Miscarriage Care and Facilities in Scotland: Scoping Report National Overview
This report details the findings of a scoping exercise to enable better understanding of miscarriage care in Scotland nationally. The report seeks to aid policy makers and Health Boards in making decisions about what improvements are required to miscarriage care in Scotland.
Data about miscarriages
It is not possible to accurately assess the number of miscarriages that occur in Scotland at present, as only miscarriages that require hospital inpatient or day case treatment are routinely recorded.
The Lancet series on Miscarriage Care recommended that:
- miscarriage data are gathered and reported to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development; and
- every country reports annual aggregate miscarriage data, similarly to the reporting of stillbirth.
The Scottish Government is currently working with Public Health Scotland to find ways to improve miscarriage data recording and to gather a more accurate picture of the number of miscarriages in Scotland. This will be used to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development.
This scoping exercise found that there is variation in what is being recorded as a miscarriage and this varies both across and within Health Boards (Table 27).
Number of sites |
|
|---|---|
All miscarriages - once pre-booking contact made |
9 |
All miscarriages - after positive test (at home or within an NHS service) |
8 |
All miscarriages - including biochemical pregnancies |
6 |
All miscarriages - including self-report |
3 |
All miscarriages – for women that present or access an NHS service |
2 |
Only when confirmed by ultrasound scan |
4 |
Only once a miscarriage has been confirmed by an NHS service |
2 |
Verbal reporting by patient |
4 |
Positive pregnancy test 5-6 weeks after last menstrual period |
1 |
Scan or positive test 6 weeks after last menstrual period |
1 |
Once a pregnancy is confirmed |
1 |
Data not collected |
1 |
Not known |
2 |
Miscarriage data is not collected in all sites or in all Health Boards in Scotland. Some data is collected in 11 of the 14 Health Boards(Table 28).
Number of Sites |
Number of miscarriages |
Miscarriages as proportion of pregnancies |
Gestation |
Maternal Age |
Parity |
SIMD |
Ethnicity |
None |
|---|---|---|---|---|---|---|---|---|
Scotland Sites |
21 |
15 |
20 |
18 |
16 |
11 |
16 |
22 |
Health Boards |
11 |
9 |
11 |
10 |
9 |
7 |
9 |
6 |
In some areas additional characteristics such as those outlined in Table 28 are also captured although this is not uniform both within and across Health Board areas. Data is collected both electronically and on paper. While some Health Boards appear to have a process by which oversight of miscarriage data takes place others do not.
Information technology systems used to collect Miscarriage Data
Across Scotland different IT systems are used by Health Boards to collect data about those accessing miscarriage care. BadgerNet Maternity is used by 11 out of 14 Health Boards to collect miscarriage data. Currently BadgerNet is not used by NHS Borders, NHS Fife or NHS Lothian for miscarriage data. Trakcare is used by eight Health Boards to capture miscarriage data. One Health Board, NHS Borders, stated they do not collect data locally about those accessing miscarriage care. Other systems used by Health Boards include Clinical Portal, Portal, Symphony and Badgernet Early Pregnancy and Gynaecology Unit (EPAGU) (Table 29).
BadgerNet Maternity |
Trakcare |
Not Collected |
Other |
|
|---|---|---|---|---|
Scotland Sites |
40 |
16 |
1 |
4 (Badgernet EPAGU, Symphony, Portal, Clinical Portal) |
Health Boards |
11 |
8 |
1 |
4 |
Contact
Email: socialresearch@gov.scot
There is a problem
Thanks for your feedback