Our Core Goals

We seek a significant improvement in care for people who experience miscarriage and those who love and support them.

Best practice care dictates that at the hospital/health service level:

1. Early pregnancy assessment services/clinics (EPAS) are located away from maternity services.

2. Discrete (separate) seating areas are provided for those seeking services at the time of miscarriage or threatened miscarriage, such as ultrasound/imaging, GP clinics to reduce trauma and provide privacy.

3. At the time of miscarriage diagnosis, parents must be informed of all their options for management, and depending on the individual's situation, preference and medical advice, supported to access their preferred option in a reasonable timeframe. This advice must also be provided in writing, should the parent not be in a fit state to absorb information verbally.

On emergency / urgent care:

Where parents cannot receive care in a reasonable time, printed information (including referral pathways for support) on how to access appropriate support services must be provided. This information should also be tailored to people from under-represented groups, including but not limited to:

1. Aboriginal and Torres Strait Islander People

2. People with disability

3. LGBTIQ+ and gender diverse people

4. People with low English language literacy

5. People from cultural and ethno-religiously diverse communities

Language and communication used or deployed in this space must be modernised and sensitised to alleviate the compounding of trauma.

1. We call on Australian medical colleges to end the use of terms (in all contexts) such as:

a) spontaneous abortion

b) products of conception

c) incompetent cervix

d) failed pregnancy

2. Alternative phrasing must be established with bereaved parents for all terms that compound their trauma.

3. Work to assess and reduce stigma around miscarriage, including:

a) Media guidelines for reporting (including referral pathways for support)

b) Creative sector guidelines for depiction

c) National campaigns around pregnancy loss awareness month

d) The introduction of education in the national primary and high school curricula and in universities

4. National bereavement care guidelines for healthcare professionals need to be developed and endorsed by major medical bodies.

We acknowledge and recommend the wider use of the Australasian Society of Ultrasound in Medicine (ASUM) Guidelines for Parent-Centred Communication in Obstetric Ultrasound.

In addition, we advocate for additional education and training for healthcare professionals to ensure appropriate language and behaviour is used to show respect for the grief of the parent/s.

Australia must collect miscarriage data for the development of fit-for-purpose public health policy, appropriate funding decisions and health services.

1. Australian miscarriage data must be tracked, stored and available publicly (deidentified). Data must consider appropriate socio-economic classifications to inform funding priorities for miscarriage (i.e., by postcode and/or remoteness, where possible, acknowledging that many miscarriages happen outside the medical system, meaning a self-reporting database may need to be an option).

2. The Australian Institute of Health and Welfare (AIHW) must provide clear definitions of and separate coding for miscarriage, elective abortion and termination for medical reasons.

3. Miscarriage management methods must also be tracked and quantified (surgical vs medical vs expectant).

4. A strategy to capture miscarriages that do not meet the clinical definition and those that take place outside the hospital system (such as a self-reporting database) is also required. Alternatively, the clinical definition of miscarriage must be reassessed to capture a more realistic and thorough picture of the issue.

We are advocating for government funding of $30 million for care initiatives and miscarriage research (miscarriage research funding to be disseminated by the Medical Research Future Fund, National Health and Medical Research Council or other statutory body).

We need to lay the foundations to improve miscarriage care and support in Australia. This can be achieved by better understanding miscarriage support needs, service provision, socio-economic impacts and future research priorities in Australia. This research will provide a clear, solid evidence base from which to develop new, innovative responses and changes in policy, practice and funding to improve miscarriage support in Australia. To achieve this, we must firstly:

1. Undertake an immediate analysis of the socio-economic cost of miscarriage to the Australian economy as conducted in the UK by Tommy’s Centre for Miscarriage Research.

2. Undertake a national miscarriage priority setting partnership (PSP) to establish the research priorities for miscarriage support. This will provide a critical evidence base of support needs and priorities, clearly establishing where research and funding efforts need to be directed to have the greatest public health benefits in both physical care and psychosocial support.

3. EPAS are considered the gold standard for miscarriage management however their standards of care, eligibility, and services in Australia vary enormously, and they are not available nationwide. As such, we seek to:

a) Audit and map existing EPAS services across Australia to determine their availability, locations, standards and models of care, eligibility and patient satisfaction.

b) Assess funding sources, models of care and annual patient numbers.

c) Assess both staffing and referral models and services provided.

d) Understand the extent to which EPAS clinics are fit-for-purpose from both the healthcare provider and patient perspective.