What was the RECURRENT project?

The RE:CURRENT project evaluated recurrent miscarriage (RM) services in Ireland to inform efforts to standardise and improve the quality of these services.

The provision of individualised care, respect for women’s opinions and appropriate clinical information is imperative to those who experience recurrent miscarriage (defined in the project as two or more consecutive first trimester miscarriages). When the project was designed, there was no national standard for the provision of services and supports for people who experience recurrent miscarriage. Findings from the project informed efforts to standardise and optimise the quality of recurrent miscarriage services.

In December 2022, Professor Keelin O'Donoghue was awarded funding from the Health Research Board for RE:CURRENT-KTA to deliver knowledge translation activities that would improve the exchange of the RE:CURRENT project findings into policy and practice.

What was involved?

RE:CURRENT

• Identification of clinical guidelines (systematic review)
• Qualitative study on stakeholder views on recurrent miscarriage services
• Development of key performance indicators
• Recurrent miscarriage service evaluation
• Care experience survey
• Health economic analysis

RE:CURRENT-KTA

• Increase awareness and knowledge about recurrent miscarriage by developing and disseminating tailored plain language information resources about RM for people experiencing RM (women and men) and healthcare professionals, in a variety of formats and languages
• Enable health professionals and decision-makers to improve services and advocate/lobby for change/service improvements based on findings from the RE:CURRENT Project by developing online resources to share examples of good practice/key messages
• Improve public awareness of miscarriage/recurrent miscarriage amongst the public and health care professionals/trainees by co-producing resources in a variety of formats to share across multiple channels

Who was involved?

Project Management Team

Dissemination activities

Journal articles

• Flannery C, Burke L-A, Gillespie P, Hennessy M, O'Leary H, Dennehy R, O'Donoghue K. Economic and health-related quality of life impacts of receiving recurrent miscarriage care in Ireland: exploratory analysis drawing on results from a national care experience survey. Reproductive, Female and Child Health. 2024;3:e105. https://doi.org/10.1002/rfc2.105. 
• Dennehy R, Hennessy M, Ui Dhubhgain J, Lucey C, O′Donoghue K. ‘An extra level of kind of torment’: views and experiences of recurrent miscarriage care during the initial phases of COVID-19 in Ireland—a qualitative interview study. Health Expectations. 2023;26(4):1768-1782. https://doi.org/10.1111/hex.13791. 
• Flannery C, Hennessy M, Dennehy R, Matvienko-Sikar K, Lucey C, Ui Dhubhgain J, O'Donoghue K. Factors that shape recurrent miscarriage care experiences: findings from a national survey. BMC Health Services Research. 2023;23:317. https://doi.org/10.1186/s12913-023-09347-1. 
• Hennessy M, Linehan L, Flannery C, Cotter R, O'Connell O, O'Donoghue K. A national evaluation of recurrent miscarriage care services. Irish Medical Journal. 2023;116(1):P713. https://imj.ie/a-national-evaluation-of-recurrent-miscarriage-care-services/. 
• Flannery C, Burke L-A, Gillespie P, O’Donoghue K. Estimating the costs associated with the implementation of a best practice model of care for recurrent miscarriage clinics in Ireland: a cost analysis [version 1; peer review: awaiting peer review]. HRB Open Research. 2022;5:74. https://doi.org/10.12688/hrbopenres.13625.1.
• Dennehy R, Hennessy M, Meaney S, Matvienko-Sikar K, O’Sullivan-Lago R, Ui Dhubhgain J, Lucey C, O’Donoghue K. How we define recurrent miscarriage matters: a qualitative exploration of the views of people with professional or lived experience. Health Expectations. 2022;25(6):2992-3004. https://doi.org/10.1111/hex.13607.
• Hennessy M, Dennehy R, Doherty J, O’Donoghue K. Outsourcing transcription: Extending ethical considerations in qualitative research. Qualitative Health Research 2022;32(7):1197-1204. https://doi.org/10.1177%2F10497323221101709.
• Hennessy M, Linehan L, Dennehy R, Devane D, Rice R, Meaney S, O'Donoghue K. Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group. Research Involvement and Engagement. 2022;8:18. https://doi.org/10.1186/s40900-022-00355-9.
• Hennessy M, Dennehy R, Meaney S, Linehan L, Devane D, Rice R, O'Donoghue K. Clinical practice guidelines for recurrent miscarriage in high-income countries: A systematic review. Reproductive BioMedicine Online. 2021;42(6):1146-1171. https://www.rbmojournal.com/article/sS1472-6483(21)00100-0/fulltext.
• Hennessy M, Dennehy R, Meaney S et al. A protocol for a systematic review of clinical practice guidelines for recurrent miscarriage [version 3; peer review: 2 approved, 2 approved with reservations]. HRB Open Research. 2020;3:12. https://doi.org/10.12688/hrbopenres.13024.3. 

Clinical guideline

• Linehan L, Hennessy M, Khalid A, Whelan J, O’Donoghue K. National Clinical Practice Guideline: Assessment and Management of Recurrent Miscarriage. National Women and Infants Health Programme and The Institute of Obstetricians and Gynaecologists. January 2023. https://www.hse.ie/eng/about/who/acute-hospitals-division/woman-infants/clinical-guidelines/.

Outreach events

• O'Donoghue K, Hennessy M, Flannery C, Dennehy D, Nuzum D. RE:CURRENT Study Day, in conjunction with the Institute of Obstetricians and Gynaecolgists and Royal College of Physicians of Ireland [Webinar], 27 May 2022. 
• O’Donoghue K, Nuzum D, Hennessy M. Recurrent miscarriage matters: Evidence to inform policy & practice. Presentation to the Women’s Health Taskforce [Webinar], 29 September 2022.  
• O’Donoghue K, Cotter R, Cregan M. Pregnancy loss matters: Evidence & impact to inform policy & practice. Joint Presentation to the Oireachtas, 19 October 2022.
• Hennessy M, O'Donoghue K, on behalf of the RE:CURRENT Team. The RE:CURRENT Study: Enhancing recurrent miscarriage care through an integrated knowledge translation approach. INFANT Seminar. Paediatric Academic Unit, Cork University Hospital, Cork, 24 November 2023. 

Project updates

• Project Update 1: July 2020
• Project Update 2: October 2020
• Project Update 3: December 2020
• Project Update 4: February 2021
• Project Update 5: June 2021
• Project Update 6: September 2021
• Project Update 7: November 2021
• Project Update 8: March 2022
• Project Update 9: July 2022

Policy briefs

• Hennessy M, Dennehy R, Meaney S, Linehan L, Devane D, Rice R, Keelin O'Donoghue K. Clinical practice guidelines for recurrent miscarriage in high-income countries: A systematic review. PLRG Policy Brief 2. 2021; Jun 29.  
• Hennessy M, Dennehy R, O'Donoghue K. How we define recurrent miscarriage matters. PLRG Policy Brief 3. 2022; Sept 27.
• Hennessy M, Linehan L, Flannery C, Cotter R, O'Connell O, O'Donoghue K. Recurrent miscarriage in Ireland: A national service evaluation. PLRG Policy Brief 4. 2022; Sept 27. 
• Dennehy R, Hennessy M, Ui Dhubhgain J, Lucey C, O’Leary H, O’Donoghue K. Impact of the COVID-19 pandemic on recurrent miscarriage services: More compassionate, person-centred policies and approaches within maternity services needed. PLRG Policy Brief 13. 2023; Jul 31. 

Blogs

• Hennessy M, Dennehy R, Rice R. Using evidence and stakeholder engagement to optimise and standardise care for women and men who experience recurrent miscarriage. HRB Open Res, 12 October 2020.  

Press releases

• INFANT. (2021, September 22) New survey examines the care experiences of women and their partners who have had recurrent miscarriages.
• INFANT. (2020, October 14) Baby Loss Awareness Week.

Radio interviews

• O'Donoghue K. "Why we need to talk about pregnancy loss". Moncrieff, interviewed by Stefanie Preissner. Newstalk, 06 June 2023. https://www.newstalk.com/podcasts/highlights-from-moncrieff/why-we-need-to-talk-about-pregnancy-loss.
• O'Donoghue K. "Miscarriage bereavement leave - 'They're not ill, they're grieving'". Lunchtime Live, interviewed by Andrea Gilligan. Newstalk, 17 August 2023. https://www.newstalk.com/news/miscarriage-bereavement-leave-theyre-not-ill-theyre-grieving-1497759.

Podcast

• Pleace, Kate, host. “Kate Pleace and Marita Hennessy.” Gynae Listen and Learn, DCU, 09 May 2024. https://youtu.be/loo3X4pIeVw?si=7vYmjSRqC7oW9306.   

Newspaper/Magazine articles

• McDonnell C, O’Callaghan H, Stevens J. (2021, June 11) Miscarriage in Ireland: "I am so sorry, but your baby has no heartbeat". Irish Examiner. https://www.irishexaminer.com/lifestyle/healthandwellbeing/arid-40311575.html.
• Walker M. (2022, February 14) One of Ireland’s foremost pregnancy loss clinicians, Professor Keelin O’Donoghue on coping with multiple miscarriages. Image Magazine. https://www.image.ie/self/one-of-irelands-foremost-pregnancy-loss-clinicians-professor-keelin-odonoghue-on-coping-with-multiple-miscarriages-383444.
• Sheridan C. (2022, March 24) Researchers on path to help reduce numbers of miscarriages. Irish Examiner. https://www.irishexaminer.com/sponsored/arid-40830269.html.
• Sheridan C. (2022, March 24) Couple's joy at forming a family despite nine miscarriages. Irish Examiner. https://www.irishexaminer.com/sponsored/arid-40830290.html.
• Donaghy K. (2023, July 10) Five things you need to know about recurrent miscarriage. Irish Independent. https://www.independent.ie/life/health-wellbeing/health-features/five-things-you-need-to-know-about-recurrent-miscarriage/a652634080.html.

RE:CURRENT-KTA outputs

Templates for hospitals

• Checklist for Emergency Room Staff: First Trimester Miscarriage [.docx] | Checklist Implementation Guide [PDF]
• Recurrent Miscarriage / Pregnancy Loss Clinic Appointment Letter Template [.docx]

Information booklets

• Recurrent Miscarriage Information Booklet [PDF]

Information videos

• Recurrent miscarriage information and guidance (Arabic)
• Recurrent miscarriage information and guidance (English)
• Recurrent miscarriage information and guidance (Irish Sign Language)
• Recurrent miscarriage information and guidance (Polish)

Case studies: Spaces and Places

The 'Spaces and Places' case studies from maternity hospitals/units across the country are useful resources for people who wish to improve physical environments or spaces within maternity services, to better provide for and support people who experience pregnancy loss. They showcase examples of good practice, as well as key learning points and opportunities for further improvements. All 18 case studies are available to view/download via this link: Case Studies: Hospital Spaces - Pregnancy & Infant Loss Ireland

Project status

Completed: January 2020 to December 2023 (RE:CURRENT completed in April 2023)

Further information

Please email Marita Hennessy PhD: maritahennessy@ucc.ie