A national evaluation of recurrent miscarriage care services

While some good practice was identified, there was variation, e.g. in referral criteria, clinic locations, genetic counselling, recording of subsequent pregnancy outcomes. A national guideline for recurrent miscarriage is required, and services must be adequately resourced.


Marita Hennessy, Laura Linehan, Caragh Flannery, Rióna Cotter, Orla O’Connell, Keelin O’Donoghue

Journal Name
Irish Medical Journal
Journal Article
Audit / Service evaluation, Recurrent miscarriage


Full Citation

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.

Link to Publication


We evaluated recurrent miscarriage (RM) service provision in the 19 Irish maternity units/hospitals against guideline-based key performance indicators (KPIs) we previously developed during a multi-stage consensus process with key stakeholders. We invited Clinical Leads for pregnancy loss, Doctors-in-training, Clinical Nurse/Midwife Specialists and Directors of Midwifery within each unit/hospital to complete an online survey on behalf of their service between November 2021 and February 2022. We only required one response per unit/hospital. The survey comprised predominantly multiple choice questions concerning the KPIs, covering five categories: (i) structure of care, (ii) investigations, (iii) treatments, (iv) counselling and supportive care, and (v) outcomes. 18/19 units/hospitals completed the survey (95% response rate). While we identified some good practice, there was considerable variation - most obvious in areas such as: (1) referral criteria (provisions regarding the number of miscarriages or maternal age and number of living children); (2) location of clinics; (3) genetic counselling; (4) recording of subsequent pregnancy-related outcomes. A national guideline for RM is required. There needs to be adequate resourcing of services to implement recommendations, as well as systems for recording pregnancy outcomes and provisions for a national audit of RM care.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,