Key highlights from study:
- NHS routinely offers follow-up care only after three miscarriages
- Tommy's model shows benefit of earlier support and pick-up of miscarriage risk factors
- Tommy’s Ambassador Myleene Klass MBE hails report as ‘a turning point’ and ‘lifechanging opportunity’
Earlier support could prevent thousands of miscarriages each year
A new study by Tommy’s researchers, led by Professor Arri Coomarasamy, suggests that offering follow-up care from the first miscarriage could help prevent around 10,000 pregnancy losses each year in the UK.
The NHS usually only provides tests and support after a third miscarriage, leaving thousands of women and families without adequate help after a first or second loss. Even after a third miscarriage, services are inconsistent and women and birthing people cannot always access the advice and care they need.
Tommy’s researchers have evaluated a ‘graded model’ that offers care after every miscarriage, including the first. This creates earlier opportunities to support families devastated by loss and to identify treatable health issues and other risk factors that can affect pregnancy outcomes.
The pilot study, from Tommy’s National Centre for Miscarriage Research and conducted at Birmingham Women’s Hospital, with input from researchers at the University of Oxford’s Nuffield Department of Women’s & Reproductive Health, found the Graded Model of Care identified more miscarriage risk factors and medical conditions than standard NHS care.
New evidence shows first-loss care can improve outcomes
The findings provide real-world evidence that earlier, structured intervention after miscarriage can help identify manageable conditions and risks and could improve future pregnancy outcomes.
“If the graded model were implemented across the UK, our study indicates it could prevent around 10,075 miscarriages every year. That’s more than 10,000 families bringing their babies home instead of suffering the trauma of a pregnancy loss.” Professor Arri Coomarasamy OBE, Professor of Gynaecology at the University of Oxford’s Nuffield Department of Women’s & Reproductive Health and Director of Tommy’s National Centre for Miscarriage Research
The study builds on ongoing research into miscarriage at the University of Oxford and across NHS settings, focused on improving outcomes through earlier diagnosis and intervention.
Under the Graded Model of Miscarriage Care, a specialist nurse provides a one-to-one consultation after a first loss to discuss optimising preconception and pregnancy health. The hormone progesterone, which a trial found to be effective in preventing some miscarriages, is offered in future pregnancies if a woman is experiencing early vaginal bleeding that signals she may be at risk of loss.
After two miscarriages, women are additionally offered tests for anaemia and abnormal thyroid function, both of which are treatable and can affect pregnancy outcomes. Early reassurance scans are offered in future pregnancies.
After three miscarriages, as well as the care provided after the first and second losses, women join the pathway offered usually by the NHS. They are referred to a recurrent miscarriage clinic overseen by a consultant and offered tests to look for ‘sticky blood’ syndrome (antiphospholipid syndrome, which increases the risk of blood clots and related pregnancy complications), possible genetic causes for their miscarriages and a pelvic ultrasound scan.
Of the women in the Graded Model of Miscarriage Care pilot group who had experienced two miscarriages, one in five were found to have either thyroid problems or anaemia, identified by a blood test they would not have had at that stage under standard NHS miscarriage care.
Other key findings from the pilot include:
- 99% of women who took part said they were satisfied or very satisfied with their care
- 93% of healthcare professionals involved said the graded model was straightforward to deliver
- 86% of women who took part had one or more risk factors identified that could increase their risk of miscarriage and were given advice about changes they could make. This was compared with 58% in the usual care group.
In the foreword to the report, Tommy’s Ambassador Myleene Klass MBE (who has shared her own experience of recurrent pregnancy loss and campaigned extensively for change) hails the Graded Model of Miscarriage Care as ‘a turning point’. Describing it as ‘an honour’ to have met some of the parents who took part in the study and went on to have a baby.
“This is our moment to give every family that same life-changing opportunity.” - Myleene Klass MBE, Tommy’s Ambassador
Calls grow for nationwide NHS rollout
Kath Abrahams, Chief Executive of Tommy’s, said: “NHS care and support for women who experience a miscarriage in the UK is inconsistent and generally involves no follow-up or tests until after a third loss.
“The three-miscarriage wait means women and families are left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that we know affect so many who experience pregnancy loss.
“Our pilot study indicates that providing support after a first miscarriage, with escalating care after further losses, is not only effective but achievable without significant additional workload for NHS teams who are already working extremely hard to deliver good care. Put simply, it is the right thing to do.
“Scotland has already taken the first step towards implementation, embedding this model into its miscarriage pathway. We are now urging policymakers in England, Wales and Northern Ireland to make the Graded Model of Miscarriage Care available across the UK as soon as possible.”
““We welcome the Government’s commitment in its Women’s Health Strategy to review the results of our pilot study and consider the roll-out of the Graded Model of Miscarriage Care throughout the NHS in England.” - Kath Abrahams, Chief Executive of Tommy’s
An estimated 250,000 pregnancies end in miscarriage in the UK every year, although the true scale of the problem is not known as no figures are collected or recorded centrally.
Tommy’s is also calling for an official record of loss by the NHS, so that we can better understand the scale of miscarriage in the UK and offer families better treatment, care and support.
The research reflects a growing focus within academic and clinical communities, including the University of Oxford’s Nuffield Department of Women’s & Reproductive Health, on improving miscarriage care through evidence-based approaches.
Further information
Read the full report: Tommy's Graded Model of Miscarriage Care (29.04.2026)
In the media
- BBC: Early care scheme could prevent thousands of miscarriages a year
- The Independent: Earlier miscarriage tests could prevent 10,000 pregnancy losses a year, finds study
- The Times: Call to scrap the wait until three miscarriages for more NHS tests
- Sky News: Offering tests after first baby loss could prevent 10,000 miscarriages a year, study claims
- BBC Local: Calls for better care after first miscarriage
- The Guardian: Earlier specialised care could prevent 10,000 miscarriages a year, UK study finds