Finland issues first national guidelines for miscarriage care with focus on mental health support

Finland has published its first national clinical guidelines for miscarriage treatment, placing emphasis on empathetic care and psychological support, according to a statement by the Finnish Medical Society Duodecim.

The new recommendations stress that healthcare professionals should meet patients who have experienced miscarriage with compassion and respect, provide adequate pain management, and avoid dismissing grief. Terms like “pregnancy material” should be avoided, said Maarit Niinimäki, chair of the working group behind the guidelines and a specialist in obstetrics and gynaecology.

“We have heard many accounts of women feeling their grief and recovery were not taken seriously,” Niinimäki said. “This guideline aims to ensure professionals meet these patients with empathy.”

A follow-up appointment at a maternal clinic is now recommended even after a single miscarriage to assess recovery, support needs, and potential further investigations. After a first miscarriage, lifestyle factors affecting risk are reviewed; after two, primary healthcare examines risk factors more closely; and after three, specialised care begins more detailed investigations.

Niinimäki acknowledged that implementation depends on regional healthcare capacity, as the guidelines are recommendations rather than mandates.

The guidelines were developed over two years by reviewing scientific literature, though Eero Varila, a fertility specialist at private clinic Dextran, criticised their reliance on randomised controlled trials, which he noted are ethically difficult to conduct for recurrent miscarriages. He argued that clinical experience and international research centres show active investigation of causes—such as hormonal, immunological, or uterine factors—can improve outcomes.

Varila also advocated for early ultrasound monitoring in subsequent pregnancies, calling it a cost-effective diagnostic tool, whereas public healthcare often follows standardised protocols.

Hennariikka Niinistö, who has experienced multiple miscarriages, welcomed the new follow-up recommendations as a “positive step forward,” noting that previously, those affected were often left without support.

Miscarriage is defined as pregnancy loss before the 22nd week. While 50–60% of cases are linked to chromosomal abnormalities, nearly half have other causes, including hormonal imbalances, endometriosis, or blood flow issues.