Irina Spirieva, general manager of Besins Healthcare UK and Ireland, explores the inconsistencies in miscarriage care across the UK and calls for national action to ensure all women receive timely, compassionate, and evidence-based support
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Miscarriage is one of the most common complications of pregnancy – and one of the most overlooked. An estimated 250,000 pregnancies end in miscarriage every year in the UK,[1] yet too many women and their partners are left to cope alone, receiving inconsistent care that depends more on geography than clinical need.
The Department of Health and Social Care-commissioned independent Pregnancy Loss Review, published in July 2023, was clear: current provision is inadequate.[2] Despite progress through the Women’s Health Strategy, miscarriage remains an area where national ambition has not yet translated into local delivery.
Disparities in care
Experiencing a miscarriage can be devastating. We know that timely intervention and compassionate care can make a difference. National Institute for Health and Care Excellence guidance sets out evidence-based recommendations for miscarriage management,[3] yet access to essential support services and interventions varies by trust.
Many areas have dedicated early pregnancy units (EPUs) and offer investigations after two or more losses, but very few EPUs are accessible 24/7, with many open only during standard working hours.[2] Eligibility criteria for access also vary widely – some units see women up to 16 or even 22 weeks gestation, while others only offer care up to 12 weeks.[2] Some EPUs do not even publish their opening hours or access criteria,[2] making it even harder for women to find the help they need.
As integrated care boards (ICBs) and the NHS model continue to evolve following the recent launch of the 10-Year Health Plan[4], we have a window of opportunity to embed national standards. Scotland has led the way, introducing a national framework that includes a graded model of care from the first miscarriage, access to bereavement support, and a tailored treatment pathway.[5] England is now piloting this approach[6] – but we already know enough to act.
Towards a national delivery framework
We are calling for the development of a national delivery framework for miscarriage care – one that embeds consistent expectations across ICBs, and ensures timely access to assessment and care. Investment in EPUs to expand availability, enhance access, and improve quality of care is vital.
Miscarriage is not just an individual loss – it carries wider clinical, economic and emotional impacts. The NHS sees more than 50,000 miscarriage-related hospital admissions annually,[3] at an estimated £471m in short-term costs.[7] Meanwhile, there is some evidence to show that miscarriage is associated with an increase of coronary heart disease, anxiety, depression, post-traumatic stress disorder, and suicide.[8]
Investing in consistent, evidence-based miscarriage care is not just clinically appropriate; it is a matter of dignity, equity, and justice. With the NHS undergoing a period of transformation, the opportunity to get this right, and finally end the postcode lottery, is now.
Job bag: MAT-BHUK-NP-0574
Date of preparation: November 2025
Sources:
[1] Austin L, Littlemore J, McGuinness S, Turner S, Fuller D, Kuberska K. Effective communication following pregnancy loss: A study in England. Camb Q Healthc Ethics. 2021;30(1):175-87. doi:10.1017/S0963180120000651. PMID: 33371918.
[2] DHSC. The Independent Pregnancy Loss Review. July 2023. Available from: https://www.gov.uk/government/publications/pregnancy-loss-review Accessed November 2025.
[3] NICE. Ectopic pregnancy and miscarriage: diagnosis and initial management (NICE guideline NG126). 2019 (updated 2023). Available from: https://www.nice.org.uk/guidance/ng126 Accessed November 2025.
[4] UK Government. Fit for the Future: 10 Year Health Plan for England. July 2025. Available from: https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-for-the-future-10-year-health-plan-for-england.pdf
[5] The Scottish Government. Improving Miscarriage Care. 6 February 2025. Available from: https://www.gov.scot/news/improving-miscarriage-care/ Accessed November 2025.
[6] University of Birmingham. Leading research to prevent miscarriage continues. 10 July 2024. Available from: https://www.birmingham.ac.uk/news/2024/leading-research-to-prevent-miscarriage-continues Accessed November 2025.
[7] Quenby S, Gallos ID, Dhillon-Smith RK, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021;397(10285):1658-67. doi:10.1016/S0140-6736(21)00682-6.
[8] McNestry C, Killeen SL, Crowley RK, McAuliffe FM. Pregnancy complications and later life women’s health. Acta Obstet Gynecol Scand. 2023; 102: 523-531. doi:10.1111/aogs.14523
