To think an Early Pregancy Unit is not the best place to deal with miscarriage aftercare?(47 Posts)
I've been through this twice in quick succession now and I'm wondering if there's really no other way to do it.
Logically, the EPU has the equipment to perform ultrasound and cervical scans, which would be needed in both early pregnancy and after a miscarriage. However, it's hard to describe how difficult it is to wait in a room full of bumps in various stages, being asked when your EDD is and having to say yet again that there isn't one any more, and having wall-to-wall information on birth options and parenting surrounding you in the waiting room. I was even offered a Bounty pack last time which I had to explain why I was declining.
It's very easy for EPUs to trigger off emotions at a time where they're everywhere anyway; and in my case they haven't been able to advise on much in terms of what happens next or what I should or shouldn't do (can I lift things? when can I exercise?) . If a hysterectomy is treated as a gynaecological issue and followed up accordingly, could the same not be done for miscarriage? I'd rather be going to the EPU when I was actually pregnant.
I understand your point, and If I designed hospitals I would have the departments back to back, so the relevant people could go between but the clients would only be in a suitable department.
but it is just one of those things,
Having spent the best part of ten pregnancies daily in one, I do know how it can be raw, monday morning being the highlight.
but until they bother with decent hospital design it is not going to change.
When I had my early scans (previous history of mmcs so they monitored me from the beginning) I was waiting with loads of women having early scans and after the scan we all had to come back into the waiting room and wait to speak to a nurse, it was a mixture of people being excited having seen a little heartbeat and women who had had bad news, it was awful
I was there over Easter and the whole thing was traumatising.
I never imagined that treating miscarriages was so insensitive.
I mc at 12 weeks and it was horrific. Sitting with lots of ladies with big bumps or paying for their photos while waiting for it to be confirmed that I'd lost my baby was almost like an out of body experience.
I remember getting a photo of the scan at about 6 weeks and being told to not get it out, mention it, look excited etc while we were leaving through the waiting room as some women didn't have the good news we had.
I think maybe some places handle it better than others.
I agree with Bramshaw, different hospitals treat it differently.
I found ours really sensitive.
The EPU is only up to 14 weeks, so no bumps.
The scanner asks you to keep photos hidden and not to talk about it in the waiting room.
The nurse is lovely, I loved the fact that I saw the same nurse each time, she remembered enough to make it not too painful.
After a scan confirms a miscarriage they take you straight to another empty room with a box of tissues abs you see a doctor straight away.
My follow up scan was at the random ultrasound place. No where near other pregnant women, it was men getting man scans etc.
OP, I'm sorry you had a bad experience. It's worth writing to PALS and asking them to review procedures.
Oh, and our EPU is in a totally different part of the hospital to normal pregnancy scans or the maternity wing.
I'm very fortunate to have had positive experiences of a horrendous situation. I had some infertility appointments at Canterbury hospital and found the experience awful in comparison.
I work as a nurse (not in gynae) and know that my hospital's EPU is only for women before 18 weeks. The scanning they do there is only for emergencies. It sounds like some of the other posters on this thread have had to go to a hospital's main ultrasound department and be seen along with all the planned scans, which I agree sounds very insensitive.
I guess that a lot of hospitals just don't don't have the money to pay for separate scanning equipment/staff etc. I would expect to see these sort of "non essential" services reducing further as cuts continue, sadly.
Our EPU is horrible, but it is at least totally separate to the maternity unit.
Mind you, on my last visit there (to confirm a mmc) the other woman in the waiting room had brought her whole family. Including her toddler. FFS!
I thought that's exactly what EPUs were for?
YABU, but I totally get why. Logically speaking tho, how on Earth could they hope to separate those who had miscarried with those who were still pregnant without having scanned them first? Make them leave through different doors?!
I agree with Eeyoreish, our EPU was lovely and very, very sensitive to the fact that not all ladies would receive good news.
There were notices all over advertising details of the Miscarriage Association and very few references to pregnancy. The scanning ladies and midwives were all incredible and so reassuring, both during my mmc and my subsequent pregnancy.
When we were told about our mmc we were taken to a room unlike a hospital room, it had sofas and books and tissues and was very informal, and the midwife came in there to talk us through our options. It was as "nice" an experience as it could have been, plus my follow up scan was done before the clinic opened so I wasn't exposed to happy pregnant ladies (sounds horrible to say).
Think, though, this was a direct response to it being in a Woman's / Maternity hospital; I've subsequently been to another hospital for a routine internal scan and that was in the EPU (though not pg related) which was in Maternity which seemed a bit crass.
And my thoughts and sympathies are with all ladies experiencing such losses.
Yanbu Op, so sorry for your loss
My friend had the same experience after being told they couldn't see a heartbeat she was lead through a waiting room of various sized bumps and beaming smiles.
At my hospital the EPU is on a different floor from A/N clinic, L&D etc. It's situated next to the gynae ward.
So your initial "panic panic" appointment takes place well away from the bumps (although you do have to go through the main door with new parents taking their babies home ) and you then get transferred downstairs to antenatal, with Bounty and bumps agogo, or next door to gynae.
To be honest it is hard enough being in a waiting room with two other women, and seeing one coming out looking relieved and one devastated.
My first pg I was told I'd mc'd at 7 weeks, went to hospital waiting for a d&c with heavily pregnant women, several of whom had toddlers and small children with them. It was so cruel. It turned out that that pregnancy was actually alive and well (stupid doctor) but it reminded me of a girl I knew who mc'd in south africa where she was put to recover in the labour ward! Horrifically badly thought out.
Our EPU is also in a completely different part of the hospital from the antenatal/maternity ward and the EPU is prior to 12 weeks so no bumps etc. I was fortunate I found ours very sensitive and it had lots of private rooms to wait in. Sorry for everyone who has suffered a loss
The EPU at our hospital is in the maternity unit but separated, and next to a side door and down a quiet corridor. It has its own waiting room. The scans are done in the rooms where all the scans are done, but you get to it via a different route from everyone with bumps, so it has been quite sensitively done.
The staff were brilliant, kind, patient, tactful. And there was even a quiet room where you could sit and recover from the bad news, and it had a little book of condolence you could write in if you wished.
So sorry for everyone's losses
Our EPU handles things incredibly sensitively, but is unfortunately located in the maternity block. I was discharged from my ERPC just as visiting hours started. It was horrible exiting the lift and finding a whole gaggle of excited grandparents bearing gifts and balloons.
What was harder for me though was having to return to the same part of the same hospital when I was lucky enough to have a viable pregnancy. I was an emotional wreck at my 12 week scan as old memories flooded back.
So sorry for everyone's sad losses.
I think children should be banned from EPU's and mums visiting them should have access to any nursery facility on the hospital site t drop them in while they are in the EPU
Indeed soured - I'm going to have to bring DD with me tomorrow as I can't get childcare. Not good for me, her, or anyone else waiting (indefinitely) for their scans.
Funnily enough the ERPCs are in the general surgery ward so much easier to deal with at my local hospital.
I went through this with my first pregnancy which turned out to be an ectopic and it's not a nice experience I can clearly remember one woman complaining cos her baby was due over the Christmas period and although she's wasn't to know who was behind her in the queue it was incredibly frustrating. I have also seen it from the other side with my last 3 pregnancies I can remember being so excited about my 20 week scan and turning around to see a lady crying silently next to me. The only comfort I can hope to give to people in this situation is that the vast majority of woman will go on to have successful pregnancies but I have often thought that the services should be separated.
I'm not sure what hospitals can do about this sort of thing but there must be something. My daughter recently had to give birth to her 27 wk still born baby in the labour ward. Full of screaming mums pushing out lusty crying babies.
She said the staff were wonderful, but the ward layout made things even more difficult.
I am really sorry for your loss.
I have a choice of two hospitals where I live. My first PG ended in MMC and the EPU was just in the same place as all PG assessments it was horrendous (as was leaving the hospital passing two massively PG women in their PJs laughing and smoking outside ) I haven't been back to that hospital since.
I had DS at the other hospital which was fantastic, my next PG ended in an early MC and the EPU there was completely separate, didn't see a later stage PG women and was treated very differently and with compassion...it does make a difference and I wish all hospitals would take note YANBU
Our epu is also for ladies pregnant up to 18 weeks, and as mentioned above i had to sit in the waiting room full of pregnant women with their children, in various stages of joy and sadness. That i could handle, what i couldnt handle was whilst locked in a toilet and actually miscarrying in the very same toilet, a lady decided to bang on the door telling me to hurry up as she was miscarrying also.
I literally couldnt move for crying and pain, so let the banging continue, she didnt even apologise when i did leave the toilet only told me that she was having an emergency, i just said to her what did she think i was there for, a day out?
Then after it was confirmed i was handed a photocopied leaflet abot having a miscarriage and a small packet of tissues.
Been back twice now and the only saving grace was the nurse who did the internal scan, she was lovely, but the place fills me with dread when i think of having to go there.
In our hospital they seem to keep people separate. There are different waiting areas. They also keep the appointments on different times.
I ended up at the pregnancy problems/miscarriages section at 19w (although pregnancy is fine) and the only other people there were there for suspected miscarriages (no I did not ask any but it was quite obvious as every single one came out of the consultant's room visibly very upset).
I felt terribly sorry for them. I think it's done the separation is done quite well; the only thing shared is the hallway and the early pregnancy problem bit (not sure how they call the unit) is right at the end so no prying eyes.
Also when I've had scans done they never seem to overbook. I never have to wait with other people. This is a very big hospital with huge maternity ward so I'm not sure if it's just not a busy time for them.
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