Tommy’s welcomes ‘milestone’ changes to miscarriage care in Scotland

The Scottish Government has today announced a raft of improvements to miscarriage care in Scotland, drawing on Tommy’s research and recommendations.

Its new Delivery Framework for Miscarriage Care means women and birthing people in Scotland will not have to experience 3 miscarriages before they have access to specialist support.

Instead, they will have access to the Graded Model of Care, proposed by experts at Tommy’s National Centre for Miscarriage Research.

Under the Graded Model, women and birthing people are seen by a healthcare professional after a first miscarriage, screened for mental health, and provided with guidance and information to reduce the risk of future miscarriage.  

After 2 miscarriages they are offered an appointment in a nurse or midwife-led clinic in an Early Pregnancy Unit and have access to further tests. They will be referred for specialist care if needed, and have access to early reassurance scans in future pregnancies.  

Following a third miscarriage they are offered a consultant-led appointment at a recurrent miscarriage clinic, and further advanced tests and treatments.

In 2023 the Independent Pregnancy Loss Review recommended that NHS England should adopt the Graded Model of Care. It is currently being trialled by the team at Tommy’s National Centre for Centre for Miscarriage Research in Birmingham.

Alongside the Graded Model of Care, the Delivery Framework for Miscarriage Care in Scotland promises improvements around access to care and support for women and birthing people with miscarriage symptoms.

The aim is to implement most of the Delivery Framework across Scotland within the next 15 months, although some changes are expected to be in place within 6 months and some may take up to 2 years.

Kath Abrahams, Chief Executive of Tommy’s, said:

“We are delighted to see the Delivery Framework for Miscarriage Care in Scotland launching today.

“Based on recommendations made by the Tommy’s National Centre for Miscarriage Research, and including our Graded Model of Care, the Framework is a real milestone on the path to excellent care for women and birthing people in Scotland.

“Tommy’s has been pleased to work closely with our colleagues in Scottish Government as they have developed the Framework, which aims to ensure the right support and care for parents after every tragic loss.

“With compassionate care at its heart, we are looking forward to continuing to support our Scottish colleagues as they oversee the rollout.”

The Scottish Government has also published new guidance setting out when progesterone should be offered as a treatment in early pregnancy for those at risk of miscarriage, drawing on evidence from Tommy’s-funded research.

In addition, Tommy’s has worked closely with the Scottish Government to create new information resources around miscarriage.

Deirdre de Barra, Head of Pregnancy Information at Tommy's, who chaired the group that developed the guides in collaboration with organisations across Scotland and families with lived experience, said:

“The development of these important patient information resources will provide clear and accessible information for women and families and is an integral part of the Scottish Government’s commitment to improving miscarriage care.”