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Miscarriage campaign - next steps

(86 Posts)
JustineMumsnet (MNHQ) Tue 22-Mar-11 11:13:14

Hi all

As many of you will know, we launched a miscarriage campaign a while back to try to do something about the awful experiences that some women (and their partners) have when they miscarry. We came up with a ten point plan, and since then we have been lobbying relevant bodies to get these issues looked at.

Now that we've given the new government a few months to bed in, we reckon it's time we started making a bigger noise about this in government and Department of Health circles. Before we do so, we wanted to run the Code past you one more time. Do these ten points still represent the most important issues, in terms of where healthcare professionals could do better in miscarriage care?

Do let us know your thoughts.

LeninGrad Tue 22-Mar-11 11:49:18

I really wish I'd been handed a leaflet that referred me to MN before I left the hospital to miscarry at home at 13 weeks (routine scan established a missed mc, there had been no development past the early weeks). I got the most help and support at that time from the women on here.

I think they should expectations around cxs and pain for last first trimester miscarriages too, it was much worse than I expected it to be and I din't feel there was anyone I could call or anywhere to go. MN was brilliant.

CMOTdibbler Wed 23-Mar-11 16:59:24

Yes, I think that from the posts on MN, change is desperatly needed. Too many women are sent home with no idea of what to expect, or what to do

froggers1 Wed 23-Mar-11 17:06:26

I had a miscarriage at 12 weeks while living in NZ and over there you have surgery etc in day surgery - I was not exposed to other pregnant women at all. Much better than friends' experiences here. Also the hospital phoned me the next day to see how I was doing.

Yes, they are still points that need addressing. In my experience a couple of months ago;

Access to scanning facilities in the case of suspected miscarriage should be easier. When you know something is wrong it's galling and upsetting to be told your concerns aren't serious enough to be scanned. When I eventually was scanned, my baby had died 5 weeks before, that's 5 weeks of hell I could have avoided. I knew throughout that 5 weeks that all wasn't well but no one wanted to know.

Women undergoing miscarriage or suspected miscarriage should be separated from women having routine antenatal and postnatal care, or women terminating an unwanted pregnancy. IME this is the most important thing. I sat in a waiting room for over 2 hours with massive bumps, newborns and cheery promotional videos. I was waiting for my ERPC. There must have been better places for me to wait.

Consideration should be given to renaming the surgical procedure Evacuation of Retained Products of Conception (ERPC) as many parents find this confusing and upsetting. Every single HCP that I dealt with apologised for the horridness of this term. So why the hell do they use it?

Of course the other points are very important as well but purely speaking from my own experience, the above were the three that upset me the most.

ALovelyBunchOfCoconuts Wed 23-Mar-11 18:03:08

Definitely things need to be improved.

The things that upset me most, after 2 mcs, one natural and one missed, was that I was stuck in a room with pregnant or early labouring women.

If mc begins out of office hours in my county you have to wait to be scanned the next day as the scanners only run 9-5. I was rushed into hospital on blue lights with suspected ectopic at 13:30, was left until 18:30 when I was told it was too late to scan and I had to be admitted and scanned the next day, on a ward with heavily pregnant women. Luckily all was fine. But things could have and should have been dealt with much more promptly.

I had to have the ERPC for my missed mc, and on the day of the "procedure" I found the nurses and doctors to have no compassion whatsoever. One even came up to me cheerily asking what I was in for.

The question I have though is: Is the money there for anything to be put in place? Are they really going to rearrange hospital waiting areas to spare our feelings? Unfortunately I expect it'll be too much to ask to have some compassion for the life we have lost.

swedie Wed 23-Mar-11 18:03:51

I've recently suffered 2 miscarriages in 4 months and have started my own local campaign to improve services. For me the most important thing is to get same day, or at worst next day scan when suffering symptoms of miscarriage. The worst part is waiting for an answer.
I'm not sure if you are aware but Nice are currently reviewing and consulting on guidelines for early pregnancy care. In my opinion the reason so many hospitals have such poor services is because they have no standards to follow so can get away with low funding levels. I'd suggest directing the campaign to Nice so they can set national standards equitable with what you suggest.
Another thought is that services are currently commissioned by pcts, which will be done by gp consortia in the future. These would be good organizations to lobby with these standards.
Finally, MPs will respond to direct complaints from their constituents on services, once the standards are agreed could all of us who are unhappy with services at our local hospitals ask our MPs to lobby hospitals for them.

Havingkittens Wed 23-Mar-11 18:09:29

I think women over, say, 35 should be referred for recurrent miscarriage testing after two rather than three miscarriages. Waiting to get pregnant again and suffering a third miscarriage can take a year or so of an already dwindling window so to find out there was a specific reason for miscarriage that could have been prevented with the right treatment protocol is not particularly helpful if it is too late.

Having been lucky enough to be referred for NK Cell testing on the NHS and having read the leaflet that tells me that Immunity issues account for about 50% of miscarriages, I feel that the NHS should seriously consider making NK Cell testing more widely available. Perhaps not as a first step but certainly as the next stage if no cause is found as a result of the current standard tests available.

Management with tablets should be offered as a matter of course. I have never been offered this option and I have had 4 miscarriages. I would definitely have chosen this over surgery. Also consultants when offering ERPC under local anesthetic as an option should not be allowed to tell you it doesn't hurt. It was one of the most painful and upsetting experiences of my life!

Every single point of the code is totally relevant.
I particularly think the point 4 "Waiting times in confirmed as well as threatened pregnancy loss, but, in particular, for women who need surgery, should be kept to a minimum and not be spent in antenatal or labour ward settings." I waited two days for a scan after losing ds2's twin. It was hideous. I've had several mc's and I'm not even going to start telling you the catalogue of things that could have been improved.
I don't see it specifically pointed out - but I think that mums who have had a mc are far more likely to get pnd, and so should be treated as high risk (without it being discussed too much as a 'likelihood', that they will have it, obv) All the friends I know who had pnd and obviously myself, had both. In some ways it's an obvious link, in others maybe it's not necessarily going to follow. Being monitored would help. That said, your proposal for counselling for those who want to take it, may just avoid it to some degree for some people. In my case nothing worked, and the pnd got worse each time, including after some of the mcs.
I've had 'natural' ones, managed ones, ERPCs, and some when I didn't even see a doctor. It was all horrific and there is no 'right' option. And they trivialise it. I am sure that to an experienced medical professional it may be an everyday occurrence, but it's still my^ baby. They may well see so many that they think "another one" but maybe try to appear that they care a ^bit. And more support during pregnancy for known recurrent mc-ers.
I've never put it all down in one place like this before, but a huge thank you for trying to get something done. I won't need it again thankfully but I think it's essential that mums are treated better than this.

ALovelyBunchOfCoconuts Wed 23-Mar-11 18:54:02

I also think the 3 consecutive mcs needed for a referral is also something that could be looked into, as Kittens had said. I don't think it is fair to change to rules for women over a certain age but across the board. If a woman has had 3 mcs referral should be put in place regardless if a child has been born in between.

Voddy Wed 23-Mar-11 19:01:00

i'll read your recommendations in a sec, but really want to echo wha leningrad says about the agony of a medically managed early miscarriage, ie tablet. I was told, like many others to go home and wait for period type pains. Instead i went home and ended up crawling across the bedroom floor at midnight with full on agonising contractions. Horrific. I've heard many women say the same. This offer to be addressed.

cherrychoo Wed 23-Mar-11 19:08:06

i was the same voddy and was told to get some paracetamol for pain.

so when i had pain which were contractions and went to hosptial for gas & air, morphine, tramadol and co codamol...i thought i was dying.

It isnt "period pains" which is what i have been told for all 5 of my mcs.

period pains does not even come close.

Voddy Wed 23-Mar-11 19:08:33

This needs to be addressed.

Also, the nurse who was working that night in the Women's Hospital told me it was very common for the contractions to be so excrutiating due to the womb contracting but there being virtually nothing (at that stage pregnancy) for it to contract around.

The Code is you have put together is excellent.

cherrychoo Wed 23-Mar-11 19:12:41

Yes, proper pain control should be a consideration for women while miscarrying. When ladies are deliviring after 24 weeks, there are no restrictions on pain relief.

I don't have anything to add but I want to be on this thread. I agree with all that has been written.

Sympathy and tact are so important.

LAF77 Wed 23-Mar-11 19:23:09

I'm so glad the sensitive comments was mentioned first. There should be a way to communicate that is honest and direct. Miracles do happen, but they should say, the likelihood is not good for your pregnancy if things don't seem to be right. Don't give false hope or be all doom and gloom. There has to be a better way of handling it. You shouldn't leave the EPU wondering what is going to happen next when you are miscarrying or threatening to miscarry.

The horrible things that were said to me at the local EPU will stay with me forever. "Women these days have early miscarriages instead of late periods" during my first miscarriage. Also, having a medical student in the room and the EPU nurse whispering to him whilst I was dressing after the scan in what would result in my third miscarriage. They weren't honest with me at the follow-up scan when they said that the heart rate was slow and the growth rates weren't fast enough. After I wished her a Merry Christmas, the nurse told me "I would wish you a Merry Christmas, but..." I didn't know what was going to happen. I had to go home and google it and realise that I was going to lose my pregnancy sooner or later. They insisted I come in for a follow-up appointment in the new year after I lost it. I said that it wouldn't be necessary as I had been through all of it before. When I arrived, they wondered why I was there and more or less accused me of wasting their time. It still makes me angry, three months on.

Good luck MN in giving us our dignity during one of the darkest moments of our lives.

Havingkittens Wed 23-Mar-11 19:42:38

coconuts - Ideally, yes they should test across the board. I only said over 35 because I suspect they have a limited budget and that maybe if they wouldn't consider allocating the budget for general testing they may at least consider it for those on a 'time limit'.

I didn't realise medical management was so awful, hence my comment earlier. I have known a couple of people have medically managed abortions for their unwanted pregnancies, (which I'm not sure if the same form of tablet as that prescribed for miscarriage management) and not suffer that badly at all. I assumed it would be the same form of medication as essentially, despite the emotional motivation, it performs the same function. Perhaps they were lucky with their physical reactions. Sorry to mention abortion in this thread, I don't mean to be insensitive. It's just that I have always wondered why they didn't deal with missed miscarriages in the same sort of way rather than surgery, which carries risks of uterine scarring and possible fertility problems as a result.

iggi999 Wed 23-Mar-11 19:59:49

Any mention of counselling or other support would be a start. I was fortunate in having already discovered MN before my mcs stared, don't know how I'd have coped otherwise. No mention at all was made of this by EPU or GP, the Miscarriage Association or SANDS could have been brought up but nothing was.
I think the points are very good. We have a good EPU but it is in the same place I went into to have my DS. Not nice at all.
The one I doubt anything will be done about is in relation to testing. I imagine scans and ERPCs cost the NHS money, so couldn't some blood tests actually save them money?

Voddy Wed 23-Mar-11 20:04:24

I think maybe it's like birth, Kittens, everyone's experience can be different. I have read on here about women saying that it was like quite bad period pains. But honestly, the pain I experienced literally floored me. The contractions I experienced on synoticin (sp) during induction were about the same level of pain. My husband was traumatised from the drive to hospital - I was vomitting, wetting myself blush and contorting all over the car trying to relieve the pain. Like Cherrychoo I ended up with gas and air, morphine, tramadol etc.

We just were not prepared for it and he thought I was dying or something shock

InMyPrime Wed 23-Mar-11 20:21:26

Just wanted to second some of the comments here and add support to the campaign. It's a great idea to keep pushing for this Code to be implemented in all NHS hospitals for all women. Two things in particular:

1. The waiting room area - there REALLY needs to be provision made for women who may receive bad news from a scan or have received bad news and are waiting for a post-loss scan or are waiting for an ERPC. Instead of lumping everyone together they should take special care for miscarriage and treat it on the gynae ward only. I had a MMC at 11+5 and had a really horrendous natural miscarriage where I ended up in A&E. When I was waiting for my scan the next day to ensure that everything was clear, I had to sit in a waiting room full of women in later pregnancy, happy couples walking out with their healthy scan pictures etc. I actually broke down and got very upset with the staff - that can't just have been upsetting for me but also for the healthy people waiting and for the staff as well. There has to be a more intelligent way of handling this.

2. Realistic expectations about natural miscarriage: like Voddy says above, natural miscarriage at a later stage can be extremely painful and a few ibuprofen or co-codamol, as I was given, won't cut the mustard. DH and I still laugh bitterly about the '2 to 4 hours of intense pain' mentioned in the NHS information leaflet. More like 8 hours of intense pain and 4 hours of real contractions that had me crawling around on the floor screaming. I was in total shock and thought I was dying or haemmorraghing because the pain was so horrendous - nowhere near '2 to 4 hours of intense, period-like pain' - but when I finally got to A&E and saw the consultants, they said that my level of pain was not abnormal and is common for MC at that stage. The gynae nurses said the same thing. If that's the case, why not warn people so they can make an informed choice instead of pretending that natural MC could be managed at home with ibuprofen, as the leaflet claims? It's a difficult situation, I appreciate, because doctors don't want to scare or upset you but really bad pain is a possibility with natural, later MC and people should be aware of that.

Anyway, keep up the good work. I think some of the points on the Code are being implemented already e.g. on understanding that MC is a bereavement and on access to scans but it seems like there is a still a lot of variance between hospitals.

pecanpie Wed 23-Mar-11 20:25:39

Mixed day wards (UCH - London) are not an appropriate place for patients coming in for ERPC procedures. .

Yes, the pain point needs to be addressed. I think that could be covered off in the leaflet but really, if you decide to have a natural MC, they should prescribe some bloody good painkillers. I was in agony on and off for three days which really wasn't what I'd been led to expect

ClaireDeLoon Wed 23-Mar-11 21:09:11

Completely agree with comments about pain. Usually described as 'like strong period pains'. Yes, they can be like that, my first was, but my second was agony. I have never had pain like it. Proper pain relief needs to be prescribed so it's on hand to take when needed.

When going in for ERPC they should ALWAYS give you the option to have your partner sit with you.

Supersunnyday Wed 23-Mar-11 21:09:54

Agree with all the points raised, though I didn't experience all of these issues in my own care when I had a missed miscarriage (no bleeding before 11.5 weeks).

I think it is very important to ensure that ALL staff, not just medical staff understand how terrible it is to lose a much longed for and loved baby. A lot of the problems I experienced were caused by uncaring and rude admin staff.

For example, on arriving for a scan having been told already that there was an 80% chance our baby was not viable, I was greeted at the arrival desk by a receptionist with a monologue relevant only to someone expecting to see a live baby, including the unit's policy on "baby photos". I explained very politely and gently that it was highly likely that our baby had already died. The staff member then snapped the price of every "baby photo" package at us regardless. This left me in floods of tears in the waiting area as all the happy parents went in and out to their normal scans.

We found a number of the receptionists in EPU to be unsympathetic, rude, impersonal and snappy. I appreciate they have a high stress job and that they must become to some extent used to the personal tragedies they see each day. However, I cannot believe they could have been properly trained given some of the treatment we received. By contrast all the medical staff were very compassionate.

I am also unsure how up to date some of the medical advice is and this is perhaps something that could be raised in the code? The MIST study of miscarriages has a huge amount of data on the success rates of each method of management, but the information I received did not seem to completely tally with this. For example, I was told that the likelihood of complete natural miscarriage after a missed miscarriage was 50%. From the MIST study I understand it to be only 25%. Had I been told this I would not have waited until 13.5 weeks for a natural mc before opting to have an ERPC.

Waiting times have to be made shorter. After opting for the ERPC at 13.5 weeks I was told it could not be done until 15.5 weeks.

onadietcokebreak Wed 23-Mar-11 21:28:28

Definately separate waiting areas.

Staff need to step away from the medical model when dealing with loss and recognise that it's indiviual to each person.

Voddy Wed 23-Mar-11 21:39:23

i'll read your recommendations in a sec, but really want to echo wha leningrad says about the agony of a medically managed early miscarriage, ie tablet. I was told, like many others to go home and wait for period type pains. Instead i went home and ended up crawling across the bedroom floor at midnight with full on agonising contractions. Horrific. I've heard many women say the same. This offer to be addressed.

Voddy Wed 23-Mar-11 21:40:00

i'll read your recommendations in a sec, but really want to echo wha leningrad says about the agony of a medically managed early miscarriage, ie tablet. I was told, like many others to go home and wait for period type pains. Instead i went home and ended up crawling across the bedroom floor at midnight with full on agonising contractions. Horrific. I've heard many women say the same. This offer to be addressed.

Voddy Wed 23-Mar-11 21:40:41

i'll read your recommendations in a sec, but really want to echo wha leningrad says about the agony of a medically managed early miscarriage, ie tablet. I was told, like many others to go home and wait for period type pains. Instead i went home and ended up crawling across the bedroom floor at midnight with full on agonising contractions. Horrific. I've heard many women say the same. This offer to be addressed.

bosch Wed 23-Mar-11 21:46:41

Not sure that I can add anything to your recommendations, they look pretty impressive to me.

Sometimes, you just want people to be brave and honest in their approach to you. When I had my second mm/c, (v early, died a day or two after early scan had confirmed that all was going well) the foetus came out when I was on the toilet and I picked it out and took it to hospital the next day, as I had appt for a scan to check if m/c was progressing. Nurse gave me to believe there would be some examination of the foetus, which gave me false hope that I might get an explanation of what went wrong. When I returned to hospital a few days later for follow up scan, a different nurse told me that any examination of what I brought in would be limited to determining if it was the foetus or not. I felt enormously disappointed that all they'd done was cut it up and throw it away. I wish the first nurse had been a bit more direct, and not got my hopes up.

SGertie Wed 23-Mar-11 21:55:35

I agree with the need separate waiting areas and more understanding staff. On my follow up scan to check if my natural mc had progressed ok, the sonographer didn't look at my notes and asked me how many week pg I was. I'm not sure it's a mistake she'll make again after my reaction blush

SGertie Wed 23-Mar-11 22:00:24

I should have said, I think MN have hit the nail on the head with the 10 points.
You have reminded me my (locum) GP told me to call the maternity hospital to cancel my appointments sad

MmeLindt Wed 23-Mar-11 22:04:45

Very good recommendations.

I am interested in the fact that women in UK are advised to wait for a natural miscarriage. Where I was (Germany then Switzerland) this is not done, an ERPC is done as a matter of course. Presumably this is a cost issue though.

It has always seemed exceedingly cruel to send the woman home and tell her to wait until it happens naturally, without making it clear how long this could take, and how bad the pain can be.

TheSleepFairy Wed 23-Mar-11 22:13:49

The 10 point plan is so upsetting to read as I recognise every point made. I've had 6 mc's & I have never been offered anything other than an erpc.

I have never been pffered an option other than "the hospital dealing with remains" I didn't even know I had a say - that hurts me now even after all those years.

I remember camping outside EPU with a bottle of water & refussing to leave until some one scanned me & put me out of my misery.

I wish I had known about MN back then.

I felt like the staff had seen it all before & couldn't give two hoots that it was me again sad

I just wanted to add that any appointments that had been made for following weeks & months were left in place & I received countless reminders for scans & consultant appointments even though I rang the departments & told them we were no longer with child - would it take a member of staff that much longer to ensure through patient care that records are updated when the patient is discharged and appointments cancelled within the hospital?

FunnysInTheGarden Wed 23-Mar-11 22:24:57

women should be encouraged to opt for ERPC (for want of a better term). It is no good to say to an inexperienced woman, 'do you want to wait for it to happen naturally?' You have no idea with your first what it entails. I was very lucky and with both mine, had an ERPC without any discussion, because it was the right thing for the hospital to do. It is bad enough as it is, without having to wait for the baby to miscarry.

mnistooaddictive Wed 23-Mar-11 22:26:01

The worst thing for me in my 4 mc was due to a foreign doctor with poor English, her description of erpc was we will take a spoon and scrape out the bits from your womb. That one sentence still has me on years 7 years and 2 children later. I am not racist or against immigrants, quite the reverse but her poor choice of language caused me emotional harm. Also the other doctor who was do busy telling me about returning from India for her fathers funeral she didn't have time to answer my questions about m/c. Ininderstand it was traumatic for her but I was also suffering. These these can't be legislated for.

mnistooaddictive Wed 23-Mar-11 22:27:22

Funnys. With my first m/c I was told to have an erpc and being new to this whole thing I did it as I didn't know better. It was unnecessary, I had already told them I gad passed everything already.

FunnysInTheGarden Wed 23-Mar-11 22:29:28

Havingkittens I can't believe that you had ERPC with a local, that is horrific. I had a general with both of mine, and no discussion about any other option for which I was eternally grateful.

kat2504 Wed 23-Mar-11 22:34:10

Very good work on this - well done. There are so many issues that need to be looked at.

The most important is realistic expectations. A few hours after ERPC I was discharged, expecting a period-like experience of bleeding and cramps. like a heavy period is what I was told. 48 hours later I was re-admitted to hospital overnight with agonising pain requiring tramadol, and much heavier blood loss than I have ever had in a whole period, let alone in a few hours.
I didn't need to be in the hospital. I could have been prescribed decent painkillers and told what to expect. The reason I ended upin A and E is because I was scared as it was not what I expected. I was also never warned about passing clots.

When I went in for the ERPC I was treated very sympathetically by the staff and we were given a private room where my partner could wait with me. However, before this point we had to spend about an hour sitting in a big waiting room outside day surgery area. I was petrified at this point and it was hard to keep it together in such a public place.

I found the EPU to be very sympathetic and they took a long time to talk to me. The people who dealt with me were very kind. I wish I hadn't had to wait so many days before the ERPC, I know it isn't technically urgent surgery but it was so horrible to know you are carrying a dead baby inside.

I also think women need more realistic expectations about their emotional recovery and to be provided with sources of help with this, such as counselling or support groups. I was given a leaflet along with the standard We are sorry you had an mc leaflet about a support group but when i saw a doctor 6 weeks later for a check up I was never asked about how I was doing emotionally. Obviously I could have brought this up myself I know, but it would have been nice to have been asked.

not having separate waiting areas is clearly unacceptable. If the EPU is not open for a scan there must be somewhere else apart from the maternity ward. surely emergency gynae ward have a scanner?

ClaireDeLoon Thu 24-Mar-11 09:28:14

Kat the problem is that there may be scanning equipment but nobody competent to use it. That's certainly the way it is at my local hospital, it's a complete waste of resources.

Rainbowpenguin Thu 24-Mar-11 09:30:58

I totally support mumsnet in this campaign. My 1st mc at 13 weeks was the easiest one as the hospital were a lot better. I went into A and E on a Sunday, was scanned within a couple o hours. Then I was told I would have surgery the next day. They also gave me a private room on a gynae ward and let my friends and family visit whenvever they wanted.
My 2nd miscarriage was handled appaulingly. I started to bleed and went to A and E, and they made an appointment for me at EPU for 5 days later. Tehy told me to come back if the bleeding returned. It did so I went back on a bank holiday and they were horrible to me, they treated an abusive drunk with more compassion than me. I never even saw a senior nurse, they left me with a student. The senior nurse popped her head round the door as I was being told I was going home.
I went back the next day as I was developing pain and they were a lot better they actually kept me in hospital. It was a good job really as I ended up miscarrying naturally and I haemorragged. I didnt realise that I would experience contractions and how similar it would be to a birth. In the end the baby got stuck and the Dr had to remove it while I was on the ward. If I had been at home I would have become very poorly and my kids would have seen what was happening.
I had so many inappropriate comments from staff it is unreal.
The most important thing for me is that hcps treat miscarriage very flippantly, it is not acknowledged as the loss of a baby and they all completely ignore the fact that it is such a horrendous experience. A little compassion would have made all the difference to me.
In hospitals now, they are veering away from the surgical option and promoting medical management for miscarriage. They are doing this WITHOUT explaining fully what the process of medical management involves and what will happen. I have met so many mums who have had this option but have been so traumatised by the experience and the thing they comment on the most is that they didn't realise how traumatic it would be. They are not prepared and when they are left traumatised there is no follow up or opportunity for counselling leaving many women to try and come to terms with it on their own in an environment that doesn't accept how traumatic miscarriage is.
If I can help in anyway with the mn campaign I will!!

InMyPrime Thu 24-Mar-11 10:06:16

Glad (in an odd way) to hear that I'm not the only one who experienced extreme pain and had to go to A&E. It seems to be something that very few people are honest about. Just to clarify as well, part of my problem was the waiting time for ERPC. I had my scan on a Thursday and took a while to make a decision to go for ERPC as I was scared of the risks of surgery. When I did decide on the Saturday, they couldn't get me an ERPC appointment until the following Friday so I ended up going the natural route, not out of choice, but just because it happened anyway. ERPC is the way most countries handle MMC, as MmeLindt says above, so I am pretty appalled to hear that some hospitals are going the route of encouraging natural or pill-induced MC to save costs.

I think one of the biggest issues is that hardly anyone who hasn't had an MC, particularly an MMC, has any concept of how traumatising it is. I didn't either, to be fair, until it happened to me. It's hard enough to deal with people's ignorance in the general world e.g. at work but really the medical profession should be more informed.

florizella Thu 24-Mar-11 10:53:23

Hi.. I've just joined mumsnet for this particular campaign.

I got pregnant after 3 years TTC and miscarried after 9 weeks (empty sac). The nurse commented that the sac was very small and was I sure I was 9 weeks? To which of course I said I was definitely sure, but they said no more.

I miscarried again after 6 weeks, I was told then not to try for a baby for another 3 months, I was 34 at the time, and not willing to wait for so long, when I said this to the doctor, she commented that if I miscarried again then perhaps I would know why.
When scanned, again the comment was that nothing was visible, and was I sure that I had been pregnant at all? Again I said I was sure, again nothing came from this. After these, I demanded some further testing for why I was not conceiving or keeping babies, and the doctor gave in and gave me a referral. Blood testing showed I was pregnant, but I had a 'period' at 4.5 weeks as usual. Further testing showed I had Factor V leiden (symptomised by small sac growth and slower develpopment), and suspected protein S deficiency. It seems likely I am miscarrying multiple times at 4.5 - 5 weeks. However, the NHS will offer no treatment for this, despite some evidence from the US that anticoagulants can help if given before conception.

I too had to deal with incredible pain during miscarriage, being blamed by medical staff, and sharing wards and waiting rooms with healthy pregnant women holding scan pictures of babies.

Please please please can MumsNet help improve care for women like me!

CuppaTeaJanice Thu 24-Mar-11 11:33:34

Grrr....wrote a long post then the internet connection crashed.

I think the booklet that they give you when they confirm a MMC needs to be significantly improved, with specific detail about the physical processes of a miscarriage. Just vaguely saying 'it's like a heavy period' isn't particularly helpful to someone who (without going into detail) has used up five toilet rolls in twenty minutes and passed out on the toilet. It's not nice stuff to read about but people need to know things like the range of normal blood loss, the possibility that 'product' can get stuck, cervical shock, the pain issues described by posters above that thankfully I avoided.

And yes, a link to Mumsnet would be great. I don't want to join an association where I'm going to be sent a magazine about miscarriage every 3 months, just to remind me of the horrors that have happened, yet this was the only 'support' system suggested.

CuppaTeaJanice Thu 24-Mar-11 11:38:16

I should probably add that I was very lucky with my EPU. They only had scanning available mon-fri 9-5, but that is my only criticism. The staff were great and very compassionate, and there were no obviously pregnant people there. In fact I was surprised at the high numbers of geriatric women for an early pregnancy unit - I can only assume they did general gynae stuff too.

Shame other hospitals can't be so good.

swedie Thu 24-Mar-11 12:16:50

Have got a campaign suggestion, apologies if I'm over stepping the boundaries of the feedback you're looking for.
In the research I've done into this topic following complaints I've made locally I've discovered that my pct doesn't give out funding for epu specifically but it's part of the wider gynae funding. Nor does the pct specify what epu services the hospital must provide. I think it's a combination of this non existent commissioning and the lack of Nice guidelines that have led to such poor services.
Can I suggest that a way to really demonstrate the poor services miscarrying women receive and the inconsistencies in provision nationally would be to put a freedom of information request to each pct asking what level of activity the commission for epu services and what funding they make available.
I think we'd see real evidence then that this is an under funded, under resourced service and that's why mumsnet is having to tell clinicians what women should get.
Another one who'd be happy to help with the campaign here.
And my thoughts are with all of you who've had such appalling care.

MummyAbroad Thu 24-Mar-11 13:29:26

I think it would be helpful if this part read

"What each option involves and the likely timescales, and risks for each should be explained clearly, sympathetically and honestly either by trained medical professionals or in a leaflet."

I had an ERPC on the NHS and later discovered that I had Ashermans Syndrome (scar tissue on the uterus caused by surgery) which caused a miscarriage, then complete infertility (no periods) and I then needed very expensive private surgery to correct it.

I also think that whether women have a natural, medically managed miscarriage or an ERPC there should be a mandatory check up a few weeks afterwards with your GP/EPU/hospital where the woman gets to discuss any issues resulting from the mc, and has a chance to ask for a scan if necessary to check the uterus is now clear. At the moment there is no follow up of mc Why not? There are a huge amount of women who suffer from complications after mc (retained tissues, infections, molar pregnancy, ashermans) that are simply being ignored. There should be a formal appointment where women are assessed to see if they have any of these complications, and are given a chance to have their questions answered.

Thank you MN for running this campaign, its a fantastic idea.

ttalloo Thu 24-Mar-11 13:46:18

I think this is a brilliant campaign. The code is great, although I support an earlier suggestion that women over 35 should be checked out after two, rather than three MC because of the drop in fertility after that age, and that three MC should be investigated even if there have been successful pgs in between.

I also support the need for follow-up scans after an MC. I had an ERPC after my second MC, and when my first period after that lasted for three weeks and produced heavy blood clots that flooded my clothing, my GP wanted to give me antibiotics for an infection, and the hospital didn't want to know. It was only when I gave it up in despair and had a private scan that I learnt that the ERPC hadn't been done properly.

Part of the problem is having to cope with:
general stupidity in medical staff (like the midwife who rang me at work after my first MC to ask whether I still wanted my 12-week scan because she saw from their records that I had had an MC four weeks earlier);
insensitivity (a gynaecologist who told me when I was bleeding heavily and experiencing what I now know to have been labour-like cramps that he had seen women in worse condition than me go on to have a healthy pregnancy - I went home and passed the foetus in the loo an hour later);

Probably the code can't do much about that, but at least if it empowers vulnerable women to stand up for themselves because they know that they have rights, it might go some way to making people think twice before they do or say something that makes a terrible situation worse.

harassedinherpants Thu 24-Mar-11 13:54:29

This is a brilliant campaign!

I'm currently experiencing my 3rd mc (2nd this year), 2 natural and one mmc & erpc. No one explained to me that there was any option with the remains of my baby after the erpc. This was only in January too. I was devastated to subsequently find out that we could have had some options, and feel that I let my baby down.

I'm also sick to death of the whole "it's one of those things" mentality. Even yesterday when I was talking to the doctor after receiving my blood test results to confirm my mc. She said they won't do any tests until I've had 3 mc's with my dh (1st was with ex), but I've now had two in a row, there's obviously something not right.

I think miscarriage, and the effects on women and our families, really needs to be brought out into the open more. I've seen people of knew I was prg and mc'd totally ignore the fact, and in some cases ignore me! I put it down to ignorance of the facts and a kind of embarassment similar to that surrounding mental health issues.

ChessPiece Thu 24-Mar-11 15:25:33

When in for a scan for a successful pregnancy, I had a sonographer casually remark while reading my notes, "One miscarriage, that's right is it?", without even looking up at me.

As it happens, dh hadn't known about it and was devastated. I also felt the way she spoke was disrespectful and insensitive. My child died!!!! In any other context a professional would hopefully handle that sort of conversation with great delicacy and not just blurt out the bald fact with no conversational context or kindness. A mc is a bereavement not a bundle of cellular matter. angry

I must admit I was utterly ignorant that women are sent home to manage a miscarriage on their own. shock Are there perhaps some women who feel comfortable about this? Sorry, I can only imagine myself doing this and am freaking. Objectively speaking, it seems bizarrely callous.

Fantastic campaign MN. Will hopefully do so much to stop adding to the pain of women suffering miscarriage.

JustineMumsnet (MNHQ) Thu 24-Mar-11 16:08:03

Thanks for all the input/comments. We're going to keep this thread stickied for a couple more days to allow everyone a chance to input. So do keep the thoughts coming.

Hospitals really need to have a better policy to deal with women who come in at the weekend too. I was taken to A&E at 15 weeks on a Saturday with heavy bleeding and the registrar who used a doppler on me couldn't find a heartbeat and told me my baby had died (he was very sympathetic though). BUT he hadn't died (he's now 4!) but I spent an agonising weekend until I could go to the ERPC and have a scan. If people don't really know what they're doing (and I know it's hard to find a heartbeat sometime with a doppler) then really they would be better off telling women they just don't know and to wait.

libelulle Thu 24-Mar-11 18:55:33

I still find it amazing that scanning is not available more readily in cases of suspected miscarriage, and that the expectation is that you'll just go away and see what happens, possibly waiting weeks and weeks to find out if you have miscarried. I've suffered heavy bleeds at 5 and 9 weeks in both my successful pregnancies, and each time have had to argue my case for getting a scan to see what was going on! Last time the (lovely) A&E doctor said she actually had to bend the rules to get me an ultrasound as it 'wasn't policy' to give 'reassurance' scans!!! The idea was that I'd wait nearly four weeks until the 12/13 week scan to find out if I still had a viable pregnancy. I find that just disgusting. How hard would it be for every A&E to have a mobile ultrasound machine available 24/7?

This code is great, I agree with all of it. The only thing I would add is that there should be a routine follow-up for those that are having a natural MC. I bled for 5 weeks, and eventually went back to the EPU to discuss it. Luckily the gynae went above and beyond and examined me and found a big lump of tissue blocking my cervix and causing me to retain. If he hadn't checked though, I have no idea what would have happened. I also agree being told about mumsnet would be really helpful - I happened upon it by accident and it has been an absolute lifeline.

harassedinherpants Thu 24-Mar-11 20:18:55

Just coming back with some more thoughts after seeing the doctor to beg for some tests this afternoon.

Follow-up care: there is none! Nothing after my erpc, and there will be nothing after the one I'm going through now except they want me poas in a week and let them know the results. Not only is it scary not knowing what's going on, but people don't seem to realise that we're grieving for the loss. There's no medical follow up and no offer of counselling.

Three consecutive mc's in order to get referred for testing. Only someone that has never had the misfortune to have gone through a mc would have set this..........

I am pleased to say that my experience ticked a lot of these boxes, but would have been so much worse if this is not the norm.

Good luck, mumsnet, I think you've articulated it beautifully.

MadMommaMemoo Fri 25-Mar-11 00:44:51

I've said this before but can this be extended to include women who have an ectopic pregnancy??? I feel that we get forgot sometimes. I was treated dreadfully and some of the things said to me were at best insensitive but at worst down right cruel.

luciemorgan3 Fri 25-Mar-11 05:59:52

I agree with every thing you have put in the code. i had a mc at 14weeks ,i found the staff at the hospital to be cold, i was sent home and told to 'rest' with nothing to help with the pain, next day rushed bk in and found the trement to be the same! i had to wait 5 days for a scan and found it very hard to sit in a waiting room surrounded by big bumps and smiles, i had no after care and found informing doctors/midwife heart breaking.

emmanumber3 Fri 25-Mar-11 10:28:03

I have to say that, reading other people's experiences here, our local hospital is at least making an effort. 10 years ago when I had to go to the EPAU for an early scan with DS2 it was basically a side room of the maternity ward. Luckily for me, everything was fine but clearly, a lot of the women being seen there weren't going to be so lucky. When I had a missed mc last June & had to go to the EPAU again, I was pretty thankful to see that it is now part of the gynae ward instead - much more appropriate in my opinion. I didn't have to go through the ERPC in the end as my body "dealt with it" naturally at about 13 weeks, however, at our hospital patients having ERPC procedures are cared for on the gynae ward - not in the maternity unit.

Also, I was offered so much advice by a very lovely gynae ward sister that I really did feel well supported & cared for. I just wish that everyone going through MC could have the same level of care sad.

I am now pregnant again (18+5) and am absolutely terrified that something may go wrong again. The midwives & staff at the antenatal clinic are lovely though - they seem to really understand why I might be worried smile.

MadMommaMemoo Fri 25-Mar-11 12:39:49

Does anyone else think this should be extended to include ectopics or is it just me?

Havingkittens Fri 25-Mar-11 13:09:55

Yes, I totally agree MadMomma. Especially as, given the risks involved, it is shocking how many people are refused an immediate scan in these cases.

Unfortunately there is even less support for things that are less commonplace, like ectopics, molar pregnancies, and also for those who have had to make the horrible decision to terminate a pregnancy after finding their baby has certain conditions incompatible with life (or even full term pregnancy). All of whom are feeling pretty shell shocked and devastated, with little access to information/counselling etc. and also don't want to be hanging around in waiting rooms with misty eyed, smiling pregnant ladies whilst dealing with their own heartbreaking reality.

These are all cases which should come under some of these codes of practice. Obviously not all of the points are relevant to those who have had terrible situations to deal with after a bad Nuchal/CVS result but these are also people who are suffering from the some of the same emotions, who need to be dealt with with similar tact and tenderness.

RoobyMurray Sat 26-Mar-11 00:01:19

MC is not akin to a bereavement. it is a bereavement.

lemonsquish Sat 26-Mar-11 00:12:30

I was left in a room on my own for about an hour after my scan said that there was no heart beat. It was over 12 years ago, but I can remember every minute! It was as if noone knew what to say, even though i was on a maternity ward. It turned out that it was a molar pregnancy, but I had no idea that they would test for anything, or what would happen to the products of conception. Luckily things are different now, and mothers have a choice in what happens eg cremation or hospital disposal. I wish I had had that choice.
With my subsequent pregnancy, after going through 2 years of screening following the molar pregnancy, I found that the consultant didn't take any fears I had seriously esp early on. When I asked for an early scan he just said 'I'm sure everything's fine' and I had weeks of worry that something was wrong. Thankfully everything was fine and I had a perfect baby girl, but all through the pregnancy I convinced myself that something was wrong.

Message withdrawn

WuzzAndBuddy Sat 26-Mar-11 10:04:38

Oh reading people's experiences here just makes me feel so sad.
It highlights just how badly the system is failing us sad

I've had a missed miscarriage, a molar pregnancy, then DS and then a miscarriage, in 6yrs.

I had a molar pregnancy 5yrs ago. When I went for my 12wk scan I was asked if I was sure I was pregnant... hmm There was 'nothing' there...
We'd seen a heartbeat at 6wks and had to convince the sonographer in the same unit we'd had the previous scan that we'd seen a baby at 6wks and yes, I was very sure I hadn't had any bleeding!
That was in the November, I had an ERPC a week later but no one explained why my baby had vanished. 'Its just gone, it happens sometimes' was the explanation I was given.
Two months later I received a phone call from Charing Cross hospital informing me I'd had a molar pregnancy and would need to have a follow up appointment.... 2 months later...
My local hospital were clueless about molar pregnancies, no one even mentioned it.

My last miscarriage, in November was really difficult as DH was away, he's in the Army.
After a week of bleeding I had a scan and was told I'd miscarried.
Then I went through to another room to be 'counselled' by a nurse.
She said 'Oh it must be very hard for you... but you can try again when DH comes home!' and 'A lot of girlies have many miscarriages between healthy pregnancies.' and then finished off with 'Would you like some leaflets?' hmm
I would have much preferred some preparation for what was still to come, what I was going to have to deal with on my own... none of my previous experiences prepared me for actually seeing what I'd passed sad
If I'd have known I would have opted for a ERPC given my circumstances of being on my own...

Then a few days later I was called by a midwife wanting to book 12wk scan, I told her I no longer needed one.
Then the week between Christmas and New Year, I had another call from the same midwife asking if everything was ok as I'd not turned up for my scan that morning. Totally not what I needed.

I'm so pleased MN is prepared to do something to highlight the problems with the system.
The ten points are great, I will support the campaign right through to the end!

FromGirders Sat 26-Mar-11 20:51:43

I'm very lucky to have had no personal experience of miscarriage, but just wanted to offer my support.
Those ten points seem like a very reasonable list of expectations. In fact I'd have thought they were a minimum level of decent care.
So sad reading the horrible experiences some of you have had sad.

stream Sun 27-Mar-11 02:54:28

Stronger pain killers should be given to women expected to miscarry at home. It hurts a lot more than you think it will, even for an early miscarriage.

For those women who want it, examination by a geneticist after a miscarriage, to determine the cause. I had this done, through my GP. It was the overriding thought in my mind.

Message withdrawn

Message withdrawn

WuzzAndBuddy Sun 27-Mar-11 09:56:28

Oh Swallowed thats awful! sad
I don't think people realise just how much these experiences affect us, how they affect subsequent pregnancies. That bad experience stays with you forever sad

Message withdrawn

emmanumber3 Sun 27-Mar-11 23:22:51

I agree swallow - I had a MC in June 2010 & am now 19 weeks pregnant again. I spent the entire time from the positive pregnancy test to my 12 week scan convinced that something would be wrong again (last time was a missed miscarriage, so only picked up at the 12 week scan). An early scan would really have helped & saved me alot of stress & worry. I'm fairly confident that things are going OK now as the physical signs are all progressing normally - but in the early weeks when there can be few signs, it can be very hard to be positive.

emmanumber3 Sun 27-Mar-11 23:24:47

P.S. I was also given the "before scans women just had late periods, not early miscarriages" like that was supposed to help. Seeing as how early scans are possible I would have liked one!!

WuzzAndBuddy Sun 27-Mar-11 23:51:52

I'm 6wks pregnant now, that 'worry' is back again, although not the same as last time. In november I just had a feeling I was going to miscarry, this time round it really feels different. Fingers crossed.

With DS I didn't enjoy my pregnancy or believe that I was going to get a baby at the end of it. I was just pregnant, I never said 'I'm having a baby', think it was self preservation, stopped me getting hurt if it went wrong sad

'Late periods'?? Bloody hell, how insensitive shock
Even if thats what it 'technically' is, to the woman (and man) its their child sad

Message withdrawn

Twit Mon 28-Mar-11 13:23:16

I want to add my support to this.
I had a MMC which was picked up at the 12 week scan, it had died perhaps a week or so earlier, and I was suffering from HG. I was taken up to the Maternity unit to be re-scanned in the same room they do the 20 week scans, so surrounded by happy bumps etc.Then I was left for 2-3 hours in a room on the maternity ward (constantly throwing up).
Eventually I was seen, told my options, and dismissed.
I went in to be rescanned internally a week later (again in the maternity unit) and given the tablets and told to come back in two days for the pessary (to the day ward).
I was still throwing up, barely managed the tablets and the consultant wrote, clearly so I could see it, abortion (for why I was having treatment). I made her change it to MMC but she was pissed off about it. It was important to me though.
I was told DH would have to drop me off as it was a female ward so I would have to lose the baby alone. We got there and i was throwing up, bleeding and in pain - the sister talking to me and giving me the pessary was lovely, and kept checking on me until her shift ended.
But the worst thing was listening to the nurses at the station, with everyone's notes in front of them merrily chatting about some-one they knew who had just had a baby. On and on they went, before sticking their hed around the curtain and asking me if I wanted a paracetamol for the pain. (Er no, something stronger would be great and you shutting the fuck up ) before resuming the conversation about pregnancy and babies.

digitalgirl Tue 29-Mar-11 23:36:38

I can't fault the way I've been treated by my hospital for my miscarriages. I remember reading the code when it was first brought up by MN. I hadnt miscarried then. So when my first two miscarriages happened I knew what to look out for. I made sure I went to a&e on a weekday and was scanned within a few hours. After that they told me I could just call the epu direct for an early reassurance scan from 6 weeks, no need to be referred by my gp.
After my third I was referred for recurrent miscarriage testing. It was at this point that I was at my lowest - as lovely and sympathetic as they were I had to wait two cycles before I could be tested, different to what others had been told at different practices/clinics. The wait for testing and the results was torture - if anything could be done to improve testing backlogs/conflicting testing conditions that would be great. I also think testing for causes of recurrent miscarriage should be done after the first miscarriage. The hormone tests, clotting tests and a thorough scan of your uterus - none of these cost much and you could save a lot of heartache as well as give couples the confidence to try again knowing they'd ruled out the most obvious reasons. Doctors don't wait till you have three strokes to begin investigating the cause, I don't see why three babies should die before investigating. Incidentally all my tests came back clear (so I'm having some extra ones done privately).
With my fourth there was lots of sympathy but unfortunately no further testing or treatment to offer. I may never have an answer as to why I keep miscarrying but at least I can feel confident that my local epu will treat me with respect and dignity.

Likethisandthat Tue 29-Mar-11 23:41:55

I just wanted to add my support to this campaign. I have had 2 mcs, and the first, which was also my first pregnancy, was appaulingly managed.

However, both my mcs happened naturally and at home, and whilst painful, neither was actually any worse than bad period pains. Both were far far more distressing, but my experience of the pain was thankfully not as horrendous as many here have had. I would also not have wanted to have an EPRC, and preferred to deal with things in the privacy of my own home and without any infection risks. What I did want, especially first time, was a much clearer idea of what I would actually pass, as imagining what might come out was quite frightening and also the bleeding was heavier than I expected, though perfectly normal.

I too had comments about late periods and people testing too early these days (i.e. before 2 missed periods!!). My body was screaming it was pregnant, I was cripplingly tired, had stinging nipples & swollen breasts, metallic taste etc etc. Especially the second time, when I'd had a child already, it was 100% obvious to me from before I tested. Just because women couldn't test years ago and didn't know for sure, doesn't mean they didn't know they were miscarrying. Then, like now, I expect it was a topic not much talked about. Those who've not been through it really do struggle to understand the emotional pain involved. Before it happened to me, I too thought it 'just one of those things' and knew how common it was. The steamroller of grief, disappointment and crushed dreams that knocked me off my feet, especially the first time was all the worse because the strength of my distress was to me so unexpected.

Twit Wed 30-Mar-11 13:13:46

I should add, the lovely Sister who booked me in when I arrived told me that the remains were taken to be cremated after a service in the hospital chapel - once a month and that I was welcome to come along.

gingercat12 Wed 30-Mar-11 13:43:04

I second Lenin MN was a life saviour when I lost my little one at 11 weeks.

In terms of scanning, we would probably need a complete change in attitude. I was not given a scan until it happened (probably to save me the heartache, it still makes me cry...).
Also because it all has to be natural, they just sent me home from the hospital when it was crystal clear I was miscarrying.
On the plus side all the staff was really understanding and kind, and they thought they were doing the best they can for us. I had a lot of hugs. And they explained to me very well why I should not blame myself, which was very important later.

DrNortherner Thu 31-Mar-11 11:49:53

I support this too. Had a miscarriage at 11 weeks over an Easter weekend. Passed the feotus at home, wrapped it in tissue and went to A&E. Sat there for ages, then A&E nurse asked a series of questions in a very non emotional manner. All I could think was a dead feaotus was in my handbag. A&E were totally concerned with the physical sypmtoms only. Finally got moved to a Gynae ward and was treated much better.

owlbooty Thu 31-Mar-11 13:22:40

I think the message here is unfortunately the same one you see for many aspects of the NHS - care in some areas is exceptionally good and in some areas it is exceptionally poor. There is a big need to set a nation-wide NHS standard for the level of care that should be provided - exactly as has been done for other conditions and clinical pathways.

The points in the Code are all very valid and cover pretty much all of it. The only thing I would add is concerning pain relief and expectations of pain - I had a natural miscarriage at 7 weeks and as it was so early on I thought it would just be like a heavy period. I was at home and took a couple of paracetamol as advised by NHS Direct and my GP. Nobody warned me that when it really started I would have full-on contractions and the worst pain I have ever experienced in my life - it was very, very frightening for me and also for my husband as neither of us had any idea whether this was normal or whether I was in serious trouble. Some advance warning might have been alarming but at least I would have been prepared for what actually happened. Pain and fear tend to stay with you for a very long time afterwards and this experience has had a massive impact on how I have coped with my current pregnancy.

RowanMumsnet (MNHQ) Thu 31-Mar-11 22:30:30

Hello all. Thanks so much for your support and suggestions, and for sharing what must be painful experiences. We'll be reading this through carefully and we'll be back with a plan in the near future. Do keep posting if you have any further thoughts in the meantime.

MNHQ x

Message withdrawn at poster's request.

Your ten points all look very relevant.

When I suspected I was miscarrying my 2nd pregnancy I phoned my GP (to get the pg test result actually) and explained that I had started bleeding. She asked me if I wanted the baby. WTF?!?!?!?!

She offered me no advice whatsoever re the MC, only to go to A&E if I continued bleeding.

I did, so I went & they were good in so far as I saw a constultant & was able to talk about what was happening, but that was only after waiting in the 'Major Trauma' unit with RTA victims as I was 'bleeding'

What a total waste of everyone's time.

I was never offered a scan or follow up appointment of any kind, and after the totally unsympathetic/useless reaction from my GP just got on with it at home.

Thankfully the pain I had was just like period pain.

God help women who go through this more than once!

RowanMumsnet (MNHQ) Sun 08-May-11 17:11:46

Hello,

Just to keep you all up to date: thanks so much for all the suggestions on here. We're going to look into the possibility of feeding into the current NICE review of its miscarriage and ectopic pregnancy guidelines; we're also going to try to get a grip of how the shift to GP consortia will affect this issue, and see whether there's anything we can do there. We're also looking at this thread to see whether anything needs to be added to our code (such as pain management).

Thanks,

MNHQ x

mrszimmerman Mon 26-Sep-11 11:02:10

MN was an enormous help after my mc I think it would be good if women could be referred straight to the forum with a strong emphasis that it's completely anonymous among other support options.

This code is really excellent and comprehensive.

I would have found it useful if the EPAU had made sure I knew how profound the psychological effects of mc might be. I wish I'd been warned that it might take me a long time to get over. (It took me two years and a successful pg).

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