (9.1) |
| Reproductive health issues | |
| Week of miscarriage (a) | 9+3 (6+5–12+4) |
| Ultrasound diagnosis (b) | 11(100) |
| Spontaneous miscarriage (b) | 11 (100) |
| Medical treatment (b) | 11 (100) |
| How many times have you been pregnant (a) | 4 (2–10) |
| Previous miscarriage (b) | 11 (100) |
| Previous children (b) | 11 (100) |
| Number of previous children (a) | 3 (1–8) |
| Infertility treatment (b) | 0 (0) |
| Planned pregnancy (b) | 10 (91.0) |
| Subjective mental health | |
| Not good not bad (b) | 10 (91.0) |
| Good subjective (b) | 1 (9.1) |
Table 3: The table shows scores of women's sociodemographic characteristics, lifestyle factors, and reproductive health issues. Data are given as median and range = (a) and as numbers (n) and percentage (%) = (b). Women with miscarriage (n = 11)
| Meaningbearing units | Condensed meaning bearing units | Codes | Sub-Categories | Categories | Themesnumber | Themes |
| "I was happy to be pregnant and thanked the Lord" | The women felt happy when they became pregnant | Women Happy Emotions Thoughts Feelings Pregnancy | The women were happy to get pregnant | The women felt happy emotions, thoughts and feelings about pregnancy | No. 1 | Perceptions of women's emotions, thoughts, and feelings regarding the happiness of becoming pregnant |
| "I thanked the healthcare providers for the care they provided to me during my miscarriage" | Women received quality care from their healthcare providers during miscarriage | Quality care Healthcare providers DuringMiscarriage | Health care providers delivered quality care to the women during miscarriage | Women received quality care from their healthcare providers during miscarriage | No. 2 | Women's perspectives on the quality of care during miscarriage |
| "I am devastated; I have lost my baby " | Women's thoughts and feelings of losing a baby during the miscarriage | Women Emotions Thoughts Feelings of losing a baby Miscarriage | Women's emotions, thoughts, and feelings of losing a baby | Women's emotions, thoughts, and feelings of losing a baby due to miscarriage | No. 3 | Perception of women's emotions, thoughts, and feelings after miscarriage |
| "During the early stages of my pregnancy. I worked too hard; I was farming and walked a long distance to collect water and firewood. I believe that's why I had a miscarriage" | Women believed their actions during pregnancy caused the miscarriage | Women Emotions Thoughts Feelings Self-blame Following Miscarriage | Women ' s feelings of self-blame following the miscarriage | Women ' s emotions, thoughts, and feelings of self-blame following a miscarriage | No. 4 | Perceptions of women's emotions, thoughts, and feelings of self-blame following a miscarriage |
| "My family members' feel sadness and grief after my miscarriage" | Family members were saddened and grieving after the women experienced the miscarriage | Family members' Emotions Thoughts Feelings Women Miscarriage | Family members' emotions | Family members' emotions, thoughts, and feelings following the woman's miscarriage | No. 5 | Perception of women's emotions, thoughts, and feelings after miscarriage |
| "I did not receive any miscarriage information before I left the hospital, and I don't understand why I got a miscarriage" | Women did not received any information about the miscarriage from healthcare providers | WomenLack of InformationAbout miscarriage Healthcare providers | Lack of information about miscarriage from healthcare providers | Women reported lack of information about the miscarriage from healthcare providers | No. 6 | Women's perception of insufficient miscarriage information from healthcare providers |
| "Thank you for your counseling. now I feel peace and hope for the future" | The health care providers offer the woman a follow-up appointment following the miscarriage | WomenFollow-up Appointment Healthcare providers | Women appreciated a follow-up appointment from their healthcare providers | Women appreciated a follow-up appointment from healthcare providers following their miscarriage | No. 7 | Women's perceptions of follow-up appointments with healthcare providers after experiencing a miscarriage |
Table 4: The table shows (n=11) Interviews with women and content analysis. Meaning-bearing units, condensed meaning-bearing units, codes, sub-categories, categories, themes numbers, and themes.
| Sociodemographic characteristics | |
| Born in Burundi (b) | 23 (100) |
| Parents born in Burundi (b) | 23 (100) |
| Partner born in Burundi (b) | 23 (100) |
| Partner parents born in Burundi (b) | 23 (100) |
| Woman's age (a) | 33.5 (21–40) |
| Married (b) | 23 (100) |
| Cohabitating (b) | 0 (0) |
| Unmarried (b) | 0 (0) |
| Vocational training (b) | 10 (43.5) |
| Primary school (b) | 8 (34.8) |
| Secondary school (b) | 5 (21.7) |
| University (b) | 0 (0) |
| Working as a farmer (b) | 23 (100) |
| Lifestyles factors | |
| Smoking (b) | 0 (0) |
| Sometimes drinking alcohol (b) | 5 (21.7) |
| Body Mass Index, underweight (b) | 9 (39.1) |
| Body Mass Index, normal weight (b) | 14 (60.9) |
| Exercise (b) | 1 (4.3) |
| Diseases | |
| Malaria (b) | 5 (21.7) |
| Reumatism (b) | 1 (4.3) |
| Anemi (b) | 3 (13.0) |
| Tyfoid (b) | 1 (4.3) |
| Reproductive health issues | |
| Week of miscarriage (a) | 9+1 (6+1–12+3) |
| Ultrasound diagnosis (b) | 23 (100) |
| Spontaneous miscarriage (b) | 23 (100) |
| Medical treatment (b) | 23 (100) |
| Previous miscarriage (b) | 23 (100) |
| Numbers of previous miscarriage (a) | 2 (1–5) |
| Previous children (b) | 23 (100) |
| Number of previous children (a) | 4.5 (0–12) |
| Infertility (b) | 0 (0) |
| Infertility treatment (b) | 0 (0) |
| Planned pregnancy (b) | 16 (69.6) |
| Subjective mental health | |
| Poor (b) | 4 (17.4) |
| Not good not bad (b) | 18 (78.3) |
| Good (b) | 1 (4.3) |
Table 5: The table shows scores of women’s socio-demographic characteristics, Lifestyle factors, and reproductive health issues. Data are given as median and range = (a) and as numbers (n) and percentage (%) = (b). Women with miscarriage (n = 23).
| Isolation and guilt | |||
| RIMS questions with answers 1- 4 | Women n = (23) Mean ± SD | Men n = (23) Mean ± SD | P-value |
| Factor; Isolation and guilt | 22.05 ± 3.79 | 20.70 ± 4.82 | 0.034* |
| Question 1 (%) | 3.83 ± 0.38 | 3.83 ± 0.65 | 0.430 |
| 1 | 0 (0) | 1 (4.3) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 4 (17.4) | 1 (4.3) | – |
| 4 | 19 (82.6) | 21 (91.3) | – |
| Question 2 (%) | 3.52 ± 0.79 | 3.48 ± 0.73 | 0.655 |
| 1 | 1 (4.3) | 1 (4.3) | – |
| 2 | 1 (4.3) | 0 (0) | – |
| 3 | 6 (26.1) | 9 (39.1) | – |
| 4 | 15 (65.3) | 13 (56.6) | – |
| Question 3 (%) | 3.65 ± 0.71 | 3. 09 ± 1.04 | 0.028* |
| 1 | 1 (4.3) | 3 (13.0) | – |
| 2 | 0 (0) | 2 (8.7) | – |
| 3 | 5 (21.7) | 8 (34.8) | – |
| 4 | 17 (74.0) | 10 (43.5) | – |
| Question 4 (%) | 3.70 ± 0.70 | 3.26 ± 1.14 | 0.162 |
| 1 | 1 (4.3) | 4 (17.4) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 4 (17.4) | 5 (21.7) | – |
| 4 | 18 (78.3) | 14 (60.9) | – |
| Question 5 (%) | 3.78 ± 0.42 | 3.91 ± 0.29 | 0.223 |
| 1 | 0 (0) | 0 (0) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 5 (21.7) | 2 (8.7) | – |
| 4 | 18 (78.3) | 21 (91.3) | – |
| Question 6 (%) | 3.57 ± 0.79 | 3.13 ± 0.97 | 0.053 |
| 1 | 1 (4.3) | 3 (13.1) | – |
| 2 | 1 4.3) | 0 (0) | – |
| 3 | 5 (21.8) | 11 (47.8) | – |
| 4 | 16 (69.6) | 9 (39.1) | – |
| Loss of a baby | |||
| Factor; Loss of a baby | 19.08 ± 1.67 | 17.39 ± 4.42 | 0.002** |
| Question 1 (%) | 3.78 ± 0.42 | 3.48 ± 0.78 | 0.163 |
| 1 | 0 (0) | 1 (4.3) | – |
| 2 | 0 (0) | 1 (4.3) | – |
| 3 | 5 (21.7) | 7 (30.5) | – |
| 4 | 18 (78.3) | 14 (60.9) | – |
| Question 2 (%) | 3.87 ± 0.34 | 3.39 ± 0.94 | 0.035* |
| 1 | 0 (0) | 2 (8.7) | – |
| 2 | 0 (0) | 1 (4.3) | – |
| 3 | 3 (13.0) | 6 (26.1) | – |
| 4 | 20 (87.0) | 14 (60.9) | – |
| Question 3 (%) | 3.65 ± 0.49 | 3.52 ± 0.90 | 0.925 |
| 1 | 0 (0) | 2 (8.7) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 8 (34.8) | 5 (21.7) | – |
| 4 | 15 (65.2) | 16 (69.6) | – |
| Question 4 (%) | 4.00 ± 0.00 | 3.52 ± 0.90 | 0.005** |
| 1 | 1 (4.3) | 2 (8.7) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 4 (17.4) | 5 (21.7) | – |
| 4 | 18 (78.3) | 16 (69.6) | – |
| Question 5 (%) | 3.78 ± 0.42 | 3.48 ± 0.90 | 0.269 |
| 1 | 0 (0) | 2 (8.7) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 5 (21.7) | 6 (26.1) | – |
| 4 | 18 (78.3) | 15 (65.2) | – |
| Devastating events | |||
| Factor; Devastating events | 18.75 ± 2.34 | 17.34 ± 3.97 | 0.006** |
| Question 1 (%) | 3.83 ± 0.39 | 3.39 ± 0.78 | 0.024* |
| 1 | 0 (0) | 1 (4.3) | – |
| 2 | 0 (0) | 1 (4.3) | – |
| 3 | 4 (17.4) | 9 (39.2) | – |
| 4 | 19 (82.6) | 12 (52.2) | – |
| Question 2 (%) | 3.57 ± 0.59 | 3.43 ± 0.94 | 0.979 |
| 1 | 0 (0) | 2 (8.7) | – |
| 2 | 1 (4.3) | 1 (4.3) | – |
| 3 | 8 (34.8) | 5 (21.8) | – |
| 4 | 14 (60.9) | 15 (65.2) | – |
| Question 3 (%) | 3.78 ± 0.52 | 3.39 ± 0.94 | 0.095 |
| 1 | 0 (0) | 2 (8.7) | – |
| 2 | 1 (4.3) | 1 (4.3) | – |
| 3 | 3 (13.1) | 6 (26.1) | – |
| 4 | 19 (82.6) | 14 (60.9) | – |
| Question 4 (%) | 3.83 ± 0.39 | 3.61 ± 0.72 | 0.279 |
| 1 | 0 (0) | 1 (4.3) | – |
| 2 | 0 (0) | 0 (0) | – |
| 3 | 4 (17.4) | 6 (26.1) | – |
| 4 | 19 (82.6) | 16 (69.6) | – |
| Question 5 (%) | 3.74 ± 0.45 | 3.52 ± 0.59 | 0.194 |
| 1 | 0 (0) | 0 (0) | – |
| 2 | 0 (0) | 1 (4.3) | – |
| 3 | 6 (26.1) | 9 (39.1) | – |
| 4 | 17 (73.9) | 13 (56.6) | – |
Table 6: Scores from the Revised Impact of Miscarriage Scale (RIMS) in women with miscarriages (n=23). The answer options are revised and coded. (1) Definitely true for me (very good), (2) Quite true for me (good), (3) Rarely true for me (average), (4) Definitely not true for me (poor).
Note: Statistical analysis was performed with the Mann-Whitney U-test and data are reported as mean ± SD or n (%). P < 0.05 was a significant difference. *p<0.05 **p<0.01.
Tables at a glance