On Wednesday 24 November I woke up to several messages from friends all sharing the same news with me. Women in England will now be offered the hormone progesterone to help prevent pregnancy loss. New guidance, from The National Institute for Health and Care Excellence (NICE), now recommends that women who experience bleeding in early pregnancy and have had at least one miscarriage should be treated with progesterone.
As relieving as this news feels, it also brought back my own painful experience of miscarriage and my fight for this same hormone treatment through the NHS. After suffering two miscarriages in 2017 I went along to my GP to beg for help. The experience was all consuming, I was grief stricken and it left me feeling utterly helpless.
The NHS guidance at the time was that until a woman has experienced three consecutive miscarriages, no investigations (or treatments) were recommended. I knew this but I dragged myself to my GP anyway because I couldn’t go through another pregnancy, and potential loss, without actively doing something different. Something that might prevent me from losing another baby.
I asked my GP about the use of progesterone in early pregnancy and the research I’d found suggesting it could help prevent miscarriages. He was unaware of any link, unwilling to investigate further, and I was dismissed.
I went back to another GP and although he had no knowledge on this type of hormone treatment himself, he kindly referred me to a consultant. My appointment arrived promptly in the post only to be followed by a cancellation letter days later – the reason being that I had ‘only’ suffered two consecutive miscarriages.
Devastated, I carried on trying for a baby. Once I became pregnant for the third time, I went to see my midwife earlier than planned to ask for progesterone again. She had no knowledge of this type of treatment so called a consultant who, frustrated at the number of questions we were asking, instructed the midwife to send me in to the clinic to discuss it further.
When I arrived the consultant said she was confused “Why are you here? This is an infertility clinic, and you’re…pregnant?” I was well prepared with my please-give-me-progesterone-before-I-explode pitch, and they begrudgingly prescribed it as it ‘wouldn’t do me any harm’.
I took it every day until I was 14 weeks pregnant. Now I have a son. His name is Noah.
Maybe it helped, maybe it didn’t. But I went back to my GP in 2021 and got it again, this time without a fight, and I took it as soon as I became pregnant. I had no further miscarriages and now I have another son. His name is Alexander.
This was my experience. It was exhausting and lonely. But of course, sadly, I wasn’t alone.
Women across the country have been denied this treatment for years, until this week when new guidance based on research found use of the hormone could prevent 8,450 miscarriages a year by helping the womb prepare for a growing baby.
Lizzie* had three miscarriages and was turned away multiple times due to a lack of knowledge amongst NHS staff. ‘I spoke to my GP after my second and third loss but they refused my request for progesterone, claiming miscarriages were common and it was likely that I would still have a successful pregnancy at some point. I brought the research with me, and I also spoke to a consultant at the Early Pregnancy Clinic. She discarded any possibility that progesterone might help.’
This story is all too familiar for many women desperately looking for answers and being denied support and treatment, left to find a solution alone.
‘I looked into buying progesterone online but I wasn’t sure which one to go for and felt uneasy that I might do damage to myself or my baby. I just wanted help,’ Lizzie told me.
‘Eventually, I spoke to a private fertility specialist who agreed there would be no harm in taking progesterone and possibly something to gain from taking it. The appointment was about £250 and a private prescription was roughly £150. My healthy baby was born 10 months after that.’
NICE’s chief executive, Professor Gillian Leng, confirmed the treatment ‘will be of benefit to some women and as an inexpensive treatment option can be made available to women on the NHS from today.’
Unfortunately, however, progesterone treatment is not a guaranteed to prevent early pregnancy loss and is only recommended for women who meet the criteria but for women like me, it’s a relief to see things move in the right direction. Professor Leng has indicated that more work is still to be done adding, ‘our committee has called for more research to be carried out in this area.’
I have been determined to share my own positive story and as a result, have spoken to numerous women across the UK whose stressful and varying experiences have confirmed what many charities and campaigners have been flagging. The inconsistent approach to miscarriage and miscarriage services across the country needs to be addressed urgently.
This week’s updated guidance is just one step forward but it’s a welcome one.