Why was miscarriage care absent from the government’s landmark women’s health strategy?

Women must have three consecutive miscarriages before they are eligible for even the most simple tests. We wouldn’t expect someone to go through three heart attacks before we tried to find out what was wrong and treat them

Olivia Blake
Thursday 11 August 2022 10:06 BST
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Last month, the government published their long-awaited Women’s Health Strategy, heralding it as a “landmark strategy” to “right the wrongs” and “end the injustices” that are systemic in so many areas of women’s health.

Ministers have thanked the thousands of women who have fed into the consultation, and credited the department for reflecting these voices in the strategy and their calls for change.

But whilst there are some important and long over due reforms in the strategy – like removing barriers to IVF for LGBT+ women and those whose partners have children from former relationships; endometriosis; and menopause – on miscarriage care, however, the strategy falls well short.

Globally, approximately 15 per cent of recognised pregnancies end in miscarriage. That’s 23 million a year, or 44 miscarriages a minute. Black mothers face a 40 per cent higher relative risk compared to white mothers. Research also highlights the anxiety, depression, PTSD and in some cases suicide risks that are associated with going through a miscarriage.

Despite this bleak picture, support for those experiencing miscarriage has remained an afterthought. We don’t have a standardised system of care in the UK. I’ve heard from women without 24/7 access to services in their communities, meaning they’ve had to travel miles and wait weeks for medical treatments relating to their miscarriage.

According to current NHS guidelines, women must have three consecutive miscarriages before they are eligible for even the most simple tests. We wouldn’t expect someone to go through three heart attacks before we tried to find out what was wrong and treat them, so why do we expect women to go through three – in some cases preventable – losses before offering answers and treatments?

Mental health support for individuals and families is also rarely offered or available. Miscarriage is seen as a “fact of life” that should be swept under the rug – leaving many to suffer in silence.

Last year, I held a debate in parliament to shine a light on the state of care and call for reform. During my debate, Nadine Dorries committed to including two of the three Lancet Series findings into the long-trailed Women’s Health Strategy.

Firstly, 24/7 standardised care and support must be made available, including follow up mental health support. Secondly, miscarriage should be recorded on medical records and national miscarriage data should be collected, to break the taboo and ensure research receives the attention and funding it deserves.

For all the people, myself included, who had fought back tears over the years to break the silence and speak up about their experiences, it was a huge moment. It seemed like we were finally getting somewhere. Our collective pain every time we spoke up about our miscarriage had been worth it. If implemented, these reforms would represent a substantial move away from the current fragmented system of care, which has left so many unable to access support.

Now, 13 months on, it feels like we are going backwards. Instead of the concrete commitments we were promised, the strategy will do nothing to improve the situation for women up and down the country forced to go through in some cases multiple avoidable miscarriages before recieving support.

Once again, we have been promised further considerations rather than any proper reform. Once again miscarriage care and support has been kicked into the long grass, put in the “too hard to deal with” box.

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The roughly 500 word section on miscarriage does offer some small, welcome changes to bereavement care, namley the introduction of pregnancy loss certificates. But bereavement care is not the same as medical care. Providing tests or information could help the one in five women who will experience a miscarraige from having to go through multiple, in some cases preventable losses. And whilst I welcome the introduction of a certificate, this unofficial document is not an adequate alternative to having miscarriages marked on medical records and proper data collection.

Not only would proper data collection uncover the scale of miscarriage and form the basis of research which could help stop thousands of preventable miscarriages, but it would also save families the grief of having to explain to multiple medical staff that they have miscarried.

When I was called for my flu jab in the winter following my miscarriage I asked the nurse why I had been called in. The nurse said, “because you’re pregnant.” This was obviously an uncomfortable situation for the nurse, but for me it was a reminder of what I had lost. A reminder of how little our health system seems to care about miscarriage. This wouldn’t have happened if my miscarriage had been properly recorded on my medical records. I, and so many others, could be saved from this pain.

We need action now, not in six months or six years time. We need adequate care that rapidly reduces the likelihood that people experience this trauma again and again. The government must use its Pregnancy Loss Review to commit in full to the Lancet Series findings and fix the holes in the system. Without proper action to address this scandal, grandiose statements about ending the inequalities in women’s health are meaningless.

Olivia Blake is the Labour MP for Sheffield Hallam

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