The Lancet - Miscarriage: worldwide reform of care is needed (2)

30 April, 2021

Recurrent miscarriage: evidence to accelerate action

The paper on recurrent miscarriage describes three models that are widely used worldwide. A 2019 conference in the UK looked at these and 96% voted for a graded model as follows:

'The second model is based on a graded approach. After the first miscarriage, women will be guided to information about miscarriage, resources to address their physical and mental health needs following pregnancy loss, and ways to optimise their health for future pregnancy. This approach could involve patient support groups, online self-help strategies for mental health, weight management, smoking and recreational drugs cessation services, information on appropriate preconceptual folate and vitamin D supplementation, referral to necessary services for management and optimisation of chronic maternal medical conditions (eg, diabetes, hypertension, heart disease, and epilepsy), and screening for mental health issues. Following a second miscarriage, women will be offered an appointment at a miscarriage clinic that could be nurse or midwifery-led, in which tests for full blood count and thyroid function are offered, in addition to addressing lifestyle issues...'

As with so many aspects of health, empowering people with the information they need to take a proactive role is critical.

Best wishes, Neil

Neil Pakenham-Walsh, HIFA Coordinator,