Miscarriage = Abandoned by your Midwife?

[FannyAnn]

Hello,

Please allow me to introduce myself: I'm a 3rd year Student Midwife with a particular interest in supporting women who have suffered a childbearing loss. In June 2005 I myself suffered a missed miscarriage at 13 week's gestation, complicated by subsequent sepsis following ERPC during which I very nearly lost my life. While the clinical management at the time was exemplary, I have to say I was utterly appalled at the lack of compassion shown to me by the staff who were supposed to be 'caring' for me throughout my ordeal. While some adopted a cold, 'matter of fact' approach, others seemed completely out of their depth and appeared not to know how to act or what to say to me, which in turn, made me feel worse.

However, the biggest blow to me was that on losing my baby my relationship with my midwife ended. She was a lovely individual with whom I connected immediately and we had met on 3 occasions during my early antenatal appointments. I was, therefore, shocked and upset that she didn't phone or visit me after I lost the baby. I was in a terrible state emotionally and had so many questions that I needed answering by someone I trusted - I felt completely abandoned by her, as if the fact I didn't have a baby in my womb anymore meant I was no longer worthy of her time.

As part of my third year studies, I'm looking at formulating an holistic care pathway to guide Healthcare Professionals in caring for women who have experienced early pregnancy loss, concentrating specifically on the role the Midwife plays during this time. Having spoken to numerous Community Midwives, I am sad to say that many do not see it as within their remit to be contacting/visiting women in their caseload who have experienced early miscarriage. I therefore anticipate an uphill struggle to effect any change! However, I am determined in my aim and in order to support my endeavours, would be interested in hearing your experiences/opinions about the way your care was handled during early pregnancy loss, in particular the impact this had on your relationship/opinion of your midwife. I would also like to know exactly what you would like or expect from your Midwife during this time (preconception advice for example)and any other suggestions you think may be of relevance to a Care Pathway of this type.

Many thanks in advance and my heartfelt sympathy to all those mourning the loss of a little one xx

What an awful thing to go through but what a way to turn your experience in to something positive. I found out two weeks ago that I had miscarried. I thought I was 11wks and 4 days (the scan showed the baby had died 2 weeks previous though the sack had continued to grow - cruel twist of biology). The care I received was fantastic and the nursing staff in particular were brilliant (I had the ERPC on Monday). On my return home from hospital the first call i answered was the midwife (I hadn't met) calling to arrange my first 12 week appointment. Whilst horrified at the cruel twist of fate, it turned out to be a blessing. I'd had the scan on my own, having insisted my husband go to work - I believed that I was imagining something was wrong - but unfortunately my instincts were right. I hadn't taken in anything they'd told me - other than to sign the consent form for the ERPC. The midwife (who I will never know who's name I spoke to) was brilliant. She was a voice of reason and sympathy (I hadn't been able to talk to my husband at that point) and she explained everything I'd heard but not taken in at the hospital regarding ERPC and naturally 'miscarriage'. I am truly grateful for her kind words and information. I mentioned my 12 week scan was booked and she said she would deal with it (if she hadn't called I know I would have forgotten to cancel it). It never occurred to me until I read your post just how valuable that conversation was - to know that it was available would, I'm sure, be valuable to others going through this. Good luck with your studies, a truly worthwhile cause. G

Firstly may I say how sorry I am to hear about what happened to you. I unfortunately experienced similar when I had my last miscarriage.

I had had two previous early miscarriages - both at 6 weeks, both 'missed' miscarriages - and in those cases wasn't expecting any follow-up care as I had not yet been booked in. However, my last miscarriage was at 20 weeks, and was a completely different experience, much more traumatic and physically and emotionally draining.

I miscarried twins after one developed premature rupture of membranes. What made things worse was that I was on holiday in France when it happened, and had to endure 3 weeks in hospital without being able to speak the language (and very few people there could speak mine). On my return to the UK, I contacted the consultant I had been assigned to for that pregnancy through his secretary at the hospital, and made arrangements to meet with him to discuss everything that had happened. I also remembered that I had a 20-week scan booked in and called the scanning dept to cancel it (nobody asked me whether I had any appointments I'd need to cancel). I also went to see my GP to explain all that had happened. He made sympathetic noises, but other than updating my records, was not really interested in how I was feeling and took no follow-up steps at all. (I had touched on the subject of counselling with him but he removed any responsibility from himself by suggesting I speak to my midwife who might know of specialist neonatal bereavement counsellors). Most disappointing of all though was the contact I had with my local midwife after the event. I called her to let her know what happened and she sounded very sympathetic on the phone. I specifically asked her about bereavement counselling, as I was going through quite a tough time dealing with the emotional side of what had happened, and she said she would come back to me - but never did. I was basically forgotten by her and by my GP and it sounds as though I was feeling exactly the way you did, that we had suddenly gone from being very important, to being abandoned by the system. I had to go back to my GP specifically to insist that he referred me for counselling, which he did through the local generic counselling service as he knew of no other more specialist facility and clearly wasn't willing to make any enquiries to see if there was something better suited to me.

I am not at all surprised with what you've said about midwives not seeing it as their remit, but you would think that they could at least take a few minutes of their day to look into counselling for any of their charges who are unlucky enough to befall a tragedy like this.

The feeling I was left with was that my midwife was lazy and uncaring. I am now pregnant again and have been referred back to her as she is the only midwife covering the rural area where I live, and needless to say I have very little respect for her.

I am really pleased that you have taken up this cause, as I felt very strongly at the time that the way I had been dealt with was inadequate and uncaring. Personally I would like to see a process put in place for dealing with these cases, whereby contact is proactively made by either the GP or midwife, appointments cancelled and proper counselling offered, with another follow-up call some time later.

I wish you the best of luck with your endeavours and thanks again for taking up this cause.