After experiencing two devastating miscarriages, Lisa Varey found herself thinking something she could barely believe: she'd need to have another miscarriage before she could get the help she needed. Under current NHS rules in England, women typically don't qualify for specialist care until they've had three miscarriages - a policy that one in five pregnancies (most ending before 14 weeks) might have something to say about if they could talk.
Lisa, 34, told her husband, "We're not waiting another year. We need to be pregnant and miscarry as soon as we possibly can." She recalls them looking at each other and saying, "I can't believe I'm actually saying this out loud." Fortunately, she was invited onto a pilot project at Birmingham Women and Children's Hospital before that grim milestone. Tests revealed she would benefit from progesterone to maintain pregnancy and daily aspirin to boost healthy birth odds. She is now in her second trimester, crying as she describes how much the project helped. "There's so much support for pregnant women, but it didn't always feel like there was any support for women who were no longer pregnant."
Emily, 42, from Birmingham, suffered two miscarriages in one year while undergoing IVF, leaving her feeling her body had "failed" her. After a second loss, she joined the Birmingham project, receiving aspirin and higher-dose folic acid. Early tests gave her possible reasons for the miscarriages, removing "the guilt and shame that you feel." Tommy's, the pregnancy charity, notes that NHS care after three miscarriages can be "inconsistent and inadequate" - before that, women are often told to go home and try again. The Birmingham study compared 203 women who'd had miscarriages under standard care against 203 under a new model starting after just one loss. Researchers found a small reduction in miscarriage rates, and where losses did occur, women received better care. One in five women in the study had treatable conditions like abnormal thyroid function or anaemia. The team estimates the pilot could prevent around 10,000 miscarriages a year if rolled out across the NHS.
The new model offers one-to-one consultations with a specialist nurse after one miscarriage, covering lifestyle changes and progesterone use. After a second miscarriage, women get tested for anaemia and thyroid issues, plus early scans. After a third, they join the current NHS pathway. Professor Arri Coomarasamy, head of miscarriage research at Tommy's, calls the three-miscarriage wait "an unacceptable anomaly," pointing out, "If somebody has a heart attack, we don't say have your third heart attack and then we will see if there is anything we can do." The pilot also suggests the model could save the NHS money, as reduced miscarriage costs outweigh extra staff and training expenses.
Sally, 33, from Gloucester, has had two miscarriages and feels let down by her care. She's not ready to try again but says access to the pilot might change her mind. "Putting these systems in place show women that they are thought about, that one miscarriage is enough to be thought about and to be supported." In the recent Women's Health Strategy announcement, the government said it was considering "wider adoption" across the NHS in England. Baroness Merron, Parliamentary Under-Secretary at the Department of Health and Social Care, stated, "This will be carefully considered as part of our ongoing work to make sure women get the high-quality, compassionate NHS care they deserve." NHS Scotland is already improving miscarriage care, including not waiting for a third loss and providing separate rooms in maternity units. Northern Ireland and Wales follow England's guidelines. The Birmingham team remains "hopeful" their model will bring change. Kath Abrahams, Tommy's chief executive, says the pilot gives women understanding of their care path: "Knowing what's going to happen next can be incredibly comforting in a moment when you're in crisis."