"Management of missed miscarriage"

I contacted the EPU at 9 weeks pregnant as I had some bleeding. I was reassured and told to phone back if I had any further issues. The next day the problem had continued and I was asked to come in for a scan.

The sonographer and their assistant were excellent. I was found to be having a missed miscarriage and my baby’s heartbeat wasn’t detected. The sonographer was very compassionate towards both my husband and I and even offered me a picture of the baby to keep.

Unfortunately the way the hospital is designed we then had to walk past a waiting room filled with pregnant women. This was traumatic.

We were taken back to the EPU where a nurse came in, wearing a mask so I couldn’t see their face, and handed me a leaflet and asked me to pick what option I wanted to deal with the miscarriage. The nurse stood during the entirety of this conversation, which made me feel uncomfortable. The leaflet was also unhelpful as it only has a couple of sentences on each option with no discussion of the risks and benefits of each option - it may be helpful to have a second leaflet which has much more information about the procedures, what to expect, what to pack etc for those who like to have more information.

I was advised I would have to wait 12 days for surgical management or 7 days for medical management. I feel this is completely unacceptable. I called back the next day to beg for earlier treatment and was told there was no availability. I was given a Simba box which I did really appreciate.

I chose the medical management as I couldn’t bear to wait 12 days. When I attended back at the Early Pregnancy Unit for the initial medication, out of the three medical staff I was seen by, only the doctor said they were sorry for our loss. However, they then continually referred to the baby as the products of conception and tissue until I had to ask them to stop. I understand that scientifically that is what it is, but this was my much loved and wanted baby, and a patient-centred approach would’ve asked me what terminology I preferred.

As I was taking the medication I became upset and the midwife in the room visibly turned their back to us. I feel like the entire unit is lacking in compassion and empathy - a hand on my shoulder or some words of comfort would have made a huge difference. I was upset on a number of occasions, but I was not being dramatic, that is how I was made to feel by staff. I cannot be the only person who is upset on that unit. 

When I attended at Ward 32 two days later, I was told they don’t have a bed for you, please wait outside. I was horrified, thinking I was going to be sent away or sent to a maternity ward. Again, I feel a simple change in language - your bed isn’t quite ready yet, but don’t worry, have a wee seat outside and we’ll come get you - would have made all the difference.

Upon getting onto the ward, I was horrified to realise that I would have been expected to pass my baby in a 4-in-a-room ward and sharing a toilet with 4 other women - one of which having the same procedure as me. In my view, this is barbaric. Luckily, I had passed my baby shortly before attending as I would’ve simply went home if I hadn’t. I feel there was no privacy or dignity in the ward. There was nowhere to have a private conversation. I don’t think it was best for any of the patients to be in the same room only separated by a curtain.

I would say that the nurses and doctors on Ward 32 were far more compassionate than those at the EPU and I would really like to thank them for that. The nurses on Ward 32 were really excellent. The consultant who gave me my second scan whilst I was on the ward even told my husband they were sorry for his loss - the first to have given him any recognition at all. The systemic issues in the layout of the ward aren’t their fault.

Given than I have been told miscarriage is so common, why aren’t there special facilities for women and their partners to be whilst taking the medication to pass their baby, particularly given you are prohibited from doing it at home?

I also feel I was discharged without any proper aftercare instructions - a leaflet advising what I could do/not do and for how long, what to expect, and when to contact them would have been appreciated. One of the doctors went out their way to provide me with a letter for my travel insurance company, which I’m incredibly grateful for. Unfortunately the ward is located in the same building as the maternity wards, and I required to walk past happy pregnant women on my way home; this was also extremely traumatic.

Overall, I feel my medical care was fine, however I feel like the Early Pregnancy Unit staff really need to work on their compassion and empathy, as it was sorely lacking, and the hospital as a whole needs to consider the facilities available for those having a miscarriage. The wait between finding out my baby had died to being able to have any treatment was also unacceptable, in my view.

All of this has added to the trauma of what is already an extremely traumatic situation. I also feel there is a lack of information given - I had to google for the specifics of each procedure, the risks and benefits, what medication I would be given, and aftercare, and this could easily be rectified.