The Mumsnet Miscarriage Code of Care: the two-minute version
According to Mumsnet users, the treatment and support women receive fails to meet their needs or measure up to official national guidelines. In conjunction with Mumsnetters, we have drafted a Code of Care. This is what needs to change and why.
1. Supportive staff
GPs, Early Pregnancy Assessment Unit (EPAU) and A&E staff should be trained in communication techniques (including things NOT to say to women who are miscarrying), basic counselling skills and the psychological effects of miscarriage. Follow-up appointments and/or counselling for those who feel they need it should be routinely offered after miscarriage.
A receptionist greeted me with the phrase 'you again' when I was in hospital for my fifth miscarriage.
2. Access to scanning
Access to scanning facilities in the case of suspected miscarriage should be easier. This could mean Early Pregnancy Assessment Units (EPAUs) opening seven days a week and/or portable ultrasound and trained medical staff being available in A&E and gynaecological units at all times as standard. Those who are miscarrying naturally at home should have the option of a scan to check that there are no ongoing complications.
It was a real battle to get a scan. I kept on being told to wait and see, or that my bleeding wasn’t heavy enough.
3. Appropriate treatment spaces
Women undergoing miscarriage or suspected miscarriage should be separated from women having routine antenatal and postnatal care, or women terminating an unwanted pregnancy. EPAUs should be sited in hospitals' gynaecology, rather than antenatal, departments or next to A&E departments, to ease women's referral route. 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.
I was put on the labour suite to wait [for the surgery to remove the remains of the baby]. I could hear women giving birth.
4. Good information and effective treatment
All women experiencing miscarriage should receive clear and honest information, sympathetically delivered. Women should be given information about all the available management options - expectant, medical and surgical - and should be able, clinical considerations allowing, to choose the method of management that best suits their circumstances. Women miscarrying at home should be offered appropriate prescription pain relief. In the case of miscarriage occurring in hospital, doctors should discuss with the parents what they wish to happen to the foetus (i.e. it should not be disposed of routinely without prior consultation).
I had been under the impression that miscarrying at home would be the easy option; I was given no information whatsoever. I was in agony.
5. Joined-up care
Community midwife teams and GPs should be informed immediately when miscarriage has occurred, and subsequent bookings and scans cancelled, to avoid women who have miscarried being chased by HCPs for 'missing' pregnancy appointments.
The hospital said they’d ask a health visitor to contact me. That was two months ago; nobody has been in touch.