Evidence map›Paper›PMID 42236095›Full record

SynthesisBMJ open2026

Barriers and facilitators to implementation of peer support after miscarriage: a systematic review using thematic synthesis methods.

Leanne Burton, Juanita Charles, Mary Gemma Cherry, Rhiannon Corcoran, Shaima Hassan, Ruaraidh Hill, Sarah Little, Michelle Maden, Helen Mulholland, Elizabeth Perkins and 3 more

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Leanne BurtonDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK lrburton@liverpool.ac.uk.ORCID http://orcid.org/0000-0002-5870-4161
Juanita CharlesThe Miscarriage Association, Wakefield, UK.
Mary Gemma CherryDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Rhiannon CorcoranDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Shaima HassanDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Ruaraidh HillDepartment of Health Data Science, University of Liverpool, Liverpool, UK.
Sarah LittleIndependent Researcher (Public Advisor), Cheshire, UK.
Michelle MadenDepartment of Health Data Science, University of Liverpool, Liverpool, UK.
Helen MulhollandDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Elizabeth PerkinsDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Pauline SladeDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Selina WallisDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
Paul MarshallDepartment of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMiscarriage, defined in the UK as loss of pregnancy prior to 24 weeks gestation, can have long-term psychological implications. Clinical guidelines for perinatal bereavement care do not provide guidance on how best to support the mental health of women, and their partners, after miscarriage. Peer support (support from those who share common characteristics) is often sought, but there is little understanding of its access and use. We conducted a systematic review to understand the barriers to and facilitators of the implementation of peer support to improve mental health outcomes for parents after miscarriage.

designSystematic review and thematic synthesis. DATA SOURCES: A comprehensive systematic search across nine databases (MEDLINE, CINAHL, APA PsycINFO, Web of Science (all databases), EMBASE, CENTRAL, LENS.org, British Nursing Index and Health Management Information Consortium) was conducted in June 2025. Grey literature was identified through website searching, contact with topic experts and a national Call for Evidence. ELIGIBILITY CRITERIA: Qualitative and mixed-methods studies exploring motivations, experiences and preferences for peer support after miscarriage were included. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen, extract and code included studies. Suitable studies were evaluated using the Critical Appraisal Skills Programme Qualitative Research Checklist. Findings were extracted and subjected to a thematic synthesis.

resultsAcross nine studies included in the review, three overarching themes were developed, with seven subthemes, capturing both barriers and facilitators. 'Engaging in relational recognition' reflects the validation and connection that arise through experiential resonance, often heightened by the context of exclusion from broader social or clinical support. 'Mechanisms of Communality' describe how communality is enacted through dynamic peer interactions, including modelling and facilitating grief, benchmarking physical change and mattering through reciprocity, highlighting mutual support and shared coping. 'Dynamics of Access' consider factors which shape engagement, including changing needs of individuals across time and modalities of support and their effects.

conclusionsThese findings form the first synthesis of peer support after miscarriage and bring a nuanced service user perspective of barriers and facilitators by examining evidence from diverse studies. Peer support after miscarriage was seen to be a dynamic, relational process shaped by shared experience, mutual exchange and context-specific factors. Findings underscore key policy and practice considerations, including the use of trauma-informed, loss-sensitive approaches and consideration of intersectionality, that should be reflected when offering peer support services, with and for, those who have experienced miscarriage. PROSPERO REGISTRATION NUMBER: CRD42024518248.

Indexed as

Abortion, SpontaneousPeer GroupSocial SupportBereavementFemaleHumansPregnancyQualitative ResearchMENTAL HEALTHPeer GroupPregnancySystematic Review

Identifiers

PMID42236095
PMCPMC13239413

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.