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"That promoted us to research public attitudes to and perceptions of miscarriage and the results we got were really significant ― many were sympathetic and wanted to help, but a lot of them said they held back for fear of saying the wrong thing – and clearly, people do, albeit with the best of intentions".
Perceptions of miscarriage and of the MVA device or procedure were barriers to implementation of MVA services for miscarriage.
For example, perceptions of miscarriage and thus the MVA procedure as "too emotional" speak to the cultural characteristics of the innovation (MVA) and also to the beliefs and preferences of the user system [ 16].
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(Support Staff, LPN team leader) Much of the perception of miscarriage as emotional stemmed from the proximity of miscarriage and induced abortion services.
We were not interested in miscarriage and death specifically, but were interested in death as part of the perception of miscarriage as emotional that posed a barrier to implementation.
We found that the common major barriers to implementation were low volume and a perception of miscarriage as emotional and/or like abortion, while the inclusion of support staff in training and effective champions facilitated successful implementation of MVA services.
We identified common barriers to implementation such as low volume and a perception of miscarriage as emotional and/or like abortion, as well as facilitators, such as the inclusion of support staff in training, hands on experience, and effective champions.
Participants focused on perceptions of the diagnosis and treatment of miscarriage as highly emotional and thus a barrier to implementing the service.
Champions addressed lack of cultural fit due to perceptions of the MVA procedure or miscarriage by setting new norms; this is a type of conformity pressure, recognized as a mechanism to affect lack of cultural fit [ 16].
Our findings also raise questions for further study, such as the best way to support champions and the interaction between champions and their systems, and identification of the best strategies to positively influence perceptions of the MVA procedure and miscarriage.
The remote possibility of miscarriage?
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com