Miscarriage
Miscarriage
Miscarriage is generally defined as the loss of a pregnancy before viability, i.e. before 23 weeks of gestation. It is often referred to as ‘common’, occurring in approximately 15% of pregnancies. The risk of miscarriage depends on a number of factors, including maternal age and number of previous miscarriages. Miscarriages during the first and second trimester of pregnancies have quite different causes, with causes of second-trimester miscarriage more aligned to those of stillbirth.
Recurrent miscarriage affects 1%–3% of women/couples of reproductive age, depending on the definition used, i.e. whether ≥2 or ≥3 miscarriages. While there are several causes of recurrent miscarriage, no cause is identified in half of cases following investigations and are unexplained.
The consequences of miscarriage are both physical, such as bleeding or infection, and psychological, such as increased risk of anxiety, depression, post-traumatic stress disorder, and suicide. Miscarriage, and especially recurrent miscarriage, is also an important marker marker for future obstetric complications, including preterm birth, fetal growth restriction, placental abruption, and stillbirth in future pregnancies. It is increasingly recognised as a predictor of longer-term health problems also, including cardiovascular disease and venous thromboembolism.
The costs of miscarriage affect individuals, health-care systems, and society. Despite this, public awareness of miscarriage is limited, and care can be fragmented and of poor quality.
Our research in this area
- Care experiences
- Clinical guidelines for recurrent miscarriage
- Economic impact
- Future pregnancy outcomes
- How recurrent miscarriage is defined
- Lived experiences of miscarriage
- Men and miscarriage
- Miscarriage after infertility
- Psychological and support interventions
- Public awareness and knowledge
- Recurrent miscarriage
- Risk factors
- Service provision
Key publications
| Category | Category | Keywords | Year | Title | Abstract | Actions |
|---|---|---|---|---|---|---|
|
Guidelines |
Guidelines | Clinical guideline(s), First-trimester miscarriage, Miscarriage | 2025 |
National Clinical Practice Guideline: First Trimester Miscarriage |
Guideline produced for The National Women and Infants Health Programme and The Institute of Obstetricians and Gynaecologists, 2025. | More details Read publication |
|
Journal Article |
Journal Article | Awareness / Knowledge, Ectopic pregnancy, Infertility / IVF / Medically Assisted Reproduction, Miscarriage, Pregnancy loss, Recurrent miscarriage, Stillbirth, Termination of pregnancy | 2025 |
Enhancing young people’s pregnancy loss and fertility awareness and knowledge via schools: a way forward |
There is a need to work with young people to develop independent, evidence-informed, developmentally appropriate interventions to enhance knowledge and awareness of pregnancy loss to enable people to fully realise their reproductive rights and goals. | More details Read publication |
|
Journal Article |
Journal Article | Early pregnancy / Early pregnancy loss, Ectopic pregnancy, First-trimester miscarriage, Miscarriage, Molar pregnancy / Gestational Trophoblastic Disease, Pregnancy loss, Second-trimester miscarriage, Termination of pregnancy | 2025 |
Workplace supports for early pregnancy loss: A scoping review of international literature |
Our scoping review found a lack of empirical research on workplace supports and experiences of pregnancy loss before viability. Further research is needed to understand workers’ experiences and to develop and implement appropriate supports. | More details Read publication |
|
Journal Article |
Journal Article | PPI, Recurrent miscarriage | 2024 |
Involving knowledge users in health services research: Collective reflections and learning from a national evaluation of recurrent miscarriage services |
Our analysis reinforces the relational nature of knowledge user involvement in research. Realistic study protocols that allow time and space for the evolving nature of research, and institutional and financial support to facilitate meaningful involvement, are needed. | More details Read publication |
|
Journal Article |
Journal Article | Impact, Recurrent miscarriage | 2024 |
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 |
Recurrent miscarriage can amplify negative psychological outcomes, and impact work performance: 70% of study participants experienced decreased work productivity; 50% scored well below the population norm on the mental health component of the health related quality of life measure used. | More details Read publication |
|
Journal Article |
Journal Article | Early pregnancy / Early pregnancy loss, Ectopic pregnancy, First-trimester miscarriage, Miscarriage, Molar pregnancy / Gestational Trophoblastic Disease, Pregnancy loss, Second-trimester miscarriage, Termination of pregnancy | 2024 |
Statutory leave for early pregnancy loss: A comparative study |
Our study identified two main approaches to leave introduced for pregnancy loss before viability: sick leave model and compassionate leave model. What works in individual jurisdictions will depend-among other factors-on the way in which leave more broadly is addressed. | More details Read publication |
|
Report |
Report | Early pregnancy / Early pregnancy loss, Ectopic pregnancy,Experience, Fatal fetal anomaly, First-trimester miscarriage, Molar pregnancy / Gestational Trophoblastic Disease, Second-trimester miscarriage, Termination of pregnancy | 2024 |
PLACES | Pregnancy Loss (under 24 weeks) in Workplaces: Informing policymakers on support mechanisms |
A report submitted to the Department of Children, Equality, Disability, Integration and Youth (DCEDIY) in fulfilment of the requirements of the tender for the provision of a qualitative research study to examine the workplace experiences of people dealing with pregnancy loss. | More details Read publication |
|
Journal Article |
Journal Article | Audit / Service evaluation, Infertility / IVF / Medically Assisted Reproduction, Recurrent miscarriage | 2023 |
Recurrent miscarriage and infertility: A national service evaluation |
Our evaluation of care provision for women/couples with RM and infertility across public and private sectors in Ireland found that, while care is largely in line with clinical practice guidelines, there is variation in counselling, imaging and surgical treatments offered. | More details Read publication |
|
Journal Article |
Journal Article | COVID-19, Experience, Impact, Miscarriage, Recurrent miscarriage | 2023 |
‘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 |
Our analysis provides rich insights into the significant impacts that the COVID-19 pandemic has had on the way recurrent miscarriage care is provided & experienced, with important implications for early pregnancy, miscarriage & recurrent miscarriage care. Deprioritisation of miscarriage services is of particular concern. | More details Read publication |
|
Journal Article |
Journal Article | Experience, Recurrent miscarriage | 2023 |
Factors that shape recurrent miscarriage care experiences: findings from a national survey |
While overall experience of recurrent miscarriage care was poor, we identified areas that could potentially improve people’s care experiences such as information provision, supportive care, communication, and care coordination across settings. | More details Read publication |
|
Guidelines |
Guidelines | Clinical guideline(s), Recurrent miscarriage | 2023 |
National Clinical Practice Guideline: Recurrent Miscarriage |
Guideline produced for The National Women and Infants Health Programme and The Institute of Obstetricians and Gynaecologists, 2023. | More details Read publication |
|
Journal Article |
Journal Article | Audit / Service evaluation, Recurrent miscarriage | 2023 |
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. | More details Read publication |
|
Journal Article |
Journal Article | Audit / Service evaluation, Infertility / IVF / Medically Assisted Reproduction, Recurrent miscarriage | 2023 |
An examination of care received by women with recurrent miscarriage and infertility against guideline-based key performance indicators |
We used guideline-based KPIs to examine care for women with recurrent miscarriage and infertility. Most KPIs were met; areas for improvement were counselling on risk factors & treatments, and access to genetic counselling, ultrasound and cytogenetics. | More details Read publication |
|
Journal Article |
Journal Article | Recurrent miscarriage | 2022 |
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] |
This study advocates for a new model of care for recurrent miscarriage clinics in Ireland and provides a set of cost estimates at the patient and healthcare system level. | More details Read publication |
|
Journal Article |
Journal Article | Recurrent miscarriage | 2022 |
Reproductive outcomes following recurrent first trimester miscarriage: A retrospective cohort study |
This retrospective cohort study of 748 women with recurrent miscarriage showed that maternal characteristics such as age, smoking and parental karyotype are associated with subsequent reproductive outcomes. 77% of women conceived and the livebirth rate was 63%. | More details Read publication |
|
Journal Article |
Journal Article | Awareness / Knowledge, Bereavement care, Clinical guideline(s), Experience, Impact, Miscarriage, Recurrent miscarriage | 2022 |
How we define recurrent miscarriage matters: A qualitative exploration of the views of people with professional or lived experience |
A nuanced approach to defining recurrent miscarriage is warranted, one which is evidence-informed, recognises individual people’s needs, and considers healthcare resources. | More details Read publication |
|
Journal Article |
Journal Article | Experience, Recurrent miscarriage | 2022 |
The experiences of men following recurrent miscarriage in an Irish tertiary hospital: A qualitative analysis |
Recurrent miscarriage is a deeply emotional experience for men who describe frustration with lack of support and feeling unimportant when their partners experienced recurrent miscarriage. Dedicated support and improved information is required. | More details Read publication |
|
Journal Article |
Journal Article | Clinical guideline(s), PPI, Recurrent miscarriage | 2022 |
Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group |
It is important and feasible to develop guideline-based care key performance indicators (KPIs) with a diverse stakeholder group. We developed 110 KPIs for recurrent miscarriage care using a consensus process. Our experiences may help others undertaking similar projects. | More details Read publication |
|
Journal Article |
Journal Article | Infertility / IVF / Medically Assisted Reproduction, Recurrent miscarriage | 2021 |
Infertility and subsequent recurrent miscarriage: Current state of the literature and future considerations for practice and research |
Narrative review demonstrating women/couples with RM and infertility appear indirectly in studies evaluating investigations and treatments. High-quality studies are lacking. Furthermore, they are largely excluded from international clinical guidance and qualitative research. | More details Read publication |
|
Journal Article |
Journal Article | Clinical guideline(s), Recurrent miscarriage | 2021 |
Clinical practice guidelines for recurrent miscarriage in high-income countries: a systematic review |
Greater efforts are required to improve the quality of evidence underpinning clinical guidelines for recurrent miscarriage, the rigour of their development and the inclusion of multi-disciplinary perspectives, including those with lived experience. | More details Read publication |
|
Journal Article |
Journal Article | Awareness / Knowledge, First-trimester miscarriage | 2020 |
The general populations’ understanding of first trimester miscarriage: a cross sectional survey |
Less than 3 in 10 people who took part in our nationally representative survey were aware of the incidence of miscarriage. Family, friends and the internet were the main knowledge sources: less than 1 in 6 people engaged with healthcare providers for miscarriage information. | More details Read publication |
|
Journal Article |
Journal Article | Recurrent miscarriage | 2019 |
A review of reproductive outcomes of women with two consecutive miscarriages and no living child |
A causative factor was identified in 29% of women with two consecutive miscarriages in our study. 82% had a subsequent pregnancy, with 73% achieving a live birth. We suggest that supportive care is the single most effective therapy for women with two consecutive miscarriages. | More details Read publication |
|
Journal Article |
Journal Article | Miscarriage | 2019 |
Risk factors for miscarriage among women attending an early pregnancy assessment unit (EPAU): a prospective cohort study |
Our prospective cohort study explored risk factors among 293 women who attended an Early Pregnancy Assessment Unit in Ireland in 2012. Advanced maternal age, history of recurrent miscarriage, and lack of emotional wellbeing were risk factors for having a subsequent miscarriage. | More details Read publication |
|
Journal Article |
Journal Article | Miscarriage | 2019 |
Miscarriage hospitalisations: a national population-based study of incidence and outcomes, 2005–2016 |
In a nationwide population-based study of 50,538 hospitalisations with a diagnosis of early miscarriage in all acute maternity hospitals in Ireland during 2005–2016, we found that early miscarriage hospitalisations became 19% less common but the risk of blood transfusion doubled. | More details Read publication |
|
Journal Article |
Journal Article | Awareness / Knowledge, Miscarriage | 2018 |
University students' awareness of causes and risk factors of miscarriage: a cross-sectional study |
This cross-sectional study illustrates that common misunderstandings still prevail regarding the etiology of miscarriage, suggesting a deficiency in formal information and access to information related to reproductive health. | More details Read publication |
|
Journal Article |
Journal Article | Miscarriage, Second-trimester miscarriage | 2017 |
Psychological and support interventions to reduce levels of stress, anxiety or depression on women’s subsequent pregnancy with a history of miscarriage: an empty systematic review |
Our ‘empty’ systematic review highlights the need for randomised controlled studies to assess the effect of interventions to reduce stress in pregnant women with a history of miscarriage. | More details Read publication |
|
Journal Article |
Journal Article | Experience, Miscarriage, Recurrent miscarriage | 2017 |
Experience of miscarriage: an interpretative phenomenological analysis |
This study of men and women’s experience with miscarriage involved interviewing 16 participants. Six major themes around experience of miscarriage were identified. Key findings include a need for increased awareness of miscarriage and to prioritise investigating miscarriage. | More details Read publication |
Related policy briefs
- Clinical practice guidelines for recurrent miscarriage in high-income countries: a systematic review
- Exploratory analysis of the costs associated with receiving recurrent miscarriage care in Ireland [lunder embargo]
- How we define recurrent miscarriage matters
- Men and recurrent miscarriage: Urgent inclusion needed
- Recurrent miscarriage in Ireland: A national service evaluation