Care scheme could prevent thousands of miscarriages a year

After two miscarriages, Lisa Varey faced a difficult choice. She knew she would likely need to miscarry a third time to get specialist help from the NHS in England. Typically, support is only offered after three miscarriages.

Lisa, 34, told her husband they couldn't wait another year. They felt pressured to get pregnant and miscarry again as soon as possible, a thought she found hard to believe she was saying aloud.

A New Approach to Care

After her second miscarriage, Lisa joined a pilot project at Birmingham Women and Children's Hospital. Experts believe this project could prevent thousands of miscarriages each year by offering earlier checks and advice.

Tests showed Lisa would benefit from progesterone, a hormone that helps maintain pregnancy, and a daily aspirin tablet to improve the chances of a healthy birth. Lisa is now in the last weeks of her second trimester. She shared how much the project's support has helped her.

"There's so much support for pregnant women, but it didn't always feel like there was any support for women who were no longer pregnant," Lisa said. "We're having to go through that journey of just feeling very sad."

Emily, 42, from Birmingham, also experienced two miscarriages in one year. She felt her body had "failed" her, especially after struggling to get pregnant and undergoing IVF. After her second miscarriage, she joined the Birmingham project.

Emily was prescribed aspirin and a higher dose of folic acid. She said the early tests gave her possible reasons for the miscarriages, which helped remove "the guilt and shame that you feel." Knowing there were things that could make a difference gave her hope.

How the Pilot Project Works

The Birmingham study compared two groups of 203 women who had experienced miscarriages. One group received standard NHS care, while the other received care under a new model. This new model started after just one miscarriage and offered more care after each subsequent loss. Researchers found a small reduction in the miscarriage rate in the test group. Women who did have more miscarriages received better care and support.

The study found that one in five women had treatable health issues, like abnormal thyroid function or anaemia, which could affect their chances of a healthy birth. While no formal data is collected on the number of miscarriages each year, researchers estimate the pilot project could prevent about 10,000 miscarriages annually if adopted across the NHS.

Under the project, women who had one miscarriage received a one-to-one consultation with a specialist nurse. They discussed lifestyle changes, such as reducing alcohol and quitting smoking, and using progesterone. After a second miscarriage, women were tested for anaemia and abnormal thyroid function and offered early scans. After a third miscarriage, the care pathway aligns with current NHS offerings, including referral to a recurrent miscarriage clinic and further tests.

Professor Arri Coomarasamy, head of miscarriage research at Tommy's, a pregnancy charity, calls the three-miscarriage wait an "unacceptable anomaly." He compares it to waiting for a third heart attack before offering help. He also believes that rolling out the study's findings could save the NHS money, as the extra costs of staff and training are outweighed by fewer miscarriages.

Sally, 33, has had two miscarriages and feels let down by her care. She is not ready to try for another baby because of her experience. Living in Gloucester, she doesn't have access to the pilot project but says she might change her mind if she did.

"Putting these systems in place show women that they are thought about, that one miscarriage is enough to be thought about and to be supported," Sally said.

Looking Ahead

The government announced last week that it is considering "wider adoption" of such schemes across the NHS in England. Baroness Merron, from the Department of Health and Social Care, stated this would be carefully considered to ensure women receive high-quality, compassionate NHS care.

NHS Scotland is already improving miscarriage care, including not waiting until a third miscarriage and providing separate rooms for women experiencing pregnancy loss. Northern Ireland and Wales currently follow similar guidelines to England. The Birmingham research team is hopeful their model will lead to change.

Kath Abrahams, chief executive of Tommy's, noted that the pilot would give women a clear understanding of the care they would receive. "Knowing what's going to happen next can be incredibly comforting in a moment when you're in crisis," she said.

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