Hospital admissions for miscarriage and ectopic pregnancy in England climbed significantly following 2021 after years of decline, according to new research presented at the European Society of Human Reproduction and Embryology. A 20-year national analysis also revealed stark, persistent socioeconomic disparities, with women in deprived areas facing admission rates more than double those of the least deprived groups.
Two Decades of Pregnancy Admissions Data in England
A nationwide population-level analysis examining English pregnancy records recorded between 2004 and 2024 captured 786,984 miscarriage admissions, 211,727 ectopic pregnancy admissions, and more than 12.4 million deliveries. The data traces a long-term downward trend in miscarriage admissions that reversed abruptly at the start of the decade.
Annual miscarriage admissions fell from 45,232 in 2010 to 37,398 in 2018, followed by a sharper drop to 31,046 by 2021. Yet that trajectory reversed sharply in the post-COVID period. Between 2021 and 2024, the health service recorded 133,400 miscarriage admissions.
Ectopic pregnancy admissions followed a distinct trajectory. After climbing between 2005 and 2012, those numbers held stable for several years before mounting a significant upward trend between 2021 and 2024, totaling 44,577 admissions during that four-year window. Concurrently, annual deliveries fell from 636,401 in 2017 down to 545,149 in 2024.
Complex Drivers Behind the Post-2021 Rebound
Researchers point to a convergence of healthcare shifts and demographic pressures to explain the post-2021 rise, though the study stops short of assigning single-factor causation. Shifts in healthcare delivery and patient-seeking behavior during and after the pandemic likely altered how and when women accessed early pregnancy support.
Underlying reproductive risk factors also played a notable part. Sindhu Sekar, lead author from the Department of Women’s and Children’s Health at the University of Liverpool and Liverpool Women’s NHS Foundation Trust, noted that increasing maternal age, rising obesity levels and broader reproductive health risk factors may also be contributing.
Researchers also pointed to a progressive increase in maternal age at conception, a rising prevalence of obesity, and broader reproductive health risk factors as factors associated with the rise.
Persistent Socioeconomic Disparities Across Communities
Beyond national totals, the data exposes deep inequalities that remained largely unchanged across the entire 20-year study window. During the most recent decade, women living in the most deprived communities experienced hospital admission levels more than double those registered in affluent areas.
The analysis recorded 71,104 miscarriage admissions among women in the most deprived decile, compared to 26,414 admissions in the least deprived decile—representing an approximately 2.7-fold difference. Ectopic pregnancy admissions showed a parallel divide, with 17,845 admissions in the most deprived group against 7,580 in the least deprived group, marking a 2.4-fold gap.
“The women most affected are often those facing the greatest challenges. Women living in more deprived communities are more likely to experience risk factors associated with pregnancy loss and face greater barriers to accessing care. These findings highlight how strongly reproductive health can be shaped by wider social and economic circumstances.”
Sindhu Sekar, Lead Author, Department of Women’s and Children’s Health, University of Liverpool and Liverpool Women’s NHS Foundation Trust
Priorities for Clinical Care and Future Research
The findings were presented at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE). Professional leadership emphasized that early pregnancy complications must be viewed through a broader public health lens rather than treated strictly as isolated clinical episodes.
“These findings are an important reminder that pregnancy loss and ectopic pregnancy are not only clinical events, but also reflect broader inequalities in women’s health. The recent rise in admissions deserves careful attention, and strengthening equitable early pregnancy care is a concrete way to improve outcomes and better support women and families.”
Professor Dr Anis Feki, Chair of ESHRE
To address these gaps, researchers recommend strengthening Early Pregnancy Assessment Units, refining care pathways, and investing in preventative health measures. Investigators argue that pregnancy loss has historically been overlooked and underfunded, making it imperative to elevate it as a core women’s health research priority to uncover root causes and eliminate avoidable loss.
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