Is there/how do we start a petition for weekend miscarriage care on the NHS?

[banana87]

I have just heard one too many stories of women in early pregnancy-or even in their second trimester-having heavy bleeding on the weekend, only to be sent home or sat in a gynae ward with no scan until "Monday".

This is utterly ridiculous. Is there a petition for this (I have read something about after care on the NHS for miscarriage) and if not, how do we/I start one? Things HAVE to change.

The problem is banana even if they do have a scan at the weekend if you have bleeding in the first trimester very often there is nothing that can actually be done. Scanning takes staff and resources, all which cost money.

But miscarriages can be very painful physically.

Having a scan confirms the miscarriage and means you can be prescribed suitable pain medication. Until you have a scan you can't know for sure that you're miscarrying and this means you can't be prescribed something stronger than paracetamol until you've been seen by an expert.

If miscarriages happened to men I'm convinced that the care, including on weekends, would be better. Women's health is important and I really think we shouldn't be fobbed off. Does anyone know where there is a petition?

Poor care costs more. It would be interesting to add up the cost of ambulances called for miscarriages when women have been told to wait out bleeding, mental health treatment costs from the distress caused and so on. I think the figure would be rather high.

i do not think there is any excuse whatsoever for no scanning facilities at weekends. I personally don't agree with using these resources to scan people who know they are less than, say, six or seven weeks pregnant, as the outcome would most likely be inconclusive anyway, but to expect someone who is well into their first trimester - or, horrors, even further along - to wait up two days or more to find out what is going on with their pregnancy is third world-esque. Andy Burnham, the former health secretary, was trying to do something about all this before Labour went out of power. Somehow I doubt it's on Andrew Lansley's radar (Mumsnet worked hard to push it with Andy Burnham and I know him personally and spoke to him about it at length) . It would be great if we could get the new government interested as well.

@toughasoldboots - Sorry for your loss. how did you manage the pain (if you don't mind me asking)?

I had to be hospitalised. A scan with the right pain management could have avoided my hospitalisation and saved money.

I've had appendicitis and that pain was minor compared to the contractions I had when I miscarried.

Having scanning available at weekends would cost a fortune - what would you tell the NHS to drop to afford it? I agree with toughasoldboots. If you are in severe pain can't you go to A&E?

lal123 what would i tell the NHS to drop to afford it? hard to know where to begin, but i would first ensure that there were joined up communication systems between hospitals and GP surgeries about individual patients. this would stop the gross wastefulness of hospitals/GP surgeries repeating tests that have already been carried out on patients elsewhere because they haven't got the records. Until the NHS computer system is sorted this sort of inefficiency will continue to be rife. i would start charging patients who persistently fail to turn up to appointments. I would ration services for people who doggedly refuse to help themselves - this already happens in most trusts but it is a sensitive area.
In an ideal world the distinction between what is available on the NHS on weekdays and what is available out of hours would be minimised, though obviously i'm not suggesting everything should be available all of the time. Health does not respect weekends though, and to set up a system in which people only get the best treatment if they fall ill between 9am and 5pm is asking for trouble - as we've seen with so many of the out-of-hours care tragedies.
ok, i'll stop now - getting waaaaay too political...

When I had a molar pregnancy, I had an d+c, however tissue remained, and I collapsed with very heavy bleeding, it was at the weekend (I remember because we were about to go to a Christmas party). I had a scan, and a decision was made to do a second d+c. So there must be occasions when they do do, scans if it is deemed as an emergency.

Agree that IT systems need improved - which will cost ££££££ initially. (In Scotland we already have an electronic patient record shared between GPs/Hospitals)

Health does not see a distinction between weekends nad weekdays - thats why we have A&E open 24 hours a day 365 days a year and out of hours services.

There are systems in plave for emergency scans, but most of the time a scan re suspected miscarriage is NOT an emergency as in the majority of cases nature takes its course and medical intervention is not required.

I agree it's not often a medical emergency but it's a psychological one.

A scan for suspected miscarriage-maybe not medically necessary. But what about a scan for someone who is bleeding heavily? Who may have an ectopic pregnancy? Who may be having a miscarriage and hemmorraging? I agree that its VERY third world-esque to expect someone in this type to situation to wait up to 3 days (assuming this happened on a Fri night, for example), in excruciating pain and tell them they can only take paracetemol "just in case". It's rather disgusting, really. I am interested in starting a petition, I will look into it.

Some hospitals do have the facility for this. When I miscarried at a weekend I knew to ask for a hspital in a neighbouring trust.

I don't really know - I agree for most miscarriages there is not much you can do and as distressing as it is actually waiting 2 days will make no difference. I miscarried at 9 wks and what I found most difficult was that on Monday morning I could not get hold of the epu as they were overwhelmed with the backlog of work from the previous week and weekend - I didn't actually speak to someone til the Tuesday and that was only because I sobbed down the phone to the pg day unit staff. All I needed was to speak to someone and get an appointment - it really would have made a difference..

BTW I object to the term 'third world-esque' our health services are a million times better than those in the 3rd world (I do know what you are trying to say though)

banana 78 - that's exactly what happened to me on a weekday. i think it's fairly standard practice.

Well it shouldn't be standard practice. They are risking lives by making people wait. I know someone who went in with bleeding over the weekend, they couldn't scan her, and she ended up having an ectopic. Thank god her tube didn't burst in the time she was sat at home while there was "nothing they could do". I'll say it again, IT'S DISGUSTING.

I am sorry for what happened to you, hairytriangle.

FWIW, Downing Street aren't taking any petitions now, but as soon as they re-open I will be on the case ;-)

Thanks. It was not nice, but I didn't know to expect anything different.

If you are having an early miscarriage, afaik, there is really nothing that can be done about it, and standard practice is to see GP who usually advises to carry on as normal?

I agree that the risk of burst tubes is something to be avoided at all costs, but thought bleeding was not a symptom of ectopic?

PS: they scanned me twice and could see nothing in my womb, at 5 and 8 weeks (I bled for a long time) so it wouldnt have helped me at all. My HCG was telling a different story, so they deduced that 'something' was left over.

medical science is not perfect, scans before about 6 weeks or 1000 hcg don't show anything.

You can bleed with an ectopic and you can hemmoragge with a normal mc. There are risks to both, and any woman suspecting miscarriage should be scanned promptly to avoid these happening.

I've just found this which is quite interesting and it's also interesting to know tht there are not currently EPUs everywhere and accessible to all women.

"Women who are up to 13 weeks pregnant presenting with the key symptoms of vaginal blood loss and pelvic pain should be referred to an early pregnancy unit (EPU). This will offer rapid assessment and ultrasound scanning, either transvaginally or abdominally, to confirm the diagnosis of miscarriage and exclude ectopic pregnancy. If inconclusive, blood will be taken to detect levels of human chorionic gonadotropin (hCG) ? a hormone produced in early pregnancy to maintain progesterone levels to keep the pregnancy viable. It is detectable in urine and blood, and levels increase steadily, peaking at 14 weeks since the last menstrual period. In early miscarriage, these levels fall."

www.nursingtimes.net/nursing-practice-clinical-research/guided-learning-archive/-mi scarriage-and-ectopic-pregnancy-2-management/1543562.article

Also interesting that my hcg levels did not fall after miscsrriage, so that guideline is basically a little misinformative.

The scan to confirm my blighted ovum pregnancy was on a Friday and I was offered my ERPC the next day i.e. Saturday. I elected to wait until the Monday for a myriad of reasons but there was no question of it not being available within 24h even though it was the weekend. I'm in Scotland.

I just want to put in a thumbs up for John Radcliffe Hospital in Oxford - I ended up in A&E on a Friday night with severe pain and bleeding and almost the first thing they did was an 'informal' scan using a portable laptop scanner. The A&E doctor explained to me at the time that he was checking it wasn't ectopic - he was looking for signs of blood/fluid where there shouldn't be any or anything else suspicious. Thankfully he found nothing out of place and consulted with the on-call obs/gynae consultant for some time before booking me in with EPU for the Thursday after as there was little more that could be done immediately. He did say that if there was any more pain/excessive bleeding that I should immediately come back to A&E. When I did come for the 'proper' scan it was in a separate area from the pregnant women with a separate waiting room and I was treated with dignity and kindness.

All in all I had excellent care and feel that I was very lucky when I look at some of the dreadful things others on here have had to endure - I wish all hospitals would get their acts together, it's obviously possible to do a scan in A&E if it's medically urgent so there is no excuse. I think that MC is swept under the carpet but to be honest, how often do you hear people talking about it in the open? We're not helping ourselves here by keeping quiet about what we need. In the health service, it's the people who shout loudest that get all the funding.

Disagree with this and agree with lal123. I speak from experience - previous m/c, at weekend (having had some lighter bleeding in the days leading up to it). Also had an ectopic.

Whilst it is not a nice thing to happen, and the waiting can be very frustrating, having a scan that day would not make a jot of difference to the outcome.

Yes it can be physically painful (it's the contracting of the womb) but it's not physically harmful.

I don't think m/c is swept under the carpet, it's just that unfortunately, it's one of those things that happens in life. Having a scan on a Saturday won't stop you miscarrying in early prenancy, nori s early m/c a medical emergency warranting on call scans.

Just wanted to say I had an ERPC a few weeks ago on the Friday and on the Sunday was readmitted via A&E with severe cramps and very heavy bleeding and when I got up to gynae the consultant scanned me with the machine they have available in the gynae dept.

He's not a sonographer but he could use the equipment well enough to see that I had tissue left in my right horn (I have a bicornuate uterus, so two horns) where the foetus had been. So some NHS hospitals do have the facility to do it if they can see the bleeding is very heavy and they class it as an emergency.

I'm with Lola et al on this one. If they suspect a real serious risk to your health type problem like eptopic they should act immediately, if not then I think you just have to wait, and having had 3 mc's I do fully understand how hard that waiting is.