How do I get referred to a doctor who specialises in miscarriage?
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When can I be referred for tests after miscarriage?
How do I get referred for tests?
Are all miscarriage clinics the same?
Tommy’s National Centre for Miscarriage Research
What is the difference between NHS and Tommy’s-funded miscarriage clinics?
How do I get referred to a Tommy’s recurrent miscarriage clinic?
What is the criteria for referrals to Tommy’s recurrent miscarriage clinics?
More details about our miscarriage clinics
Looking after your mental health
When can I be referred for tests after miscarriage?
Although this can be very hard, it is very unlikely that you will be offered any tests or treatments if you have had 1 or 2 early miscarriages.
Some hospitals may be able to investigate after 2 miscarriages, so talk to your GP, explain how you are feeling and ask to be referred.
Generally, the NHS follows guidelines that say your GP will refer you to a doctor who specialises in miscarriage after you have had 3 early miscarriages (known as recurrent miscarriage), or 1 late miscarriage.
If you have had 1 ectopic pregnancy or a molar pregnancy your local Early Pregnancy Unit will offer you a scan early in your next pregnancy (at about 7 weeks).
This policy can be upsetting when you’ve had such a traumatic experience. But try to keep in mind that most miscarriages are a one-off and there is probably a good chance of having a successful pregnancy in the future.
There are some things you and your GP can do to help you make sure you (and your partner) are as healthy as possible before you try again. Find out more about your care and treatment after 1 or 2 early miscarriages.
A small number of people have 3 miscarriages, known as recurrent miscarriage. If this happens, you should be referred for further tests and investigations.
If your healthcare professional finds a risk factor for miscarriage they may be able to give you some treatment to try and prevent a miscarriage from happening again. But sometimes an issue may be found that is not treatable. Sometimes, the treatment may not work.
Sadly, these tests are not not always be able to find out why you have miscarried. No cause is found in about half of cases. Find out more about your care after 3 miscarriages.
How do I get referred for tests?
Speak to your GP. They can refer you to your local miscarriage clinic, which is usually based in a local hospital.
Not every hospital has an NHS miscarriage clinic. You can request to be referred to a specialist NHS miscarriage clinic in any hospital in the UK.
Your GP can also refer you to a Tommy’s miscarriage clinic from anywhere in the UK (see below).
If your local hospital does not have an NHS miscarriage clinic, you may be referred to a gynaecologist. A gynaecologist is a specialist in female reproductive health and may to organise any tests and treatment you need. There are also very different waiting times for appointments for clinics between 2 months and 2 years.
The NHS e-referral system will tell your GP how long these are and you can request to go to a specialist clinic with a short waiting time.
Your GP may also be able to do some tests for things that increase the risk of miscarriage. For example, they may check your full blood count, thyroid function tests, and check for a vitamin D deficiency. They can also check your immunity against Rubella for the safety of any future pregnancy.
Your GP can also talk to male partners about ways to improve their health while you are trying to get pregnancy.
Are all miscarriage clinics the same?
All NHS miscarriage clinics will have criteria for patients they will accept. This is mostly based on your age and pregnancy history. For example, you may need to be under 42 years old and have had 3 miscarriages in a row to be referred to some clinics. Not all clinics have the same criteria.
Not all NHS miscarriage clinics have the same tests and treatments available. You can ask your GP to refer you to a Tommy’s miscarriage clinic that offers tests that your local hospital doesn’t.
If you have been seen by an Early Pregnancy Unit for previous miscarriages, your GP should have been sent a letter with recommendations for your care.
Tommy’s National Centre for Miscarriage Research
Tommy’s National Centre for Miscarriage Research is based in Birmingham, Coventry and London. The centre carries out research that aim to reduce the number of miscarriages and improve care for people experiencing miscarriage.
This research centre works alongside the NHS Recurrent Miscarriage Clinics at the hospitals at Birmingham Women’s Hospital, University of Coventry & Warwickshire and Imperial College Hospital & St Mary’s Hospital.
You do not have to live in these areas to be referred to one of the clinics.
Having undertaken a huge amount of research and investigation throughout our journey, we have been advised and helped by, as well as undergone trials with, some of the best Tommy’s clinics in the country, run by the most amazing professors, consultants and midwives. Read Rubie and Ben's story here.
What is the difference between NHS miscarriage clinics and Tommy’s-funded miscarriage clinics?
Both NHS and Tommy’s recurrent miscarriage clinics have their own criteria that patients must meet before they will be seen. They also have different tests and treatments available.
Taking part in research trials
All miscarriage clinics offer different tests and treatments, the one thing that is unique to a Tommy's Miscarriage Clinic is that you may have the opportunity to take part in a Tommy's-funded research trial.
You may have the opportunity to take part in ongoing research projects if you are seen in the clinics linked to Tommy’s National Centre for Miscarriage Research. This may include a chance to take part in new tests and trials designed to find out more about what causes recurrent miscarriage.
How do I get referred to a Tommy’s recurrent miscarriage clinic?
Your GP will need to refer you via a referral service. The exact system they use may vary depending on your GP.
You can only be referred to a Tommy’s miscarriage clinic by your GP. You cannot get a referral by contacting Tommy’s directly.
What is the criteria for referrals to Tommy’s recurrent miscarriage clinics?
Tommy’s believes that everyone should be referred to a miscarriage specialist after 2 miscarriages. The centre directors and clinicians at our miscarriage clinics are working towards this goal. But until this becomes NHS policy, the Tommy’s clinics are unable to offer this as standard.
All the clinics will accept patients who have had 3 miscarriages after a referral from a GP anywhere in the UK. Currently, our clinic in Coventry accepts referrals for women who have had 2 miscarriages from anywhere in the UK.
Although Tommy’s provides funding to the miscarriage clinics, the referral criteria is decided and managed by the clinics.
More details about our miscarriage clinics
Our Birmingham clinic at Birmingham Women's Hospital
Criteria
If you meet the following criteria, ask your GP to submit an 'Advice and Guidance' request and ensure they 'allow to convert to referral':
- you have had 2 miscarriages: upon referral, the clinic will provide guidance to your GP about the investigations that can take place in primary care
- you have had 3 or more miscarriages: patients in England or Scotland will get an appointment with the team at the recurrent miscarriage clinic for further investigations and support.
Wendy Gibson (clinic's medical secretary) can be contacted via [email protected] or [email protected] although this account cannot be relied upon for any urgent enquiries.
Our London clinics at Queen Charlotte's & Chelsea Hospital and St Mary's Hospital, London
Criteria
Your GP will need to refer you via the NHS e-Referral service (often called the ‘choose & book’ system) if you meet the following criteria:
- you have had 3 or more early miscarriages
- you have had 1 or more late miscarriages.
- you do not have two or more living children.
- you are less than 42 years old.
You do not need to live in the local area to be referred to our London clinics.
Yvette Fenton (reproductive medicine coordinator) and Saffa Ali (recurrent miscarriage coordinator) can be contacted by email regarding any referral or appointment queries at [email protected]
Our Coventry clinic at University Hospital Coventry
Criteria
Your GP will need to refer you via the NHS e-Referral service (often called the ‘choose & book’ system) if you meet the following criteria:
- you have had 2 or more miscarriages
- 1 or more late miscarriages
- Any Wales, Scotland, Northern Ireland referrals need to be agreed and funded by local GP and can be sent in post.
Find out more about getting referred to a miscarriage specialist.
Please direct any questions and referrals and appointment queries to Natalie Morris, research nurse at [email protected].
Looking after your mental health
Having a miscarriage can impact on your physical and emotional health. But you do not need to go through this alone. There are lots of charity organisations that can provide more advice and support.
If you’re worried that you or your partner are struggling to cope after losing a baby, please talk to your GP. They will be able to help you get the support you need.
If you live in England and are aged 18 or over, you can access NHS psychological therapies (IAPT) services. These services offer:
- talking therapies, such as cognitive behavioural therapy (CBT), counselling, other therapies, and guided self-help
- help for common mental health problems, like anxiety and depression.
You can also talk to a Tommy’s midwife free of charge from 9am-5pm, Monday to Friday on 0800 0147 800 or you can email them at [email protected]. Our midwives are trained in bereavement support.
If you are looking for support following IVF, you can also speak to your IVF clinic. Most clinics have counselling services attached to them.
The following organisations also offer information and support after a miscarriage.
Royal College of Obstetricians & Gynaecologists. Early miscarriage. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/early-miscarriage-patient-information-leaflet/
NHS. Miscarriage diagnosis. https://www.nhs.uk/conditions/miscarriage/diagnosis/ (Page last reviewed: 9 March 2022 Next review due: 9 March 2025)
Have you had 1 or more miscarriages?
If you have miscarried before, it's understandable to feel anxious about trying again.
The Tommy's Miscarriage Support Tool can give you a percentage chance of your next pregnancy being successful and gives personalised support and information.