Perceptions of the Causes of Miscarriage Among Healthcare Providers and Women With a History of Miscarriage in Kerman: A Qualitative Exploration

Abstract

Background: Miscarriage is a common pregnancy outcome with emotional, psychological and social consequences for many women. Although several biomedical risk factors have been identified, many miscarriages remain unexplained. Perceptions of the causes of miscarriage are influenced by social, cultural and healthcare contexts; however, little is known about healthcare providers’ and women’s perceptions of the causes of miscarriage in the Iranian context. Objectives: To explore perceptions of the causes of miscarriage among healthcare providers and women with a history of miscarriage in south-eastern Iran. Design: A qualitative descriptive study informed by a feminist theoretical lens. Methods: Twenty-three participants, including six obstetricians–gynecologists, eleven midwives, and six women with history of miscarriage, were recruited using purposive sampling. Semi-structured interviews were conducted between August and October 2024 in Kerman, Iran. Data were analysed using reflexive thematic analysis supported by framework analysis. Results: Three themes were identified: (1) medical causes and risk factors, (2) lifestyle and environmental influences, and (3) emotional and psychological factors. Healthcare providers primarily attributed miscarriage to chromosomal abnormalities, chronic health conditions, and modifiable lifestyle risks. Women with a history of miscarriage also acknowledged biomedical explanations but described modifying their health behaviours and interpreted miscarriage through their personal experiences, emotional distress, and advice from family members and shared community beliefs. Conclusion: Healthcare providers and women with a history of miscarriage perceived its causes through different forms of knowledge and experience. While healthcare providers primarily emphasized biomedical explanations, women often interpreted miscarriage through their personal experiences and efforts to make sense of pregnancy loss. Both groups identified medical, lifestyle, environmental, and psychological factors as important perceived contributors, although some beliefs reflected cultural understandings rather than established scientific evidence. These findings highlight the importance of evidence-based, culturally sensitive communication and supportive miscarriage care that integrates clinical knowledge with women’s lived experiences.