Miscarriage: Calls for Welsh Government and NHS to support more research and treatment in Wales

People who have experienced miscarriages in Wales have called on the Welsh Government to do more to ensure those who are affected receive appropriate treatment.

The NHS defines miscarriage as the loss of a pregnancy before 24 weeks.

It is thought to happen to one in five pregnancies.

The current practice in Wales is for women to only be offered investigations into why they have miscarried after three consecutive losses.

However, while medical investigations can currently lead to an answer of why a single miscarriage has happened, they do not address recurrent issues.

Research suggests longer term diagnoses are possible.

Danielle gave birth to her son, Idris, three years ago. She has also experienced a total of four miscarriages, both before and after his birth.

“The loss straight after Idris really sideswiped both of us. Because we’d had a successful pregnancy,” she told ITV Cymru Wales.

“I thought right, okay, here we go again, number two is on its way and then we lost it.

“The hardest part with my miscarriages [was] ‘we’ve reached the twelve weeks’. 

“It’s at that point of the twelve weeks scan when you’re thinking you’re there you’re at that hurdle, [it’s] that point at which you come out with your picture and you announce it to everybody.

“You think you’ve jumped it and you’re about to land and your ankle gives way.”

Danielle wants to know why she has had four miscarriages and whether she will be able to have another child.

“I feel like I’m being held back by not knowing,” she continued. “I can’t afford to be held back. 

“If I was to fall pregnant now I would be having my second child at the age of 43. 

“We know the risks factors get higher, but we both do really want Idris to have a sibling. I want him to have that relationship that I have with my brothers.”

After her fourth miscarriage, Danielle was offered testing to try and find out why it had happened.

“I’m hoping that it does [give me an answer]”, Danielle continued.

“In all likelihood, the answer is there is no answer and you’ve just got to accept that it’s just one of those things.

“[If it does], it doesn’t say that there would be something wrong next time

“It’s at what point you just hang up your hat and it’s really difficult when it’s something that you want.” 

Preventative treatment, which is still in the research phase of development, can include strengthening the lining of the uterus before pregnancy.

The current recommendations by the Lancet say women should not have to wait until a third miscarriage to receive treatment and support.

However, there is no obligation on health boards to start investigations before the third consecutive miscarriage.

Kath Abrahams, the chief executive of the Tommy’s pregnancy charity, said: “I really think it’s terrible that we don’t have better miscarriage care in the UK as standard. 

“When you look at how common the problem is and how many women that affects, it’s outrageous that we’re not doing more.

“It absolutely isn’t just one of those things. It’s incredibly common and it can have a really challenging impact on people.

“We know that 18% of women who experience loss in pregnancy will meet the criteria for post traumatic stress.

“A woman who has had a miscarriage is nearly four times more likely to die by suicide.

“Rather than the situation we have now, which is you have to have three miscarriages in a row before you can get properly get help and investigations into what’s happened and why, we recommend a graded model of miscarriage care, which means some people get some support and treatment after one miscarriage and then tests and treatment after two and three.”

Access to treatment during or immediately after a miscarriage in Wales has been described as a ‘postcode lottery’, with some health boards not having specialised medical facilities to deal with miscarriage, such as early pregnancy units.

This means some women have to go to A&E if they require medical treatment. 

There is also an argument that not enough funding is provided for research into the causes of miscarriage and the development of treatments.

The Welsh Government’s quality statement refers to ‘eveidence based support’ for miscarriage and pregnancy loss, but does not contain any detail.

A specific women’s health strategy is due out later this year.

Health minister Eluned Morgan told ITV Wales that women’s health issues such as miscarriage are at the top of her agenda. 

“We need to tailor the response to the individual,” Ms Morgan said.

“Some women want to talk about it, and some women don’t, that’s why we have to deal with this on a personal basis. 

“When people do come forward and ask for that support it’s really important it’s there for them and the NHS provides that mental health support, follow the clinical guidance and to make sure we are investigating if there is a problem at the appropriate time.

“Health boards have heard loud and clear from me that this is very much at the top of my agenda.“I am very keen to make sure we shift the dial so that people understand that in relation to women’s health, we use a different lens looking at health.

“I’m the health minister, it’s my budget, I decide how it’s spent, and if I need to rebalance it in favour of research that helps women because they have not been served well in the past, I’ll do it.”

Miscarriage: The Hidden Loss airs on Thursday, October 6 at 9pm on ITV Cymru Wales