The Miscarriage Association is an expert resource for advice, information and comment on the facts and feelings of miscarriage.
You can read our comments on recent research, news stories and events below.
We recognise that print, broadcast and online media want to provide sound information, news and features; and that journalists and researchers seek wherever possible to source reliable facts and figures.
We also appreciate your assistance in raising public awareness of miscarriage, in helping to provide important information to your audience and in reducing the taboo associated with miscarriage.
We are always happy to help whenever we can, supporting responsible media coverage of the facts and feelings of miscarriage.
- Provide background information about miscarriage, ectopic pregnancy and molar pregnancy
- Help you make sense of information that you have sourced
- Comment on research findings
- Comment on issues and stories around miscarriage that are in the public domain
- Provide case studies where possible (depending on your criteria and deadlines)
You can find background information here.
Certificate of pregnancy loss
26 January 2017
When a baby dies before 24 weeks of pregnancy, there is no legal recognition of his or her brief life, no birth or death certificate.
While some parents may be relieved that they don’t have to face the ordeal of registering their loss at the local Registry office, others find this threshold immensely distressing and hurtful.
“He was my baby. I’d seen him on scan, I’d felt him kick. How can someone say he doesn’t count?”
A recent online petition seeks to lower the age of registration to 20 weeks rather than 24. That would be welcomed by many parents – although it would not help those whose babies died at, say 18 or 19 weeks.
Others campaigns have argued that that there should be no threshold at all, allowing the registration of the loss of any baby who dies at any stage of pregnancy.
It seems unlikely that the law on the age of viability will be changed in the foreseeable future, but we believe we have an opportunity now to campaign for the wider availability of certificates of loss for those parents who would like them. These would not be the same as a legal document, it’s true, but they would go some way to marking these tiniest of lives.
The Miscarriage Association – along with other organisations too – has long encouraged hospitals to offer parents some form of certification for babies lost in pregnancy. We would be delighted if you would share our guidance for hospitals with your local NHS Trust.
We talk about the emotional impact of late loss here. Our leaflet on late miscarriage provides information about both the facts and the feelings of this deeply distressing experience. And the Late Loss section of our forum is a very special place for sharing experiences and support.
26 December 2016
We send our sympathies to Zara and Mike Tindall on the announcement of the loss of their baby.
Miscarriage is sadly common – around one in four pregnancies ends before 24 weeks of pregnancy, most before 14 weeks. Miscarrying after that time – especially when all looks well at the 12 week scan – is much less common and can come as a great shock. It is hard, too, when the pregnancy has been only recently been confirmed to family and friends – and in this case the public too.
Whenever a miscarriage happens, though, most parents experience it as the loss of a baby and all the hopes, plans and dreams for that child. Feelings of loss and grief are common and it can be very important to have the support and understanding of those around you to help you through.
We hope that Zara and Mike Tindall find that support and wish them gentler times ahead.
The Miscarriage Association recognises the distress of losing a baby in pregnancy and we offer support and information to anyone affected by it.
No need to wait to conceive after miscarriage
30 November 2016
Research published this week  has highlighted that couples wanting to conceive after a miscarriage don’t have to worry about the risks of trying again too soon.
The authors conclude that conceiving within the first six months after miscarriage does not increase the risk of miscarriage or of other adverse outcomes  in the new pregnancy.
On the contrary, it showed that pregnancies conceived in the first six months after a miscarriage were actually less likely to result in another loss than pregnancies conceived more than six months later. Conceiving in those first six months was also associated with a lower risk of a pre-term birth.
Dr Sohinee Bhattacharya, from the University of Aberdeen, who led the research, acknowledges that it is not clear why conceiving within six months leads to better outcomes. Nevertheless, this comprehensive review of all the published studies about the effects of timing of conception after miscarriage has confirmed research she first published in 2010.
The new study concludes: “There is now ample evidence to conclude that delaying a pregnancy following a miscarriage is not beneficial and unless there are specific reasons for delay, couples should be advised to try for another pregnancy as soon as they feel ready”.
So what does this mean for you?
We think there are several key messages here.
- It’s important news. Above all, it confirms that that couples can choose to try again whenever they feel ready to do so.
- It’s encouraging news if you want to try to conceive soon after miscarriage and you feel emotionally and physically ready. Once any bleeding has stopped there’s almost certainly no need to wait (unless your doctor has advised otherwise).
- It’s reassuring news if you worry that you might have miscarried because you conceived too soon after a previous loss. That’s highly unlikely.
- It’s confusing news if you don’t feel ready to try again – as you might worry that you’re increasing your risk of having another miscarriage. But waiting until you feel ready is likely to be best for both your mental and physical health and the researchers themselves emphasise that “… couples should be advised to try for another pregnancy as soon as they feel ready”. (Our emphasis)
- It’s possibly upsetting news if it takes you longer than 6 months to conceive, or if you simply don’t have the option of trying again that soon, for whatever reason.
Perhaps it will help to remember that this is a statistical analysis and it talks about averages and trends – not necessarily about you and your circumstances. It tells us that overall, there is no benefit in waiting and that conceiving earlier can reduce the chance of another loss, though we don’t know why.
We do know that miscarriages happen for many reasons that have nothing to do with pregnancy interval and that most of these reasons are beyond your control. All you can do is do the best you can with your own situation , and try again whenever you are ready and able to do so.
 Kangatharan C, Labram S & Bhattacharya S Interpregnancy interval following miscarriage and adverse pregnancy outcomes: systematic review and meta-analysis. Human Reproduction Update (2016) doi: 10.1093/humupd/dmw043
 Press release at http://www.abdn.ac.uk/news/10205/ (or see below)
 Other adverse outcomes: pre-term birth, pre-eclampsia, low birth weight babies and stillbirths.
 See http://www.miscarriageassociation.org.uk/wp/wp-content/leaflets/Thinking-about-another-pregnancy.pdf. (We’ll need to update it!)
Issued on 30 November 2016 by the Communications Team, Directorate of External Relations, University of Aberdeen.
No need to wait to conceive after miscarriage
Women who get pregnant soon after a miscarriage are more likely to have a successful pregnancy than those who wait to conceive again.
Contrary to World Health Organisation (WHO) guidelines that recommend waiting at least 6 months, the comprehensive review by the University of Aberdeen found that pregnancies were most successful if conceived within 6 months of a miscarriage.
The meta-analysis, published today in Human Reproduction Update, confirms an earlier study by Dr Sohinee Bhattacharya and colleagues that found that conceptions within 6 months of a miscarriage were less likely to result in another miscarriage or a subsequent preterm birth.
Pre-eclampsia (high blood pressure in pregnancy), low birth weight babies and stillbirths were no different in conceptions within 6 months and those after 6 months.
Dr Bhattacharya who led the meta-analysis said: “This review of all the published research to date shows categorically that conceiving within 6 months after a miscarriage is best.
“In 2010 we were the first to report that conceiving straight after miscarriage was more successful than waiting. Subsequently, more papers came out finding the same thing, which is why we did a comprehensive review of all available research.
This review of all the published research to date shows categorically that conceiving within 6 months after a miscarriage is best.” Dr Sohinee Bhattacharya
“Contrary to WHO guidelines, recommending at least 6 months’ wait after a miscarriage, our meta-analysis of all published studies on this subject to date – shows definitively that less than 6 months is best.
“It is not clear why this is the case – one explanation might be that if somebody has had a miscarriage they might take particularly good care of themselves, be more motivated and may even be more fertile –but that is just speculation at this point. “
Ruth Bender Atik, National Director of the Miscarriage Association said: “This review is very important. It encourages couples who want to try to conceive soon after miscarriage, and also reassures those who worry that they may have miscarried because they conceived too soon after a previous loss.
“Above all, it confirms that that couples can choose to try again whenever they feel ready to do so.”
“Miscarriage and ectopic pregnancy may trigger post-traumatic stress disorder”
3 November 2016
New research published in the BMJ today highlights the levels of anxiety, depression and trauma felt by significant numbers of women after experiencing miscarriage or ectopic pregnancy.
We reproduce the press release below:
Miscarriage and ectopic pregnancy may trigger post-traumatic stress disorder
Women may be at risk of post-traumatic stress disorder following a miscarriage or ectopic pregnancy, suggests a new study.
The team behind the research, from Imperial College London, say the findings suggest women should be routinely screened for the condition, and receive specific psychological support following pregnancy loss.
In the study, published in the journal BMJ Open, the team surveyed 113 women who had recently experienced a miscarriage or ectopic pregnancy.
The majority of the women in the study had suffered a miscarriage in the first three months of pregnancy, while around 20 per cent had suffered an ectopic pregnancy, where the baby starts to grow outside of the womb.
The results revealed four in ten women reported symptoms of post-traumatic stress disorder (PTSD) three months after the pregnancy loss.
Miscarriage affects one in four pregnancies in the UK, and is defined as the loss of a baby before 24 weeks – although most miscarriages occur before 12 weeks. Ectopic pregnancies are much rarer, affecting around one in 90 pregnancies. The fertilised egg usually implants in the fallopian tubes connected to the womb, where it cannot grow, and so the pregnancy either miscarries or must be ended surgically or with medicine.
In the new study, funded by the Imperial College Healthcare Charity, the scientists sent the women questionnaires asking them about their thoughts and feelings after their pregnancy loss. All of the women had attended the Early Pregnancy Assessment Unit at Queen Charlotte’s and Chelsea hospital, West London.
The results revealed that three months after the pregnancy loss, nearly four in ten women (38 per cent) met criteria for probable PTSD.
Among the women who suffered a miscarriage, 45 per cent reported PTSD symptoms at this time, compared to 18 per cent of the women who suffered an ectopic pregnancy.
Post-traumatic stress disorder is caused by stressful, frightening or distressing events, and causes people to relive the event though nightmares, flashbacks, or intrusive thoughts or images that appear at unwanted moments. The symptoms can start weeks, months or even years after a traumatic event and can cause sleeping problems, anger, and depression.
The women in the study who met the criteria for PTSD reported regularly re-experiencing the feelings associated with the pregnancy loss, and suffering intrusive or unwanted thoughts about their miscarriage. Some women also reported having nightmares or flashbacks, while others avoided anything that may remind them of their loss, or friends and family who are pregnant.
Furthermore, nearly a third said their symptoms had impacted on their work life, and around 40 per cent reported their relationships with friends and family had been affected.
Dr Jessica Farren, lead author of the research from the Department of Surgery and Cancer at Imperial, said this research suggests women should have an opportunity to discuss their emotions with a medical professional.
“We were surprised at the high number of women who experienced symptoms of PTSD after early pregnancy loss. At the moment there is no routine follow-up appointment for women who have suffered a miscarriage or ectopic pregnancy. We have checks in place for postnatal depression, but we don’t have anything in place for the trauma and depression following pregnancy loss.
“Yet the symptoms that may be triggered can have a profound effect on all aspects of a woman’s everyday life, from her work to her relationships with friends and family.”
Dr Farren, who is based at Tommy’s National Centre for Miscarriage Research at Imperial, explained that previous research has suggested women who experience a stillbirth may develop post-traumatic stress disorder. However this is the first research to only focus on early pregnancy loss.
“There is an assumption in our society that you don’t tell anyone you are pregnant until after 12 weeks. But this also means that if couples experience a miscarriage in this time, they don’t tell people. This may result in the profound psychological effects of early pregnancy loss being brushed under the carpet, and not openly discussed,” she said.
The team, who conducted their research in collaboration with the University of Leuven in Belgium, also questioned a control group of 50 women with ongoing pregnancies.
The study results also revealed around one in five women had symptoms of moderate anxiety at three months after their pregnancy loss. In the control group, one in ten reported symptoms of anxiety.
Furthermore, one in 20 women reported symptoms of depression three months after their loss.
Professor Tom Bourne, senior author of the study, said the team are now planning larger follow-up studies, to confirm the findings and help identify at-risk women.
“Not all women who suffer a miscarriage or an ectopic pregnancy will go on to develop PTSD or anxiety and depression. Therefore we are now investigating why some women may be more at risk than others, to help medical professionals identify who may need extra support.”
Jane Brewin, chief executive of the charity Tommy’s, who part-funded the research, said: “This study gives a voice to many women who have suffered miscarriage in silence and the often significant consequences that follow. The message is clear: in a civilised society it is not acceptable for women to suffer in this way. Following this study there must now be added impetus to change miscarriage treatment and care; many women need more support following a miscarriage and the NHS needs to rethink how women are treated throughout the experience so they do not suffer from PTSD and other psychological impacts. Tommy’s Centre for Early Miscarriage Research was opened this year with the support of many families who want to bring about change and we’d encourage all families to join with us to find answers to miscarriage and help improve care for everyone.”
Professor Bourne added that in addition to improving diagnosis of psychological disorders following miscarriage, researchers need to assess what treatments may help.
“We know that talking therapies, such as cognitive behavioural therapy, have been successful at treating PTSD. However we need to investigate how this treatment should be tailored to women who have suffered an early pregnancy loss.”
Ian Lush, chief executive of Imperial College Healthcare Charity, who funded the study, added: “Clearly, losing a baby at any stage is devastating for parents. We recognised early on the potential this piece of research had, and equally, how important the findings would be to patients and clinical staff right across the NHS. The outcomes that are being shared will hopefully mean the effects of early pregnancy loss deservedly get the spotlight shone on them, and women and their partners, thanks to better understanding of those effects, get the extra support they need.”
Nicole Martin, 42, suffered three miscarriages between 2013 and 2014. Although she didn’t take part in the trial, she understands the enormous emotional toll of early pregnancy loss.
The PR associate director from London recalled:
We started trying for our second child after my daughter turned one. We became pregnant with twins, but the first baby died five weeks into the pregnancy, and the second at around 10 weeks.
We immediately started trying again and I feel pregnant a month or two later. I was crippled with anxiety and took pregnancy tests every day. However, we miscarried again at seven weeks.
I became consumed with what happened to us. I returned to work but was a shadow of my former self, and wracked with guilt that I was unable to give my daughter a sibling. I withdrew from social situations, and felt unable to laugh or smile. I also found it very hard to be around or even see people who had more than one child.
We were pregnant again within a couple of months, but were thrown into despair and disbelief when we miscarried a third time.
Two month later, a few weeks after my 40th birthday, we became pregnant again and our beautiful son Joseph was born in March last year. Although we are now extremely happy, I often say the miscarriages robbed me of my personality. I stopped engaging with life; even with my daughter; and was consumed by my almost compulsive desire to have another baby. I couldn’t find joy in anything; and hated the jealousy I felt towards other pregnant women. My relationship with my husband was put under strain but somehow we got through it and, in many ways, it brought us closer together, and I will forever be grateful for the unfailing support he – and many others – gave me during that time.
The research was funded by the Imperial College Healthcare Charity, Tommy’s, and the National Institute of Health Research Imperial Biomedical Research Centre.
1. ” Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study” by J. Farren at al is pubished in BMJ Open.
An embargoed copy of the paper is available for download here: https://icseclzt.cc.ic.ac.uk/pickup.php?claimID=d8X4JSwn8TFtPwWV&claimPasscode=VvueBhTvx3kTfdGE&emailAddr=k.wighton%40imperial.ac.uk
PRESS RELEASE: 25 March 2015
Human Tissue Authority guidance on disposal of pregnancy remains: the Miscarriage Association responds.
Following the publication of new HTA guidance on disposal of pregnancy remains, Ruth Bender Atik, National Director of the Miscarriage Association, said:
“The guidance contains much to be welcomed. However, it fails to fully address the issues raised when hospitals deal with pregnancy remains.
“We’re pleased to see that the guidance emphasises the need for pregnancy remains to be treated with dignity, sensitivity and respect, however early in pregnancy that loss occurred.
“There is clear consideration of the varying needs and concerns and sensitivities of women regarding what happens to the remains of their pregnancy. And there is recognition that staff who provide information on this topic need to be well informed, trained and supported.
“However, if the woman does not express a preference, hospitals are allowed to dispose of the pregnancy remains along with clinical waste. We feel this is wrong. It seems to assume that not making a decision means not caring and doesn’t take account of the distress and difficulty that many women go through in having to make this decision. Some women come back years after their loss to ask what happened to the remains of their baby.
“Added to that, the guidance refers several times to ‘sensitive incineration’, when current practice means that there is no such thing, as almost all incineration of clinical waste takes place away from the hospital. Unless there is someone who can ensure that these remains are incinerated in a dignified way, completely separate from clinical waste, we believe that this description is simply untrue and shouldn’t be used.
“We hope the government ministers responsible for this area will reconsider, and follow the admirable lead of the Scottish Government, which has created much better guidance. In the meantime, we can only hope that hospital managers will themselves decide to practise the best possible standards in this sensitive area.”
For further information please contact:
Ruth Bender Atik, National Director of the Miscarriage Association
Tel: 01924 200795 / 07527 070046 email@example.com
Notes to editors
Background to the Miscarriage Association statement
Most people would rather not think about what happens to the remains of pregnancies following miscarriage, ectopic or molar pregnancy or termination. For many of those affected by pregnancy loss, however, it matters greatly – even many years later – to know that these remains are disposed of with respect and sensitivity.
Sadly, this is not always the case, as we have noted before. While previous guidance has recommended that hospitals arrange for pregnancy remains to be cremated or buried, some pregnancy remains are still disposed of along with clinical waste. This is not illegal but it cannot be described as sensitive or respectful.
We were therefore delighted that the Human Tissue Authority was tasked last year with drawing up new guidance for hospitals and clinics on the disposal of remains of pregnancies ending before 24 weeks’ gestation. We felt this was an opportunity to clarify the legal position and make recommendations that would drive up the standard of care on this sensitive issue, as has been done recently in Scotland.
Much to be welcomed
There is much to be welcomed in this guidance. First and foremost it emphasises the need for pregnancy remains to be treated with dignity, sensitivity and respect, however early in pregnancy that loss occurred.
There is clear consideration of the varying needs and concerns and sensitivities of women* regarding what happens to the remains of their pregnancy. And there is recognition that staff who provide information on this topic need to be well informed, trained and supported**.
As before, the guidance recommends that hospitals offer the options of cremation or burial (which may be collective or individual) as well as the option for women to make their own arrangements, including taking the remains home.
In addition, they recommend that hospitals offer women the option of incineration. This may seem perverse, but it is in recognition of the fact that some women clearly do not wish any special status to be conferred on the remains of their pregnancies. We accept that some women will choose to have their pregnancy remains incinerated rather than buried or cremated.
Where the guidance disappoints
There are two main areas of serious concern.
A default option
First, the guidance includes incineration as a possible ‘default’ option for hospitals in cases where a woman does not express her wishes within a given time-frame.
The assumption appears to be that if a woman does not state her preference, then the matter is of no importance to her. It does not take account of the distress that many women experience at having to make this decision, or of any other factors that lead them not to make a decision at all. It certainly ignores evidence that some women come back even years after their loss to ask what happened to the remains of their baby.
This is truly a missed opportunity to demonstrate high standards of care, particularly in the light of the recent Scottish guidance.
Second, we are very concerned by the description of this option as ‘sensitive incineration’. This description is completely inappropriate. Given that almost all incineration of clinical waste takes place off-site, this cannot be guaranteed. Unless the incineration of pregnancy remains is conducted in a dignified manner, completely separate from clinical waste, and adequately supervised as such, this term is simply untrue and should not be used.
* Decisions rest with the woman as pregnancy remains are considered her tissue.
** There is brief guidance for health professionals here .
For more information and case studies, contact:
Ruth Bender Atik, Miscarriage Association
T: 01924 200795 M: 07527 070046 e-mail: firstname.lastname@example.org
Press release 25 Feb 2013
Miscarriage Association Unveils Awareness Campaign Encouraging People to Open Up About Miscarriage
– With one in four pregnancies ending in miscarriage, LIDA unveils nationwide campaign –
Direct and Digital agency, LIDA, has created a national poster and guerrilla marketing campaign for the Miscarriage Association, aimed at breaking the silence around miscarriage, which ends one in four pregnancies.
The campaign launches on Monday 25 February with posters located at fourteen train stations across the UK. The outdoor advertising campaign, targeted at stations with high footfall, is being supported by intriguing blue envelopes addressed ‘To anyone’, left in random places around the poster activity.
The placement of the blue envelopes reflects the randomness of miscarriage, with the message inside centring on the one in four statistic and encouraging people to start talking about miscarriage, or to speak to one of the charity’s helpline staff.
Ruth Bender Atik, National Director of the Miscarriage Association, said: “Miscarriage affects many thousands of people throughout the UK every year, and yet it’s rarely spoken about openly. We know that talking about it can make a huge difference to the women, men/partners, families and friends affected by miscarriage, and we hope that this campaign will help to end the silence.”
Nicky Bullard, Executive Creative Director at LIDA, added: “We wanted to highlight the randomness of miscarriage through our powerful little blue envelopes, left anywhere, addressed to anyone. The high stat means that there is a likelihood you will have been touched by the subject, whether it’s yourself, your partner, your daughter, friend or colleague. We just need to get people talking about it.”
– ENDS –
For more information and case studies, contact:
Ruth Bender Atik, Miscarriage Association
T: 01924 200795 M: 07527 070046 E: email@example.com
Dan Wright Copywriter (OOH campaign)
Andrew Pogson Account Director (OOH campaign)
Jo Legg Creative Director (Guerrilla campaign)
Sara Pouri Account Director (Guerrilla campaign)
Channel: Four Sheet Posters and Guerrilla Marketing
About the Miscarriage Association
The Miscarriage Association is a national charity working across England, Northern Ireland, Scotland and Wales.
It was founded in 1982 by a group of people who had experienced miscarriage and we continue to offer support and information to anyone affected by the loss of a baby in pregnancy, to raise awareness and to promote good practice in medical care.
LIDA is digital and direct marketing agency that focuses on creating Better Customer Connections between brands and consumers.
We create measurable value for brands by using customer understanding to develop action-orientated communications that connect better with customers across all channels.
Key clients include: Virgin Holidays, Boots, IKEA and Intercontinental Hotel Group