Saving Lives, Improving Mothers’ Care

This month sees publication of the latest report [1] from the UK and Ireland Confidential Enquiry into Maternal Deaths and Morbidity.

“Saving Lives, Improving Mothers’ Care” is the work of MBRRACE-UK: Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK.  The document reports on investigations into all maternal deaths during and after pregnancy between 2009 and 2014 and highlights the lessons to be learned. The message throughout is that improving training, communication and multi-disciplinary care – along with raising public awareness of danger signs – can save lives.

Deaths in early pregnancy

This year’s report focuses primarily on deaths from maternal heart disease and pre-eclampsia, as well as deaths relating to mental health problems, but there is also important information on deaths in early pregnancy, especially from ectopic pregnancy.

Ectopic pregnancy: information for health professionals, women and their partners/family/friends

Of the 191 women who died between 2009 and 2014 at less than 24 weeks of pregnancy, nine died as a direct result of ectopic pregnancy.  The report’s lay summary[2] notes the signs and symptoms of ectopic pregnancy and highlights the need to go to an early pregnancy clinic or Accident & Emergency department for assessment as soon as possible.

The full report provides more detail for hospital and community health professionals.  It highlights the need to suspect ectopic pregnancy in women of reproductive age who are either collapsed or have other symptoms of illness, and to remember that some women may not know they are pregnant. Correct diagnosis and treatment is critical:

“A diagnosis of ectopic pregnancy should be considered in any woman of reproductive age presenting to the emergency department with collapse, acute abdominal/pelvic pain or gastro-intestinal symptoms, including diarrhoea, vomiting and dizziness, regardless of whether she is known to be pregnant.  A bedside pregnancy test should be performed in these women.”

Molar pregnancy

About one in 600 pregnancies is a molar pregnancy. That means it is quite rare, especially compared with miscarriage, which affects around one in four pregnancies.

There was one death reported in a woman with molar pregnancy, but this was primarily caused by a condition called HELLP (a variant or complication of pre-eclampsia).  Deaths from molar pregnancy are extremely rare, but it is important that they are diagnosed and followed up at specialist centres.

For this reason, the lay summary suggests that women who still feel pregnant several weeks after a miscarriage do a pregnancy test, since “there is a very small chance of some abnormal placental tissue remaining”.

We feel that this note could have been clearer.  While it can take time for pregnancy symptoms to disappear after miscarriage, if they continue for more than two or three weeks and if a pregnancy test is still positive, that might be a sign of a molar pregnancy.  A follow-up scan and/or further pregnancy tests can help assess if further treatment, including surgical removal of any remaining pregnancy tissue, is needed.

We have more information about molar pregnancy here.

Recurrent miscarriage

Recurrent miscarriage is not in itself a possible cause of maternal death.  However, if it is caused by antiphospholipid antibody syndrome (also called APS or sticky blood or Hughes syndrome), it increases the risk of pre-eclampsia.

The important messages here are that if you have been diagnosed with APS, it is worth reminding health professionals of this throughout your pregnancy so that you receive additional care and assessment.  If you have had two or more consecutive miscarriages but have not been tested for APS, you may want to discuss this with your GP.

We have more information about APS and pregnancy here.  And there is more general information about recurrent miscarriage here.

Mental health problems

The report highlights that mental health problems remain a leading cause of death in pregnancy and in the 12 months after pregnancy and we welcome the authors’ advice to “speak out and get treated early”.

We know that feelings of grief, loss, anxiety and depression are common after pregnancy loss, but that doesn’t make them easy to deal with.  The Miscarriage Association can offer support, understanding and a listening ear, but that might not be enough.

If you are worried about your thoughts and feelings, especially if you feel that you are getting worse rather than better or if you have suicidal thoughts, please do seek help from your GP or specialist mental health service.



[1]Saving Lives, Improving Mothers’ Care

Knight M, Nair M, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care – Surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-14. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2016.

[2] MBRRACE-UK – Saving Lives, Improving Mothers’ Care 2016 – Lay Summary


7 December 2016



Posted in news and events |

“No need to wait to conceive after miscarriage”

Research published this week [1] has highlighted that couples wanting to conceive after a miscarriage don’t have to worry about the risks of trying again too soon.[2]

The authors conclude that conceiving within the first six months after miscarriage does not increase the risk of miscarriage or of other adverse outcomes [3] 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 [4], and try again whenever you are ready and able to do so.



[1] 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

[2] Press release at (or see below)

[3] Other adverse outcomes: pre-term birth, pre-eclampsia, low birth weight babies and stillbirths.

[4] See (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.”





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Wave of Light

We’ve been reflecting on the candles that lit up our social media channels during October’s Wave of Light, in memory of tiny lives lost far too soon.



Thank you to everyone who allowed us to include their photos in our video, and to Itty Bitty Beats for giving us permission to use their beautiful song, ‘The Last Lullaby’.  Our thanks too to digital media consultant Natasha Judd for creating the video for us all.

If you click on the video, it will pause to allow you to see individual photos. Alternatively you can find them on our gallery here:

Posted in news and events |

Talking about pregnancy loss

In a short film broadcast on BBC South TV*, Kate talks about her experience of recurrent loss, along with members of the Winchester miscarriage support group.

Recurring Miscarriage – Kate’s Story from Russell Sheath on Vimeo.

The film, made by Russell Sheath and Still River Films, confirms recent research evidence that pregnancy loss can have a huge impact on those going through it.  A significant number of women who took part in that research reported anxiety, depression and symptoms of post traumatic stress disorder, like flashbacks and panic attacks, even some months after their loss.

‘Kate’s story’ highlights the continuing sadness and distress of recurrent loss as well as new support techniques being trialled at Southampton University.  What comes over clearly too are the benefits of finding support from others who have been through something similar, whether through a local support group or by using the M.A. forum or social media.

Our helpline is also here for anyone who’d just like to talk things through, whether by phone or by email:

You really don’t have to go through this alone

*  You can watch the broadcast here – six and a half minutes into the programme.

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New research: “Miscarriage and ectopic pregnancy may trigger post-traumatic stress disorder”

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:


Posted in news and events |

Reflections on Babyloss Awareness Week

Last week was special.  The days between 9 and 15 October marked Babyloss Awareness Week, an annual opportunity to join with others to mark the brief lives of babies lost in pregnancy, at or shortly after birth or in infancy.

And people did.  There were remembrance services and memorial walks, events at Westminster and a three hour debate in the House of Commons.  Pregnancy and baby loss featured on radio and television, in the printed press and online.

The culmination of the week was on Saturday 15 October, International Babyloss Day.  At 7 p.m. their local time, people across the globe lit candles in memory of their babies’ brief lives as part of a Wave of Light.


By Sunday evening, 16 October, the image above was shared over 17,000 times, reaching 2.1 million people.  And hundreds of people have shared photographs of their candles with us.  We are saving them all on our Days That Matter website and later this month we plan to turn them into a video which we’ll share with you here and on YouTube.

Sadly, pregnancy losses happen every single day of the year, not just in October.  The statistics tell us that it is a sadly common experience – and yet people can feel very isolated and alone when it happens to them.

Babyloss Awareness Week reminds us all that while each loss of each baby is unique and individual, the thoughts and feelings for a tiny life lost are shared by many people.  There are people who understand, people who can offer understanding and a listening ear.

You don’t have to go through this alone.



Posted in news and events |

International Babyloss Awareness Day 2016

Today, Saturday 15 October, marks International Babyloss Awareness Day, the culmination of a week of activities and events that offer a special opportunity to mark the brief lives of babies lost in pregnancy, at or shortly after birth or in infancy.

The Miscarriage Association began the week by launching a new animation, telling the story of one couple’s experience of a missed miscarriage and highlighting our #heretolisten message.

There have been more public discussions of pregnancy and baby loss than ever before, thanks to the hard work and dedication of all the charities involved – and especially to MPs Will Quince and Antionette Sandbach, co-chairs of  the All Party Parliamentary Group on Babyloss, who:

  • hosted a Twitter discussion on babyloss
  • encouraged MPs to wear babyloss pin badges during Prime Minister’s Questions
  • arranged a special reception for bereaved parents, civil servants and politicians across all parties
  • organised a moving remembrance service in Westminster and
  • led a very powerful backbench debate in the House of Commons on Thursday, with excerpts widely shown on television and across social media.

M.A. ambassador Julia Hartley-Brewer broadcast interviews with Director Ruth Bender Atik and with Sports Minister Tracey Crouch; and journalist Amy Swales published her own reflections on miscarriage and fertility here and here.

But of course, Babyloss Awareness Week is primarily about and for women and men affected by babyloss.  They – and you – have been wearing pinbadges and Twibbons, organising and attending events, talking on social media, opening up to family and friends sometimes for the first time and raising awareness about the impact of pregnancy loss.

Tonight sees the culmination of the week.  At 7 p.m. local time, people from across the globe will light a candle or candles in memory of babies lost in pregnancy, at or soon after birth or in infancy, creating a Wave of Light in memory of babies who have died too soon. If you are taking part and would like to add your candle photo to our 2016 gallery and video, either upload it to our Facebook page with a message saying ‘for the gallery’ or email it to

Thanks to everyone for your support.


Posted in news and events |


The Babyloss Awareness Week animation that we launched yesterday ends with the message:

“It was such a hard time and we’ll never forget our baby, but having people listen – really listen – has helped us through.”

Here at the Miscarriage Association, we’ve supported thousands of people who have been affected by pregnancy loss, and one thing we’ve heard again and again is that it can often help to talk.

However we also know that talking can be difficult. People who want to support their friends tell us that they’re worried they’ll say the wrong thing and that they sometimes say nothing in case they make things worse.

Last year, we asked our supporters to share the helpful things that others had said to them after a pregnancy loss. There were hundreds of different answers. Everyone’s experience of loss is different, of course. However, a common message that emerged is that sometimes it’s not so much what we say, as what we do: being there for a friend, really listening to what they have to say, can make all the difference in helping them through.

That’s why, this Babyloss Awareness Week, we’re asking you to use the #heretolisten hashtag as you share one of the graphics below with your friends and family, on Facebook, on Twitter, on Instagram and across social media, to say – if you want to talk about pregnancy loss, I’m here to listen. Click on the thumbnails below for full-size images.

here-to-listen-friends here-to-listen-phone here-to-listen-scan here-to-listen-window

Illustrations by Emma Plunkett of planXdesign.

Two other people who will be here to listen later today are the chairs of the All Party Parliamentary Group on Babyloss.

From 2 to 3 p.m. today, the two group chairs, Will Quince MP and Antoinette Sandbach MP, will be on Twitter, asking questions to inform a special House of Commons debate about  pregnancy and baby loss this Wednesday. The Miscarriage Association will be participating in this event via our twitter account (@MiscarriageA). If you would also like to get involved, please follow the hashtag #babylossdebate.

For more information about the events in Westminster this week, see our Babyloss Awareness Week events page.

Posted in news and events |

Miscarriage Association launches new animation for Babyloss Awareness Week

Today is the start of Babyloss Awareness Week 2016, a special annual event to remember the brief lives of babies lost during pregnancy,  during or shortly after birth, or in infancy. Over the next seven days, women and men affected by babyloss, across the UK and around the world, will be wearing pinbadges and Twibbons, lighting candles, attending events and raising awareness about the impact of pregnancy loss.

To mark this special event, the Miscarriage Association is proud to launch a new animation, which tells the story of one couple’s experience of a missed miscarriage. The animation has three key messages: that for many, miscarriage isn’t just a physical loss, but the loss of hopes and dreams for the future; that talking about the loss can help; and that the Miscarriage Association is here to listen if you need us.

The animation was illustrated by Emma Plunkett from planXdesign and voiced by Amy Swales, both of whom have personal experience of miscarriage. The video was developed by The Service, with animation by Dom Faraway.

We have uploaded the video to both YouTube and Facebook. Please feel free to share it with your family and friends, and help raise awareness about pregnancy loss, both during Babyloss Awareness Week and beyond.

For more information about other activities and events this week, see the Babyloss Awareness Week page on our website.

Posted in news and events |

Online shop

Our sincere apologies to those of you trying to order a Babyloss pin badge, Christmas cards or other M.A. merchandise online.  Unfortunately, we’ve had to suspend the online shop, so until we have a new one in its place, please contact us directly to make your purchase.

You can:

  • call us on 01924 200799, Monday to Friday, 9 a.m. to 4 p.m. and pay by debit or credit card
  • email us at and we’ll provide details of goods and costs – but we advise against putting card details on an email
  • order by post at 17 Wentworth Terrace, Wakefield  WF1 3QW and pay either by cheque or by providing card details.

In all cases, we’ll fulfil your order just as fast as we can, although we will prioritise Babyloss pin badges.

Thank you for your support and understanding.

Posted in news and events |