UK Pilot Study Finds Miscarriage Care Model Reduces Future Risk by 4%

A study by Tommy’s National Centre for Miscarriage Research and Birmingham Women’s Hospital found that a graded model of miscarriage care reduced the risk of future miscarriages by 4% compared to usual care. The research involved 406 women and indicated this approach could prevent 10,075 miscarriages annually across the UK.

Implementing the model for one year could also save more than £40 million in NHS costs and productivity losses.

The pilot ran from November 2023 to February 2024 and compared 203 women treated under the graded model, which starts after one miscarriage, to an equal group receiving support only after three or more losses. Women in the graded care group were 47% more likely to have risk factors identified and receive relevant advice.

Among those with two miscarriages, one in five had treatable conditions like thyroid dysfunction or anaemia.

The graded model includes a nurse intervention after one miscarriage, offering advice on reducing risk factors such as low vitamin D levels, folic acid intake, alcohol consumption, and caffeine. After a second miscarriage, women receive tests for anaemia and abnormal thyroid function, plus early scans.

Following a third, they get referral to a recurrent miscarriage clinic, further blood tests, and a pelvic ultrasound.

About one in four pregnancies ends in miscarriage, mostly within the first 12 weeks, while one in five end before 14 weeks. The study identified that one in five women had treatable health issues like abnormal thyroid function and anaemia. Researchers estimate the model could prevent around 10,000 miscarriages a year if rolled out across the NHS.

Kath Abrahams, chief executive of Tommy’s, said women were being left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that affect many who experience pregnancy loss.

She added that the pilot study indicates providing support after a first miscarriage, with escalating care after further losses, is effective and achievable without significant additional workload for NHS teams.

Put simply, it is the right thing to do. ” Professor Arri Coomarasamy, head of miscarriage research at Tommy’s, said the three-miscarriage wait is an unacceptable anomaly and compared it to not waiting for a third heart attack before treatment. He stated the findings, if rolled out across the NHS, could save money as extra costs are outweighed by savings from fewer miscarriages.

Coomarasamy said: “We don't do that with any other medical condition. ” Currently, women in England, Wales, and Northern Ireland are eligible for specialist NHS care for early baby losses after a minimum of three miscarriages. The NHS offers follow-up care after three miscarriages.

The graded model proposed by Tommy’s is available in Scotland, where NHS improvements include not waiting until a third miscarriage and providing separate rooms in maternity units for women experiencing pregnancy loss. Northern Ireland and Wales follow the same guidelines as England. Lucy, 31, from Eastbourne, first miscarried during the Covid-19 pandemic and again in August 2025.

She gave birth to a healthy baby boy, Alfie, in May 2021. Lucy said she felt unsupported after her first miscarriage and believes investigations should start after one loss, stating that not being able to have support until three losses in a row is just not fair. Lisa Varey, 34, suffered two miscarriages and participated in the pilot at Birmingham Women and Children’s Hospital.

Tests showed she would benefit from taking progesterone and a regular aspirin tablet. Varey is now pregnant and in the last weeks of her second trimester. Emily, 42, from Birmingham, suffered two miscarriages in one year and participated in the Birmingham study.

She was put on aspirin and a higher dose of folic acid. Emily said being offered early tests gave her possible reasons for the miscarriages, which took away the guilt and shame, and provided hope. Sally, 33, from Gloucester, has had two miscarriages and does not have access to the pilot project.

She said she is not ready to try for another baby because of her experience, but access to such systems might change her mind, as they show women that one miscarriage is enough to be supported. The report comes ahead of the final findings of the government’s investigation into maternity care in England.

Interim findings revealed that NHS hospitals causing harm and injury to women and babies during childbirth often resorted to cover-ups, falsified medical records, and denied bereaved parents answers.

In the Women’s Health Strategy announcement last week, the government said it was considering wider adoption across the NHS in England. Gillian Merron, the women’s health minister, said pregnancy and baby loss can have a devastating impact on women and families, who too often feel left without needed care and support.

Baroness Merron, parliamentary under-secretary of state at the DHSC, stated the research would be carefully considered as part of ongoing work to ensure women get high-quality, compassionate NHS care.