Miscarriage Care and Facilities in Scotland: Scoping Report NHS Western Isles

Data on miscarriages

Accurate assessment of the number of all miscarriages that occur in Scotland is not possible at present as only miscarriages that require hospital inpatient or day case treatment are 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 miscarriage data is not collected in all sites or in all Health Boards in Scotland. While some data is collected in 11 of the 14 Health Boards, there is variation in what is being recorded as a miscarriage and this varies both across and within Health Boards.

Information technology 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 and Trakcare is used by 8 Health Boards to capture miscarriage data.

In NHS Western Isles data is collected via BadgerNet and from patient GP records. Data is collected on the number of miscarriages, miscarriages as a proportion of pregnancies, gestation, maternal age, parity and ethnicity varies depending on the site.

Like most sites across Scotland there was some disparity in what is counted as a miscarriage in NHS Western Isles. Uist and Barra Hospital indicated that a miscarriage is only recorded after booking, however, if a woman has a pregnancy loss before initial contact with a midwife, then books in a future pregnancy after this then the previous loss would be captured. Barra Community Hospital records miscarriage after a pregnancy is confirmed with a scan, similarly Western Isles Hospital would record a miscarriage after pregnancy confirmation.