Written by Jenny Wordsworth. Reviewed by Dr Phoebe Howells (2026).

Below is OVUM’s official response to the RCOG’s draft for ‘Early Miscarriage’ patient information. The information is designed by the RCOG to explain the care and support you will receive after an early misscarriage (defined as loss in the first three months of pregnancy). The RCOG is updating its patient information for ‘Early Miscarriage’ and has asked for feedback from the public and healthcare professionals. You can access the patient information and the response survey here, which is due at midnight on 19th January. 

OVUM remains committed to shaping reproductive care and has officially submitted our response to this first draft below. We have outlined 9 key recommendations for the patient information, to better provide genuine support for everyone who may be affected by early misscarriage. Loss is incredibly difficult and traumatic, impacting people differently and so it is incredibly important the resources provided by the RCOG recognise this, and provide meaningful support. 

 

OVUM’s Response

Our response focuses specifically on how support following miscarriage is addressed, in line with the stated consultation aims. Overall, this is a clinically robust, clearly written and comprehensive document, aligned with NICE guidance on ectopic pregnancy and miscarriage. However, we believe it would benefit from stronger, earlier and more explicit integration of emotional, practical and psychosocial support, to better reflect patient experience, current policy developments, and RCOG’s stated commitment to respectful, compassionate care. 

Below we outline specific, constructive recommendations, mapped directly to NICE guidance, RCOG priorities, and areas where patient feedback and community advocacy have driven recent change. 

 

1. Emotional support should be embedded earlier and throughout the document.

Current issue: 

Emotional impact and support are primarily addressed in a discrete section (“Emotional recovery”) later in the document, after detailed clinical and procedural information. For many patients, distress begins at presentation, diagnosis, and decision-making, not only after physical recovery. OVUM believes emotional support is an incredibly important part of support, and needs to be heavily embedded throughout the patient information. 

Recommendation: 

Introduce explicit emotional validation earlier, particularly:

• In “About this information”.

• Immediately following “What is an early miscarriage?” 

• At points of diagnosis and choice of management.

Suggested wording:

“A miscarriage can be shocking, distressing and deeply upsetting. People experience a wide range of emotions, including grief, numbness, anger or guilt. All of these responses are normal, and support is available.” 

Alignment: 

NICE NG126 emphasises providing women with “supportive care and information throughout management”, not solely post-treatment; and the RCOG prioritises respectful, compassionate care and trauma-informed practice. Including emotional support also reflects evidence that early validation reduces long-term psychological morbidity. 

 

2. Clear, unambiguous reassurance that miscarriage is not the patient’s fault.

Current issue:

While chromosomal causes are explained as a cause of miscarriage, the patient information does not clearly and explicitly state that miscarriage is not caused by the patient’s actions. Many people continue to experience profound self-blame despite accurate information, so it is incredibly important that the information clearly states it is not the patient’s fault. 

Recommendation:  

Add a clear, direct statement in, “Why do early miscarriages happen?”, for example. “Nothing you did or did not do caused this miscarriage.” 

Alignment: 

NICE NG126 supports clear communication to reduce anxiety and distress. Including appropriate reassurance addresses a well-recognised patient concern repeatedly identified in miscarriage care reviews and patient feedback. 

 

3. Support should be framed as routine, not optional or exceptional. 

Current issue:

Support is described using tentative language (“you may need support”, “talk to your GP if you feel you are not coping”), which may unintentionally suggest that needing support is unusual or represents a failure to cope.

Recommendation:

Reframe support as a standard and expected part of miscarriage care, for example: 

• State that many people benefit from emotional support. 

• Emphasise that support can be accessed immediately or later, and does not require reaching a crisis. 

Suggested wording:

“Many people benefit from emotional or psychological support after a miscarriage. You should be offered information about available support as part of your care.” 

Alignment:

NICE NG126 highlights that women should be offered emotional support and clear follow-up. 

 

4. Partners and non-birthing parents should be more explicitly included when relevant.

Current issue:

Partners are acknowledged but inconsistently referenced, and largely late in the document. While a partner is not always involved, when they are, it is important that support is available to them aswell. 

Recommendation:

Explicitly include partners and non-birthing parents in sections on: “Emotional impact”, “Support resources”, “Returning to work”. Acknowledge that partners may grieve differently and may feel overlooked by services. 

Alignment:

NICE guidance supports inclusive care, and providing partner support reflects contemporary family structures and patient feedback. 

 

5. Practical support: sick leave, fit notes and work 

Current issue:

There is minimal practical guidance on work, sick leave or fit notes, despite this being a common and immediate concern for patients. 

Recommendation: 

Add a short subsection under “Returning to work” or “What happens next?” covering: 

• That people may need time off work for physical recovery, emotional recovery, or both. 

• That GPs can provide fit notes where needed. 

• That there is no “right” timeframe for returning to work. 

Suggested wording:

“Some people need time off work after a miscarriage, either for physical recovery or emotional wellbeing. Your GP can provide a fit note if needed. How much time you need varies from person to person.” 

Alignment: 

The recommendation supports NICE emphasis on holistic care, and addresses a frequent gap identified in patient experience. Further, it aligns with broader NHS commitments to mental health parity and compassionate employment practices. 

 

6. Guidance on telling work, family and friends

Current issue:

The document does not address the emotional burden many patients feel around disclosure, despite this being a common source of anxiety and distress. 

Recommendation:

Include brief reassurance that:

• People are not obliged to tell anyone until they are ready. 

• Different people may choose different levels of disclosure.

• Support organisations can help with wording or decisions about disclosure. 

This does not need to be prescriptive but should acknowledge the issue.

Alignment:

Guidance supports patient autonomy and emotional wellbeing, while reflecting real-world concerns frequently raised in miscarriage support settings. 

 

7. Follow-up appointments should explicitly include emotional wellbeing

Current issue:

Follow-up is largely framed around physical resolution (pregnancy tests, scans, symptoms). OVUM believes emotional wellbeing support is incredibly important and should be embedded as a standard throughout the support offered. 

Recommendation:

Clarify that follow-up may also include: 

• Discussion of emotional wellbeing.

• Opportunity to ask questions about what happened. 

• Signposting to support if needed.

Suggested wording:

“Follow-up appointments can also be an opportunity to talk about how you are feeling emotionally and to ask any questions you may have.” 

Alignment: 

NICE NG126 highlights that a follow-up should address both physical and emotional needs. 

 

8. Recognition of baby loss certificates (England) 

Current issue:

The document does not reference the Baby Loss Certificate, introduced by the UK Government to formally recognise pregnancy loss before 24 weeks. This was a significant and hard-won development driven by sustained community advocacy. 

Recommendation:

Add reference in the section on memorials and remembrance, noting: 

• The availability of the Baby Loss Certificate in England .

• That it is optional and does not affect medical care. 

• Where patients can find further information. 

Suggested wording:

“In England, you can apply for a Baby Loss Certificate to recognise your baby and your loss. This is optional and available regardless of how early the loss occurred.” 

Alignment:

Including the Baby Loss Certificate reflects current government policy and patient-led recognition of loss. It also aligns with RCOG’s role as a national clinical leader reflecting societal and policy developments. 

 

9. Language around timelines and “moving on” 

Current issue:

Statements about recovery and future pregnancy risk may be interpreted as implying expected timelines for emotional recovery or decision-making. It is important to recognise that grief is experienced differently by everyone, and therefore there is no ‘correct’ timeframe for recovery. 

Recommendation:

Explicitly state that:

• There is no correct timeline for grief.

• Decisions about trying again are personal and may change over time. 

Alignment:

Recognising this would follow trauma-informed care principles, as well as the RCOG’s emphasis on individualised care.

 

Key Takeaways: 

In summary, this draft patient information is clinically strong and informative, but to fully meet its aim of addressing support following miscarriage, we recommend: 

• Earlier and more consistent emotional validation. This would include: clear reassurance about lack of blame for those who have experienced loss, as well as the explicit mentioning of emotional well-being follow-ups. 

• Signposting to practical guidance and resources to be clearer throughout the patient information. This would include: practical guidance on sick leave and work, and the inclusion of the Baby Loss Certificate as a recognised form of remembrance. 

• To fully speak to and include all those affected by ‘Early Miscarriage’. For example, this would mean embedding support for partners, as well as recognising that not all journeys involve another partner. 

These changes would require minimal additional length, but would substantially improve patient experience and align the document more closely with NICE guidance, RCOG values, and contemporary patient expectations.