EPU/miscarriage unit part of main maternity unit. Sick joke or what?

[GingleAllTheWay23]

I've just had to walk past at least a dozen pregnant women or women with newborns on my way to the Early Pregnancy Unit for medical management for my miscarriage. You can see the Maternity Assessment waiting area from this waiting area.

What sort of sick fucking joke is this? It couldn't be a unit in the main hospital or have it's own separate entrance?

I honestly want to put in a complaint. This is barbaric.

It’s the same in my hospital. All maternity all stages in one building. I think it’s because EPU covers a range of things and not all are miscarriage. I agree it’s not the nicest when you’re suffering a loss though. I’m so sorry 💐

It's like that at most hospitals. It's awful.
At my local the epu is in the gynae department which is in the same building as maternity. Luckily they have their own scanner. At next hospital along they don't have a separate scan so you're sat waiting with the pregnant women.
You're right it's barbaric. Definitely complain.

So sorry for you loss. I had to see pregnant women when I suffered a loss when I had to get a scan to check is I had miscarried all the tissue x

Sadly it’s like this in most hospitals because all the staff, equipment etc is the same for both depts. it’s awful, I’m so sorry for your loss. I’ve been to the EPU too many times to count and have had to see the other side too. But then I’ve had to be admitted for a medical emergency too and the gyne consultant literally came running to where I was, luckily it was just up a flight of stairs rather than across the whole hospital. So I get it, I really do. I also feel for the women going through cervical/ovarian/type cancer treatments who have to sit in the adjacent clinic to the pregnancy one. I really wish you well OP.

very sorry for your loss.

the expertise needed to work in the EPU overlaps with maternity care, and so the radiographers etc need to work in both. from a hospital management point of view, it makes sense to put those units adjacent.

it is a pity that the system is not set up for the mental health of the women attending the EPU, but I am not sure that a complaint will be able to change much.

Yes I remember feeling so sad about this. It's probably staffing / equipment etc but it's horrible. Sorry for your loss, OP.

Probably because it’s the same doctors and nurses. The EPU treats many issues and it all comes under the umbrella of pregnancy. People have to give birth to their stillborn baby on the labour ward and hear the cries of living babies. So traumatising and unfair, but it’s the same doctors and nurses who have to deliver.

Sorry for your loss, OP. Life can be so cruel 💔

Yes, I understand. I was told one of my babies had died behind a curtain in an assessment unit filled with pregnant women whose babies had not died in all the other beds.

With another pregnancy they wanted me to give birth to my little one who had not made it in the actual labour ward, in a room yes like everyone else but still listening to the sounds of newborn cries all around me. I refused to do that.

I had to give birth to my stillborn baby on labour ward, as the bereavement suite was already in use. I had to lie there after, clutching my lifeless baby hearing other newborns crying. It nearly killed me. But the worst part was walking out through the main entrance and walking past 3 heavily pregnant women stood smoking outside.

It's shit, but it's life. You can't expect the rest of the world to dance around your sorrow and I don't mean that unkindly.

Sorry for your loss op. It’s because resources and staff are shared and EPU isn’t just for miscarriage/loss. I went to EPU a number of times when I was pregnant during my healthy pregnancy and some days I went from EPU for a scan to maternity assessment for checks. I also went to EPU with the same staff when I had a miscarriage. It’s just how it is, they can’t have two completely separate areas as it wouldn’t be an efficient use of resources.

It's the same at most hospitals. It's awful and makes a bad situation worse.

so sorry for your loss

It was the same when I was using maternity services nearly 20 years ago.

So sorry for your loss 💐

It’s in a completely different standalone building at my hospital, you walk past it long before you get to the maternity and gynae building. Different staff and a different service.

There’s a regular MN survey about miscarriage care I’ve completed a few times over the years about my own losses and it’s covered this sort of thing as separate provision obviously makes such a difference to women dealing with pregnancy loss.

It can be done better. My first mcs were in 2016 and it’s been like this at my hospital since then and long before.

I remember this being upsetting

This happened to me when I had a stillborn baby (she died 5 days from due date). There were women in the surrounding rooms with their crying babies. Horrific.

Years ago I went for a hysterectomy assessment due to prolapse- thankfully I didn’t need one. But it was in the maternity dept !! I was sobbing and sobbing in the waiting room, surrounded by people heavily pregnant! I complained, but not much they could do

I experienced this, I walked out of the EPAU after being told I was having a Mc at 12 weeks past a room full of people excitedly looking at 20 week scans and phoning relatives to tell them it was a boy/girl.
It was so traumatic I never went back and with my 2 subsequent pregnancies I went Private for scans with number 1 but with number 2 my lovely GP helped me use another local hospital instead.
Fortunately around 6 or 7 years later I found myself in a position to influence certain things within our NHS Trust and this was one of the things I managed to change. The EPAU no longer shares an entrance or waiting room with the scan dept.

It will be a combination of limited space, staff and equipment shared. There just isn't the space in most hospitals to create a new department. Ours was moved off the maternity ward a few years ago after years of PALS complaints and is now in a different part of the hospital luckily, on a mixed but mostly gynae ward. Crammed into a disused private room but the ladies still have to be escorted through a busy ward to get to the scan room. It also makes it very difficult when we need additional obstetric sonographers to come and confirm our findings. Having to ring the antenatal dept and wait 10/20/30 minutes for someone to come across to EPAU to confirm a miscarriage, while the patient is lying on our couch in a state of undress already feeling vulnerable and distressed. You should mention you felt uncomfortable seeing it and definitely make the complaint. There is a good chance the hospital just does not have the space, the capacity or the staff to change the configurations of the department though. Unfortunately most hospitals weren't built with women's/maternity services in the fore front of the design and these areas end up being crammed into left over spaces. And women are being failed like this time and time again in the NHS.

I’m sorry you’re going through this. I think you have to try and reframe what you’re seeing though. Motherhood isn’t a straight road for a lot of women. I’ve had 6 losses, one being a medical management at 11 weeks. I’ve also got two dc. I remember waiting for my medical management and seeing pregnant women going for scans etc. They’re just at a different stage on the journey than you. You don’t know what’s down the road for them either. Pregnancy is precarious and worrying at all stages. I could have been one of this pregnant women you’re seeing waiting for scans. Every single scan I went to my heart was in my mouth because of previous loss. Even after I gave birth I had ptsd and wanted to cry all the time even holding my newborn.

I remember feeling exactly the same way, I was so angry.
Sitting there knowing I had had a miscarriage and watching the midwives say infront of me "goodluck with your pregnancy". I found it so upsetting. I sat in the waiting room crying probably scaring other expectant mums but I was in a state. You shouldn't be put in that situation.

While I understand the strain on resources, I agree OP that it is cruel and deeply upsetting for those of us needing to use the EPU. After my first experience sobbing in the waiting room amongst the happy expectant mothers, I learned to assert myself (and when that wasn't possible, delegated to my DH) and go straight through to a quiet waiting area while they found me a private room to wait in. It wasn't much better, I could still hear conversations from neighbouring rooms, but at least nobody was staring at me during a time of intense grief.

Also, don't wait too long to be seen. Insist that they don't forget about you. This has happened to me, once I was out of the way I became less of a priority.

I'm sorry to everyone who has to go through this.

Locally, the GAU (gynae assessment unit) was originally built in the maternity/ gynae wing, but up its own stairs and tucked away from the maternity unit. It was brilliant, quiet and out of the way. Until someone decided it would be better purposed as a private wing, and the unit was moved down into gynae outpatients, opposite antenatal clinic.

Which is where I recently had to go repeatedly when I had my miscarriage a few months ago. It made me even more annoyed that they’d had a lovely unit (I’d rotated through when I was a junior doctor) but it had been repurposed to make money.

But def complain! It’s so frustrating, and the right environment makes a huge difference I feel.