New draft guidelines issued this week by the Royal College of Obstetricians and Gynecologists (RCOG), and open for consultation, should mean people can get support after their first miscarriage, rather than having to wait until they have had three consecutive miscarriages before receiving any follow-up support.
The news follows a sustained campaign by Tommy’s, whose Lancet report into miscarriage published earlier this year has formed the basis of the new guidelines, and the campaigning efforts of Sheffield Hallam MP Olivia Blake, who has talked openly about her miscarriage last year.
New draft guidelines on miscarriage care
In June this year, Blake secured a parliamentary debate on the Lancet report recommendations. During the debate the government committed to including two of the three Lancet report recommendations into their women’s health strategy: a record of national miscarriage data, and 24/7 care and support for those who have experienced miscarriage, including follow-up mental health support.
On the third recommendation – that the three miscarriage rule be scrapped – the minister, Nadine Dorries, said she hoped the new RCOG guidelines would be aligned to the Lancet series recommendations but that she was unable to decide what the guidelines or the recommendations are on miscarriage.
Under the new draft guidelines, which if implemented would represent the biggest reform to miscarriage care for 50 years, the RCOG want all NHS trusts to adopt the policy of graded care. This would mean that after the first miscarriage you are provided information, after the second you are offered an appointment at a specialist clinic to help identify the cause, and after the third you are eligible for major investigation and care, such as blood tests. This would replace the current model, where you are only eligible for support after your third consecutive miscarriage.
The guidelines, which also redefine ‘recurrent miscarriage’ to include non-consecutive occurrences, are due to be finalised by the end of the year following a consultation.
According to Tommy’s, an estimated one in four pregnancies ends in miscarriage, although this becomes one in five if we only count women who realise or report the miscarriage. Around 11 in 1,000 pregnancies are ectopic. And about 1 in 100 women in the UK experience recurrent miscarriages of three or more in a row.
Sheffield MP Olivia Blake’s response
MP for Sheffield Hallam Olivia Blake said:
“This is a huge step and an incredible win for campaigners and individuals who have been speaking up about this injustice for years. if implemented, these new guidelines will mark the end to the outdated and immoral three miscarriage rule, which has prevented millions of people from accessing vital support and care when they most need it.
“It has been nearly a year since I first spoke publicly about my own experience of miscarriage. The number of people from Sheffield and across the country who have contacted me since that day and shared their horrific experiences of being turned away from support because they hadn’t ‘had enough miscarriages’ has only driven me to further push for change. I said then that I didn’t want anyone else to have to go through what I went through. So to know that the days of telling women to simply “go home and try again” are nearly over is truly amazing.
“I want to thank everyone who has shared their story with me and spoken up about their experience. There have been many days when it has been really difficult to talk about this issue – but today’s news makes it all worth it.”
Miscarriage and Me
Last week Olivia starred in the TV documentary “Myleene Klass: Miscarriage and Me”. The documentary, which aired as part of Baby Loss Awareness Week, followed Olivia’s campaign to reform miscarriage care and support.
“I am over the moon to see the new guidelines, which should mean women will finally be offered support and care after every miscarriage. It feels like we are finally starting to break the taboo around miscarriage and achieve real change.
“I’ve met so many incredible women over the past year who weren’t given the support they desperately needed. I hope this is the beginning of the change we need and that miscarriage is never again swept under the rug or dismissed as an inevitability.”