Your care after 1 or 2 miscarriages
Will I be referred to a specialist to find out why I miscarried?
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 (recurrent miscarriage) or 1 late miscarriage.
Tommy’s-funded miscarriage clinics follow NHS guidelines too and you will need a referral from your GP before they accept you as a patient.
If you have had 1 or 2 early miscarriages, it is very unlikely that you will be referred to a specialist to find out why it happened. But there may be some things your GP can do to help you make sure you are as healthy as possible before you try again.
This can be upsetting and feel unfair. But try to keep in mind that most miscarriages are a one-off and there is a good chance of having a successful pregnancy in the future.
Some hospitals may be able to investigate after 2 miscarriages, so it is worth talking to your GP about how you are feeling and ask to be referred.
Find out more about getting referred to a miscarriage specialist.
Do these guidelines for referral include all types of losses?
Some people consider losses such as ectopic pregnancy or molar pregnancy as a miscarriage. This is completely understandable, as these pregnancies end in loss.
But you may not be referred to a miscarriage specialist after 2 or 3 miscarriages that include these types of losses. For example, if you’ve had 1 ectopic pregnancy and 1 miscarriages where the cause was unknown, you may not be accepted for specialist miscarriage care in some areas.
This can be upsetting. But it is because we know what causes ectopic pregnancy or molar pregnancy, so further tests are not medically necessary.
Again, it is still worth talking to your GP about getting referred for specialist care if you have experienced other types of pregnancy loss.
If you’ve had an ectopic pregnancy or molar pregnancy before, you should be offered an extra scan at 6 to 8 weeks in your next pregnancy to check that the baby is developing in the right place.
Find out about types of miscarriage.
When can I try for another baby?
You can try for a baby as soon as you feel physically and emotionally ready. Some people may need time to grieve for the baby they have lost before they try again.
We have a Miscarriage Support Tool that you can use to get personalised support and find out your chance of a successful next pregnancy.
What can my GP do?
Your GP can help you access any support or services you may need to make sure you are as healthy as possible before you try to get pregnant again. For example, they can help you access support to stop smoking, access to a dietitian or treatments for mental health problems.
They can also help you manage any long-term conditions or refer you to a specialist who can help.
Your GP can also do a full blood count (FBC) to check for health conditions such as anaemia, coeliac disease and clotting problems.
Vitamin D deficiency testing
Your GP may be able to test for a vitamin D deficiency. Recent research found that women with low vitamin D levels are at significantly increased risk of miscarriage.
You may be at risk of not having enough vitamin D (known as Vitamin D deficiency) if:
- you have dark skin (for example, if you're of African, African Caribbean or south Asian origin)
- you cover your skin when outside or spend a lot of time inside
- your diet is low in vitamin D-rich foods such as eggs, meat, vitamin D-fortified margarine or breakfast cereal.
- your BMI is above 30.
A 10 microgram (or 400 IU) vitamin D supplement a day will be enough for most people to get enough vitamin D. However, if you are found to have very low levels, your doctor may prescribe a higher dose.
Thyroid function test
Your GP can also do a thyroid function test (a blood test)
The thyroid gland is a small butterfly-shaped gland in the neck, just in front of the windpipe.
It produces hormones that regulate the speed with which your body cells and organs work. If there are too many hormones, the body cells and organs work faster. If there are too little hormones, the cells and organs may be slower.
Thyroid problems can cause complications in pregnancy, including miscarriage. A thyroid function test (a blood test) can check if your hormones are within range. If they are not, you may need treatment.
Find out more about health conditions and planning a pregnancy.
Your GP can also help you if you have any concerns about your fertility (ability to get pregnant).
This may include investigating any symptoms of polycystic ovarian syndrome, which can sometimes cause difficulties getting pregnant and raise the risk of complications in pregnancy.
Fibroids can also cause fertility problems and pregnancy complications, such as a difficult labour. In rare cases, fibroids can cause miscarriage.
Your mental health
Losing a baby is heartbreaking and can cause overwhelming feelings.
It is possible to develop mental health problems because of grief and stress. Depression and anxiety are common, but some people may develop other issues, such as post-traumatic stress disorder (PTSD) or perinatal obsessive compulsive disorder (OCD).
Talk to your GP if you are worried about how you or someone else is feeling. There is support available and mental health problems are treatable.
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]
You can join the Tommy's Baby Loss Support Group on Facebook for those who have experienced any type of baby loss. You can also join the Tommy's Pregnancy and Parenting After Loss Support Group on Facebook if you want to speak to people about trying again or pregnancy after loss.
You can also refer yourself directly for talking or psychological therapies using the NHS talking therapies services known as Improving Access to Psychological Therapies (IAPT) services.
Find out more about your feelings and emotions after miscarriage.
We also have information about baby loss support specifically for dads and partners.
Your pre-pregnancy health check list
Sadly, there’s nothing anyone can do to guarantee a healthy pregnancy and most miscarriages can’t be prevented. But there are some things you can do when trying to get pregnant again and during pregnancy to make sure you are the healthiest you can be.
Taking these steps towards a healthier lifestyle will give you the best chance of getting pregnant and having a healthy pregnancy.
- If you smoke, quit or cut down.
- Stop drinking alcohol or taking illegal drugs.
- Start taking folic acid now, it needs time to build up in your body.
- Start taking vitamin D. Talk to your GP if you think you’re at risk of having a vitamin D deficiency.
- Have a healthy balanced diet.
- Cut down on caffeine if you drink a lot.
- Try to get closer to a healthy weight if you are overweight.
- Try to get closer to a healthy weight if you are underweight.
- Become more active if you are not already.
- Have a cervical screening test if you haven’t had one in the last three years.
- Check that you have had the MMR vaccine against rubella (or ask your GP).
- Get tested for STIs if you think there’s a possibility you may have one. Your partner should also get tested.
- Make sure any possible or pre-existing conditions such as diabetes, hypertension or thyroid problems are diagnosed and well managed.
- Take care of your mental wellbeing.
Do not take any new medication or stop taking existing medications without talking to your GP or healthcare professional about your plans to get pregnant.
Try our planning for pregnancy tool.
Your partner’s health
If you have a male partner that will be your baby’s biological parent, there are lots of things they can also do to help you have a healthy pregnancy. Find out more about male physical health while trying to get pregnant.
Will I get extra care in my next pregnancy?
The care you will have during your next pregnancy will depend on your medical history and your local clinic’s policy.
Some people would like an extra scan in the early weeks (6 to 10) to confirm they are pregnant because they have miscarried before. These are often known as early pregnancy or reassurance scans. Find out more about reassurance scans.
If you’ve had an ectopic pregnancy or molar pregnancy before, you should be offered an extra scan at 6 to 8 weeks to check that the baby is developing in the right place.
Having a reassurance scan may not always be possible. This may be because there is no medical reason for you to have one.
You may have heard about the use of progesterone in early pregnancy. Find out more about progesterone in early pregnancy.
Find out more about pregnancy after a miscarriage, which includes tips for reassurance in pregnancy after a miscarriage.
The Tommy's Miscarriage Support Tool
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.
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/
Tamblyn JA, Pilarski NSP, Markland AD, Marson EJ, Devall A, Hewison M, Morris RK, Coomarasamy A. Vitamin D and miscarriage: a systematic review and meta-analysis. Fertil Steril. 2022 https://pubmed.ncbi.nlm.nih.gov/35637024/
Royal College of Obstetricians & Gynaecologists. Healthy eating and vitamin supplements in pregnancy. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/healthy-eating-and-vitamin-supplements-in-pregnancy-patient-information-leaflet/
NHS. Underactive thyroid. https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/complications/ (Page last reviewed: 10 May 2021 Next review due: 10 May 2024)
NHS. Polycystic ovary syndrome. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ (Page last reviewed: 1 February 2019 Next review due: 1 February 2022)
NHS. Fibriods. https://www.nhs.uk/conditions/fibroids/complications/ (Page last reviewed: 9 September 2022 Next review due: 9 September 2025)
The Royal College of Obstetricians & Gynaecologists (February 2017) Maternal Mental Health – Women’s Voices https://www.rcog.org.uk/globalassets/documents/patients/information/maternalmental-healthwomens-voices.pdf
NHS. Miscarriage. https://www.nhs.uk/conditions/miscarriage/ (Page last reviewed: 9 March 2022 Next review due: 9 March 2025)
Royal College of Obstetricians &Gynaecologists. An ectopic pregnancy. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/ectopic-pregnancy-patient-information-leaflet/