BPAS comment on updated NICE guidance re: management of miscarriage
We welcome the updated guidance from NICE. However, there is much work still to be done in improving women’s access to healthcare technologies and medications in pregnancy as we know women can struggle to obtain pharmacological treatments even when guidance around their safety and benefit is clear. Treatment for severe pregnancy sickness, which can result in the termination of much wanted pregnancies, is a case in point. It is vital that this new guidance is communicated swiftly and effectively so women can be counselled about this line of treatment and able to access it where it is clinically suitable.
It is estimated one in four pregnancies end in miscarriage, and the causes are often unknown. This can leave women feeling that they are to blame, particularly in a climate where women's behaviours in pregnancy are often under scrutiny. More can and should be done to prevent the heartbreak of pregnancy loss, and we need more research to achieve this.
Dr Patricia Lohr, Medical Director of BPAS, and Director of the CRRC, said:
“We welcome these new guidelines from NICE that advocate for the use of evidence-based care to prevent recurrent miscarriage. This can be extremely traumatic for women and their families, and we support all researchers and care-providers, including Tommy’s National Centre for Miscarriage Research and the University of Birmingham, who are working to improve outcomes.
“We also welcome the fact that NICE have been explicit that these recommendations are not to be adopted in other circumstances, including after the use of mifepristone (the first ‘abortion pill’) in so-called ‘abortion-reversal procedures’.
“There is no evidence that giving progesterone to counteract mifepristone works and some evidence to show that it is harmful. The only randomised trial attempting to test whether high dose progesterone can interfere with the actions of mifepristone had to be stopped early because of a higher than expected rate of haemorrhage in participants. Patients who are offered this practice are being put at risk.”
For more information please contact Katherine.OBrien@bpas.org or call 07881 265276.
BPAS is a charity that sees over 100,000 women a year for reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception at clinics across Great Britain. It supports and advocates for reproductive choice. BPAS also runs the Centre for Reproductive Research and Communication, which seeks to develop and deliver a research agenda that furthers women’s access to evidence-based reproductive healthcare, driven by an understanding of women’s perspectives and needs. You can find out more here: https://www.bpas.org/get-involved/centre-for-reproductive-research-communication/
Later in 2021, BPAS will launch England's first not-for-profit fertility service, to provide ethical, evidence-based, person-centred care that supports patients. We will provide a safe, high-quality, and accessible service, without profiteering from patients. Our service will give those ineligible for NHS funding an affordable option to access the care they need.