Women should be given specialist NHS help after their first miscarriage to prevent more than 10,000 pregnancy losses a year, researchers have said.
In most of the UK, women must have three miscarriages before the health service investigates the underlying cause with blood tests or ultrasound scans.
However, a trial led by researchers at Tommy’s National Centre for Miscarriage Research and Birmingham Women’s Hospital investigated a “graded” model of miscarriage care.
This involves the NHS intervening earlier, and women offered a consultation with a specialist nurse after their first loss to discuss health before conception and during pregnancy.
Women may then be offered interventions to help prevent future miscarriages, including the hormone progesterone if they have experienced early vaginal bleeding.
After two miscarriages, patients would be offered tests for anaemia and abnormal thyroid function. If they go on to have a third, women would be offered the current standard NHS care.
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Professor Arri Coomarasamy, director of the Tommy’s centre, said: “If the graded model were implemented across the UK, our study indicates it could prevent around 10,075 miscarriages every year. That’s more than 10,000 families bringing their babies home instead of suffering the trauma of a pregnancy loss.”
The trial included 203 women with a history of one or more miscarriages who were given early intervention, and 203 who had the usual care.
Of the women in the graded group, 86 per cent were found to have one or more factors that could increase their risk of future miscarriages. This group also had a 4 per cent lower risk of miscarriage in their next pregnancy, the study found.
The measures could save the NHS more than £40 million after a year, the report suggests.
Among women who had lost two pregnancies, one in five were found to have either thyroid problems or anaemia which were picked up in blood tests they would not usually be offered at that stage.
Kath Abrahams, chief executive of Tommy’s, the baby loss charity, said: “NHS care and support for women who experience a miscarriage in the UK is inconsistent and generally involves no follow-up or tests until after a third loss.
“The three-miscarriage wait means women and families are left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that we know affect so many who experience pregnancy loss.
“Our pilot study indicates that providing support after a first miscarriage, with escalating care after further losses, is not only effective but achievable without significant additional workload for NHS teams who are already working extremely hard to deliver good care. Put simply, it is the right thing to do.”
Tommy’s estimates there are about 250,000 miscarriages in the UK each year.
Abrahams said Scotland had already adopted the model and called for policymakers in England, Wales and Northern Ireland to do the same. “We will do all we can to drive that change across the UK, so that more women and families are supported after every miscarriage,” she said.
The government has pledged to review miscarriage support in the new women’s health strategy.
Baroness Merron, parliamentary under-secretary of state at the Department of Health and Social Care, said the study’s findings “will be carefully considered”.
She added: “Pregnancy and baby loss can have a devastating impact on women and families, who too often feel they have been left without the care and support they need.
“Research like this is crucial, and our renewed women’s health strategy puts women’s voices and experiences at the heart of care.”