Social Inequalities in the Risk and Aftermath of Miscarriage

Introduction

One in four women experience a miscarriage. Loss of pregnancy may affect fertility intentions and lead to adverse mental and physical health. Yet, we know little about how social inequalities affect the risk of miscarriage; how miscarriages may exacerbate existing social inequalities in population health; or how context shapes these experiences. One reason for this is poor quality of data, as miscarriages are often either underreported in surveys or only included in health registers if they require hospital care. Moreover, to date, sexual and reproductive health has often been ignored in life course epidemiology.

Project Overview

This proposal goes beyond the state-of-the-art by being the first comprehensive study of the patterns of social inequality in miscarriage and its outcomes. It reaches this goal by assessing the patterns of miscarriage underreporting in surveys before obtaining its estimates.

Contributions

It will make ground-breaking contributions by:

1. Analysing underreporting patterns of miscarriage and using this in further analyses to obtain more reliable results than before.
2. Showing how individual and family-level social inequalities affect miscarriage risk over the life course.
3. Establishing how mental and physical health consequences of miscarriage depend on one’s social background and may widen social inequalities in health.
4. Uncovering the role of national and sub-national context in social inequalities in miscarriage.

Methodology

Unlike many previous studies based on small and outdated samples, I use longitudinal population registers and large representative surveys in Finland, France, and the UK that are exceptionally rich in miscarriage, socioeconomic, other reproductive, and health data, and can be triangulated to obtain more reliable results.

Expected Outcomes

The project will lead to a significantly better understanding of a common reproductive experience affecting mental and physical wellbeing, and can help policymakers improve reproductive and population health.