Why Are Miscarriage and Ectopic Pregnancy Admissions Rising Again?

Written by Sophie Sulehria

One of the most sobering studies presented at the European Society of Human Reproduction and Embryology (ESHRE) Annual Meeting this year focused not on new technology or advances in IVF, but on something experienced by millions of women long before fertility treatment is ever considered: pregnancy loss.

An analysis of two decades of hospital admissions in England revealed a concerning trend. After years of decline, admissions for both miscarriage and ectopic pregnancy began to rise again following the COVID-19 pandemic.

Researchers also identified stark and persistent inequalities, with women living in the most deprived communities experiencing significantly higher admission rates for both complications than those living in the least deprived areas.

The data cannot tell us why these increases are happening. However, it raises important questions about access to care, health inequalities and where research efforts need to be focused next.

Looking at 20 years of data

The study analysed national hospital records covering England between 2004 and 2024.

During that period, researchers examined:

• 786,984 hospital admissions for miscarriage

• 211,727 hospital admissions for ectopic pregnancy

• More than 12.4 million births

The sheer scale of the dataset makes it one of the most comprehensive analyses of early pregnancy complications undertaken in England.

For much of the study period, miscarriage admissions had been declining. But following the pandemic, that trend changed.

Between 2021 and 2024, there were 133,400 hospital admissions for miscarriage, representing a reversal of the previous downward trend.

Ectopic pregnancy admissions followed a similar pattern. Researchers recorded 44,577 admissions during the same post-pandemic period, with admissions increasing by an average of 4.28% each year.

The research does not conclude that more miscarriages or ectopic pregnancies are necessarily occurring overall. Rather, it highlights an increase in women requiring hospital care for these complications. Understanding what lies behind that change will require further investigation.

The inequalities that cannot be ignored

Perhaps the most striking finding from the study was not the rise in admissions itself, but who was most affected.

Women living in England’s most deprived communities experienced:

• Around 2.7 times more hospital admissions for miscarriage

• Around 2.4 times more hospital admissions for ectopic pregnancy

This was compared with women living in the least deprived areas.

These disparities have persisted over time, despite wider improvements in healthcare.

The findings are another reminder that reproductive health outcomes are closely linked to broader social inequalities.

Factors such as access to healthcare, underlying health conditions, environmental exposures, housing, nutrition, smoking prevalence, occupational factors and timely access to early pregnancy services may all contribute. However, this study was not designed to identify the specific causes behind these differences.

Instead, it highlights the scale of the gap - and the urgent need to understand it better.

Pregnancy loss is more common than many realise

Miscarriage remains one of the most common complications of pregnancy.

Yet despite how frequently it occurs, many people still experience it in silence.

Conversations around fertility often focus on conception and treatment, but pregnancy loss forms part of many people’s paths to parenthood. For some, it comes before fertility treatment. For others, it occurs during IVF or after years of trying to conceive. Many never require fertility treatment at all.

Ectopic pregnancy, while less common, is a medical emergency that requires prompt diagnosis and treatment. Early recognition and access to specialist care can be lifesaving.

Studies like this reinforce the importance of ensuring that high-quality early pregnancy services are available wherever people live.

What changed after the pandemic?

One of the obvious questions raised by the findings is why admissions have increased since the COVID-19 pandemic.

At present, there is no clear answer.

The study does not establish whether the increase reflects changes in the underlying incidence of miscarriage and ectopic pregnancy, differences in healthcare-seeking behaviour, delayed access to care, pressures on NHS services, changes in referral pathways or other factors.

It is possible that several influences are contributing, but further research will be needed before any firm conclusions can be drawn.

That uncertainty is, in itself, important.

Good research often identifies the questions that still need answering rather than claiming to have solved them.

Why this matters for fertility care

Although this study focuses on hospital admissions rather than fertility treatment itself, its implications extend across reproductive medicine.

For many individuals and couples, pregnancy loss becomes part of a much longer and more complicated path to parenthood.

Repeated miscarriage investigations, fertility referrals, IVF treatment and early pregnancy monitoring are often interconnected. Improving early pregnancy care has the potential to improve not only physical outcomes but also the emotional wellbeing of thousands of families navigating loss.

The researchers argue that the findings strengthen the case for greater investment in research, alongside more equitable access to high-quality early pregnancy services.

If where someone lives significantly affects their experience of pregnancy complications, that represents an inequality the healthcare system should seek to address.

Data that should drive change

One of the strengths of this research lies in its scope.

Looking across 20 years allows researchers to move beyond isolated snapshots and identify genuine population-level trends.

It enables clinicians and policymakers to ask bigger questions:

• Why are hospital admissions changing?

• Why do inequalities remain so pronounced?

• How can early pregnancy services better support those at greatest risk?

These are not questions that can be answered overnight, but they are questions that deserve attention.

Looking beyond the numbers

Statistics can sometimes feel impersonal.

Nearly 800,000 miscarriage admissions.

More than 200,000 ectopic pregnancy admissions.

Millions of births.

But behind every number is a person who experienced uncertainty, fear, grief or a medical emergency.

Pregnancy loss is not simply a clinical outcome. It is often a deeply emotional one, too.

This large-scale analysis serves as an important reminder that progress in reproductive health is not measured solely by advances in IVF laboratories or new fertility technologies.

It is also measured by how well healthcare systems care for people during the earliest and most vulnerable stages of pregnancy - and whether that care is available equally to everyone, regardless of where they live or their socioeconomic background.

As fertility medicine continues to advance, early pregnancy care must advance alongside it. That means investing in research to understand why hospital admissions are rising, addressing the inequalities affecting women in deprived communities and ensuring that high-quality, compassionate care is available to everyone who needs it.