Globally, an estimated 23 million miscarriages occur every year. Despite the personal toll involved, many miscarriages—defined as the loss of pregnancy before viability—are managed in relative isolation. Private grief and misconceptions—eg, the belief that miscarriage can be caused by lifting heavy objects, or that there are no effective treatments—can lead to women and their partners feeling at fault or managing alone. Similarly, in the health-care system and broader society, the continuing conviction that miscarriages are unavoidable and the requirement, enshrined in many national guidelines, that women must have recurrent miscarriages before they are eligible for investigation or intervention has created a pervasive attitude of acceptance of miscarriage, urging women to “just try again”. This mindset underestimates, and risks dismissing, the personal physical and mental consequences of a miscarriage. It has also affected the availability and quality of care that women receive after a miscarriage and does not accurately reflect the evidence on management. A new Series of 3 papers published in The Lancet reviews this evidence on miscarriage and challenges many misconceptions. The authors, Siobhan Quenby, Arri Coomarasamy, and colleagues, call for a complete rethink of the narrative around miscarriage and a comprehensive overhaul of medical care and advice offered to women who have miscarriages…more
