To think an Early Pregancy Unit is not the best place to deal with miscarriage aftercare?

[vladthedisorganised]

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.

AIBU?

[maja00]

I think EPUs are the best place to deal with miscarriage aftercare, but it seems the issue is more that in some hospitals the EPU is not separate from the general antenatal/ultrasound departments?

As I understand it where I am, the EPU only deals with women up to 12/16 weeks who are having problems. 12/20 week scans, general maternity stuff, antenatal clinics happen elsewhere.

[vladthedisorganised]

Well, discovered yesterday that all the scans in the EPU are booked to coincide with the hospital's antenatal class (or at least were yesterday!)

A waiting room packed to the gills with late-term bumps, some excited couples waiting for their 20-week scans, a screen showing 'how to care for your baby' videos, and me. There were 'some issues' so I had an hour and a half wait.

The sonographer hadn't been told in advance what he was looking for and was surprised that nobody was with me for my 20-week scan. He was very embarrassed when I told him why; the nurse thought I was there for a 12-week scan and was equally embarrassed when she read my notes (I'd adapted the 'standard' questionnaire to fit my circumstances).

The sad thing is that our local NHS trust has merged three hospitals so the maternity units for all three have been squeezed into one; hence I suppose no separation of the 'early' pregnancy care from 'anything to do with the uterus'. Could have done without the bloody screen though.

[Andcake]

I think it depends on the hospital. my EPU at uclh only dealt with emergencies prior to i think 16 weeks. all the 13 week (mostly happy scans) on a totally different floor. So no bumps or posters just people who had been referred through bleeding or other problems. It was in the basement with all the infertility stuff as well. Luckily when I was hospitalized after one of the MC i was on a normal ward.
Must admit though all my visits to epu I was mostly swallowed in a well of my own sadness or fear. Luckily i finally got out of the basement epu into the light of happy scans. I hope anyone suffering gets a happy ending.

[icklemssunshine1]

My EPU is attached to maternity & gynae is on the 2nd floor. When I went in to have my ERPC I had to walk past women with various sized bumps to get to where I wanted to go. May seem insignificant but not to a woman who's just lost her baby. 3 weeks ago I had to have a scan as I've continually bled since my periods after the MC. I had to wait in a room with heavily pregnant women. When I explained to receptionist that I'd just had a MC & I found it upsetting she said I could wait in the corridor.

[Loveitall]

Op, you mentioned could it be treated as gynae like a hyster. I had a hyster when I was 32 to treat cancer (no children), each time I have to go for a check up I have to sit in the antenatal waiting room surrounded by bumps as they are in the same building and that seems to be the case in a few hospitals so it doesn't necessarily get any better that way either. Am sorry for your losses xx

[SHarri13]

Our hospital has a seperate maternity hospital but that didn't stop them sending heavily pregnant women over to the EPU for scans. It was fucking brilliant after returning post ERPC to find out your results were abnormal

[piprabbit]

I found it very hard, waiting in the EPU for diagnosis and treatment of my ectopic pg (espcially when the family in the next bed were being absolutely vile to their little girl).

It was relief to wake up from the operation and find myself on the Gynae ward, surrounded by lots of older women pottering around and no sight nor sound of babies.

[InLoveWithDavidTennant]

going for a scan in the same department as all the pregnant women when having fertility issues is awful too. took a lot for me to not burst into tears. it was horrid and its happened more than once at 2 different hospitals!

i cant imagine what it would be like after a mc

[ProtegeMoi]

I had a miscarriage 10 years ago. I went to the doctor bleeding heavily and they made me an appointment for a scan the next day.

I went along and saw many women waiting for their 12 and 20 week scans, looking at photos excitedly.

Went in for my scan where it was confirmed I had miscarried. I was then sent back to the waiting room to wait for a doctor, walking past a stall selling baby cardigans and booties on the way. After another half an hour surronded by exciting pregnant ladies I was seen by a doctor and told a d&c would need to be performed.

I went back the next day and was waiting in bed for my surgery. I got chating to the girl in the bed next to me to find she was there having an abortion, not the nicest place to put someone who had just miscarried.

After my surgery I went home and my care was managed by my GP. I then got a letter inviting me for a 20 week scan, turns out they had forgot to remove my name.

All utterly heartbreaking.

[Shellywelly1973]

Im booked into The Whittington, North London. When i went for my 12 scan last February, it was discovered i had, had a MMC. The only way out is through the ante natel clinic. The sonographer told me it would take a few hours to be seen by a doctor & i would have to go to A& E as it was a Saturday.

I was devastated, had no reason to think anything was wrong. I went into shock. I remember saying to her my sons carer was only booked until 3pm. She wrote the phone number of the EPU on the back of the screening form...

Nothing else. No information. No advice, Infact she didn't even give me the correct paperwork or inform the EPU as they had no information when i called them the following Monday.

I had an ERPC that week but found out i the EPU was open on the Saturday & could have been seen & had surgery on that day.

Im currently 13 weeks pregnant. Had my 12 week scan last week. Same room & same sonographer. I cannot put into words the fear i felt sitting in that waiting room. Thankfully all is well with this pregnancy.

The sonographer i met on the day was incompetant. The design of the ante natel clinic is ridiculous. The staff i met when i went in for the ERPC & met in the EPU were amazing. Caring, compassionate & considerate. Unfortuately its a lottery but mc care needs to be improved. Its 2013 women should be treated well and cared for when experiencing mc, its really not much to ask.

[feekerry]

i have just come out of hospital for hypermesis. i was admitted and treated in the gyne ward. they also dealt with mc before 16 weeks.
so maybe different policy in different hospitals. i was in for a week and saw pretty much 1/2 ladies coming in per day with mc
however at least they were not around very obv pregnant people. that sounds awful.
most of the others on gyne ward were cysts, hysterectomy etc

[McNewPants2013]

The epu in my local hospital is attached to the gynea ward. There are 2 seperate rooms. 1 is before you go into the scan room and if all is well you go straight home and the 2nd is for bad news.

When I was having bleeding on dd I found the staff amazing.

[Quenelle]

So sorry you're currently going through it vladthedisorganised.

[Quenelle]

I've been there. To have the mmc confirmed I had to attend the EPU and wait until the end of the session for someone to be available. Then I had to go again when I started to lose spontaneously the day before my ERPC. This was during a normal scan clinic so lots of parents to be excitedly clutching their scan pics.

And the gynae ward is at the end of the maternity ward. The building is L-shaped so I could look out of my window and see the women with their new babies and excited dads. It was...tough, to say the least.

[MammaTJ]

I had to go three times but I can honestly say I was so wrapped up in my own misery I did not even notice anyone else there, let alone what stage they were at, or whether they had a bump.

[NameThatTuna]

I had an ectopic pregnancy, had my fallopian tube removed and told my other one was pretty much fucked. After my OP I was put in a room with a heavily pregnant woman who was on bed rest.

She kept her curtains drawn most of the time. We shared the room for a week, on the last day she spoke to me. She told me she was embarrassed to speak to me after hearing what I was in for. She was just as uncomfortable with it as I was. This ward was also linked to the maternity unit, so I heard women in labour. Fucking depressing that was.

[ArkadyRose]

My last mc was at 12 weeks, confirmed at the 12 week scan. The EPU at Whipps Cross is in a separate building to the maternity unit; the only bit that wasn't handled well I think was the initial triage with the nurse. I started flooding (sorry foe tmi ) really badly whilst seeing her, and when I came out there were two very upset & worried-looking women waiting to be seen who both went white when they saw me - my jeans were soaked in blood from groin to knee. I felt really sorry they had to see that. I was hurried away to a private room after that and the only people I saw were medical staff, but they really ought to have a second door from that nurse's office. Apart from that though I have no quibbles over how I was treated; the staff were all very gentle & sensitive.

[Pawprint]

Tell me about it, OP.

After my fourth miscarriage, I had the horror of sitting in the waiting room and overhearing a woman whining that the scan showed she was having a boy and she'd wanted a girl

[BridgetBidet]

From another point of view I had a heterotropic pregnancy (one was ectopic in the tube, the other was in my womb in the right place). They decided to treat it by keeping me in hospital for 5 days to see if it the ectopic would disappear on it's own so I wouldn't have to have surgery and endanger the normal pregnancy.

It was extremely hard for me to see people with miscarriages come in when my own pregnancy was so precarious (as I imagine most in EPUs are). I found it very upsetting, for myself and the women losing their babies.

Fortunately the ectopic did miscarry on it's own and I went on to have a normal pregnancy.

But I agree, it would be much better for these two types of patient to be treated separately as far as possible.

[TinyTear]

At the Royal Free in London the EPU is separate from where you go to the main scans. ok, there were some people there leaving happy (i had one of those) but most people were there for emergencies. and they even had a separate private room if you wanted to wait there and not in the main waiting room.

[MissHC]

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.

[Vix1980]

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.

[shellsocks]

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