Australia has issued its first state-wide set of fully-fledged national guidelines for dealing with such situations. This landmark move will go a long way in addressing the emotional and medical needs of couples suffering a miscarriage. The guidelines, which encompass recommendations for miscarriage, recurrent miscarriage, and ectopic pregnancy up to 14 weeks gestation, come amidst alarming statistics—up to one in four pregnancies ends in miscarriage within the country. Every year, over 100,000 couples experience this tragedy of unfulfilled parenthood.
The good news is that the federal government is moving to improve support for those who experience pregnancy loss. Read more about their commitment of $9.5 million to support and research miscarriage in 2024. This investment includes funding for a scoping study to establish a national miscarriage data collection system, which stakeholders believe is essential for formulating effective health policies.
Understanding the Guidelines
The recently released clinical guidelines underscore the need for meaningful, compassionate dialogue between clinicians and patients. They caution practitioners against using incendiary terms that can shape the narrative and perception of early pregnancy loss. Miscommunication can create additional burdens of grief. Such as when professionals elect to use clinical jargon, such as saying “spontaneous abortion,” which rarely resonates with patients.
“If the patient refers to their loss as a baby, [doctors] have to take that lead and refer to it in the same way,” – Isabelle Oderberg
Odderberg has endured seven miscarriages in her efforts to bring two healthy children home. She draws attention to the deep impact language can have on the emotional wellbeing of a patient. She’s a tireless advocate for a culture shift in the health care space. Miscarriage cannot be left to be still treated as simply an inconvenience of the reproductive cadence.
“We’ve seen a lot of doctors be dismissive … because it’s just seen as a natural part of the reproductive cycle, which to some extent it is, but that doesn’t lessen the grief,” – Isabelle Oderberg
The updated guidance changes the definition of recurrent miscarriage, which used to need three losses in a row. The new criteria are meant to offer richer, more comprehensive care and treatment to women who have had several miscarriages.
Addressing Variability in Care
It means the miscarriage care women and their families receive in Australia is completely inconsistent and comes down to chance. There’s no standardization on how treatment is provided because different health services take different approaches. Dr. Khot is committed to promoting value-based care practices. He argues that this disparity results in insufficient guidance and resources for families in grief.
“We don’t actually have a standard of care for miscarriage in Australia because every health service does something slightly different and every clinician probably does something slightly different,” – Dr. Khot
Dr. Khot also calls for more research dollars to better understand the causes of early pregnancy loss. An international scoping review of evidence in 2021 found that the public tends to underestimate the presence and effects of miscarriage. Our finding underlines the need for larger, comprehensive studies on the subject.
“A lot of what happens in this space of early pregnancy loss is not well understood because it is not well researched,” – Dr. Khot
In the absence of intentional data collection, healthcare providers are left without an understanding of how to best to service those who have had a miscarriage. The national miscarriage roadmap we’re advocating for would examine patient pathways to assess and uphold quality of care. Additionally, it seeks to increase funding for research over the long term.
Moving Toward Improved Support
The Early Pregnancy Loss Coalition is currently leading efforts to create a national roadmap for miscarriage care. This federal initiative aims to develop a formalized system of support that recognizes both the emotional and physical impact of pregnancy loss.
Ms. Oderberg advocates for a whole person approach to care. She feels patients should get more than just medicine – they should receive kindness and direction.
“The time to just tell patients to go home and try again is over,” – Isabelle Oderberg
Through her advocacy, she wants every person to have access to counseling and mental health support. This assistance should not place additional financial hardship on families experiencing loss.
“Whether that be counselling or mental health support, these are things women should have access to without additional costs,” – Dr. Khot
Despite some positive advancements in care through individual clinicians who demonstrate empathy and understanding, many families continue to share their “horror stories” regarding their experiences with miscarriage treatment.
“There are times when you go and seek care and you have an incredible, empathetic, knowledgeable clinician who can give you the right guidance and treat you well, both from a medical point of view but also in terms of empathy,” – Isabelle Oderberg
Yet, these experiences underscore the need for systemic change in every healthcare setting.
