I’ve just been denied medical management of a failed abortion

[Tinyteatime]

I had a medical termination last Saturday, 7 weeks pregnant after my coil failed. Thought it had passed relatively easily so came away on a short holiday with my family luckily only 1.5 hours away from home. Started heavy bleeding and bad cramps yesterday, came to a&e as as advised by the BPAS clinic as I was flooding a pad and blood leaking through my trousers. Passed some very large clots. Internal scan reveals what they think is a foetal heart beat still in there. I’ve been in hospital one night and they said they would do the surgery on me this morning. I’ve just been told that all the doctors available won’t perform the procedure due to religion. This in the U.K. in 2019, in a hospital that offers abortion services. They’ve said I can stay another night and have it tomorrow, I have a breastfed baby that I’ve already been away from for one night, I’m in pain, bleeding and I’ve already had sepsis last year from a womb infection whilst giving birth so I’ve raised infection risk as a concern. I feel so angry about this. Would they deny women treatment for miscarriage? Or is it because there may still be a foetal heartbeat present? Is it simply because I’ve chosen to end the pregnancy myself? How in an nhs hospital can women be denied healthcare like this?

The only reason OP hasn’t had the treatment she needs is due to misguided ethical objections, which is unacceptable. And I would be feeling a lot more dramatic than the OP is being, have some empathy!

I read somewhere that something like 10% of terminations fail. That’s an awful lot of women potentially having to deal with this sort of shit. Don’t do the job unless you can do the job.

Surely it would be helpful if, at the point of choosing specialties, the trainee doctors should be asked to confirm that they understand that by choosing gynaecology they will be faced with medical events that are currently entirely legal but which may conflict with their personal beliefs. Further that they will agree to prioritise the patient and the law above their own feelings, from whatever basis.

Not a hard one. If they can’t do that, at that stage, then there are plenty of other options.

We are not in Gilead. Or even the USA.

The irony of this statement, coming from the poster who said it, made me laugh out loud, albeit in horror.

"I read somewhere that something like 10% of terminations fail."

What does that mean though-that not everything is removed or that a viable foetus is left?

But it looks like the foetus is alive, diddl. It's in the OP:

Internal scan reveals what they think is a foetal heart beat still in there.

If so, then Tinyteatime will need a second TOP as the one she's already had didn't work.

The circumstances surrounding this sound understandingly upsetting and stressful for you at an already emotional time, but I am also struggling to see what basic medical care you have been denied.

There is no set up for you to be able to walk in to a hospital and instantly get an abortion as it is an elective procedure. The fact that you had one last week that may have been unsuccessful doesn't automatically change that. You will be allowed to have the procedure, but sometimes that involves a wait for someone who's prepared to do it or for someone to be free. Unless of course it's an emergency, which you were considered as for a while, then down-graded as thankfully your bleeding improved. The previous sepsis doesn't make you an emergency now unless you are showing particular symptoms or have a relevant condition that you haven't mentioned. Many departments are chronically understaffed. The doctors hate it as much as the patients and normally can't just swap things around.

The way staff have communicated with you may well be an issue that is complaint-worthy, but it really doesn't sound like your healthcare has been compromised.

The posters whipping things into a frenzy talking about doctors being unable to deny treatment to a paedophile etc are being plain silly. It's not a reasonable analogy at all - abortion objection is about not wanting to participate in intentionally ending any life, not about choosing to deny medical care from someone you don't think is worthy (women/murderers etc). There is no medical consensus about whether abortion IS ending a life, but that's why it's important to be able to opt out. It doesn't mean they hate women and shouldn't be a obstetrician/gynaecologist any more than a geriatrition who is against euthanasia doesn't obviously hate the elderly and shouldn't have to do another job. That analogy works only in places where euthanasia is legal, but it's the closest you can really get. Bottom line is some doctors are opposed to intentionally ending human life in any circumstances - that's it.

OP, I hope you manage to get back to your baby very soon for some much needed cuddles, rest and healing

This is terrible.

Religion is really full of shit, the root of so much evil in the world, in the name of religion.

I think people should keep religioun at home, do what you have to do in private but don't inflict your insanity on the rest of us.

Yes religion is a protected characteristic but it's not a free pass. In the same way that I - disabled - can't apply for a job as an Everest Sherpa and cry discrimination when they laugh at me, a doctor should not be applying for a job they have no intention of fully performing.

If we stop allowing health professionals to have their own ethics, and morals, and make them simply slaves that do what the patient wants, and is legal, I think we'll be in trouble.

I have little interest in the personal ethics and morals of healthcare professionals, I'm more interested in their professional medical ethics. Who do you think provides medical care to violent offenders, sex offenders and paedophiles? Perhaps we should just let these people die because we find their crimes unpalatable or maybe our health care professionals should leave their personal beliefs at the door and do their job. I had to many times when I worked in health care, it's called professionalism.

i would dial down the drama

Well, that has to be just about the most callous post I've ever seen on FWR. And I've seen a few.

OP. Please take heart most of us are not like this.

This is terrible! WTF why does it matter if your bleeding from an abortion what matter is you're bleeding and at risk of infection, havi g already had sepsis!!!

I will hold my hands up and say I'm pro life but that is me, I would never ever judge anyone for making a choice to have an abortion for whatever reason. And definitely wouldnt refuse to treat a women because she had one.
Each women has their own circumstances and reasons for having an abortion. Which is private to them. my two closest friends have had abortions, I dont love them any less... because my view is different.

The way you are being treated is an absolute disgrace! Dont bloody work in obs/gyne if it's against their religion its like being back in the dark ages!

Sleep warrior that would be all very well, if OP was being denied the op due to staff shortages or other emergencies. She was told she would have it and the only reason she hasn’t is because 2 doctors were unwilling to do it due to personal beliefs. That’s not ok!

OP, ask for a copy of your scan report to take home with you. What they have reported to you verbally about the scan (was this a departmental scan by Sonographer, or done out of hours by a junior, conscientiously objecting, Doctor?).

It doesn’t seem clear whether they have confirmed you still have a viable, intra-uterine pregnancy or not? This should be easily picked up, as you would have been at least 5 weeks by scan at the initial termination? It’s important that they are taking into account the scan findings prior to termination (which they can have emailed over from the provider). This talk of “possible flicker” of a heartbeat is emotive, distressing and completely irrelevant. This is a hospital that provides terminations!
It’s very standard procedure if you have an incomplete termination with significant bleeding to manage surgically asap and to give at least prophylactic antibiotics. Even more important as you are breastfeeding and they are pushing outpatient management.

I feel ashamed my peers are treating you like this. Fucking disgraceful. Stay strong OP.

Surely they cant force you to leave, and they cant stop your baby being with you?

I would stay and take baby into the ward with you

Just want to say OP. I appreciate you are going through a very traumatic time and I hope your ordeal is over soon.

What should say more clearly - if you still had an intra-uterine pregnancy and no bleeding or pain - then yes, that would be managed on an outpatient or daycase basis by either the original or another TOP provider. Not all UK gynae units provide an elective TOP service - still appalling, but understood this is the situation.
However, that is not the case here. There is no defence for delaying treatment given that OP has been assessed as needing it (unclear whether the surgery is a TOP or ERPC).

IF you no longer have an identifiable pregnancy on scan (at least a yolk sac and gestation sac intact), then any refusal to deal with retained products as a result of a TOP, in an emergency situation, does NOT come under the defence of conscientious objection. They are on extremely shaky ground if this the case, OP.

That analogy works only in places where euthanasia is legal,

Like with terminations, only certain places perform euthanasia in those countries. A better analogy would be, a doctor taking a job at a clinic that performed euthanasia and then refused to do it when asked. Doctors don’t need to get into gynaecology, they choose to. If they choose to and then refuse to perform certain gynaecological procedures, they’re placing their morals before patient care. They should not be in that area of medicine. The end.

Doctors don’t need to get into gynaecology, they choose to. If they choose to and then refuse to perform certain gynaecological procedures, they’re placing their morals before patient care. They should not be in that area of medicine. The end.

THIS.

@JessicaWakefieldSV

Totally agree.

Doesn’t this also make the case for clinics like BPAS & MSI to beef up their aftercare and put in place emergency provision?

That way women get the speedy care they need (and have paid for) and no conscientious objection issues.

Given the amount of income they generate they ought not just to abandon their clients to the NHS?

(I have the same issue with private hospitals btw. I had retained infected placenta after my first birth at the Portland, who shunted me off to A&E. I had to wait 3 days over a bank holiday before it was sorted. Breastfeeding a newborn while on IV antibiotics was fun).

As I said, I do feel for you and hope you get back to your baby soon.

Sending love. This is terrible, I'm shocked.

Several PPs have said that doctors should not choose obs and gynae as a specialty if they have religious objections to terminations.
However, gynae is not one blanket specialty. Many consultants wish to subspecialise into areas that have nothing to do with pregnancy or termination, eg gynae cancers, incontinence, prolapse surgery, infertility etc. They are only indirectly involved during their basic training, where their conscientious objection allows them to opt out and transfer cases to colleagues.
In most large hospitals, a willing colleague would be available on a daily basis, but in smaller ones the rota may be more problematic. The on call team in this case seem to feel that there is not a significant risk in waiting to the next day - the bleeding has slowed and there is no sign of sepsis. You can’t keep dragging the one willing doctor in when they’re meant to be off duty- that would only be justified in an emergency.

Op has said where for those who've missed

NORTH DEVON

"There are 2 doctors apparently here who will do it. But they are busy all day" unless they're busy dealing with abortion stuff (which I highly doubt) then why can't the Drs objecting to abortion swap duties with them?!

I too in your position would be asking even demanding they put their refusal to treat on religious grounds IN BRITAIN in writing including that they acknowledge they're increasing your medical risk, I'd be telling them if you do end up incurring illness or medical injury as a result you WILL be suing, also request the information on their complaints procedure, and start calling lawyers.

I'd also be strongly suggesting the press might be hearing from me!

Quite honestly I'd also be asking to speak to the consultant and higher if necessary as a matter of priority.

Fucking outraged on your behalf! Wtf! Denying a patient NECESSARY medical treatment on religious/moral grounds is UNACCEPTABLE!

Name and shame op maybe somebody in that hospital/health trust can help?

"I have no problem with people who are religious practicing medicine, but if your religion prevents you from caring for some gynae issues then you should not be working in OB/GYN." Totally agree!

"Anyone who CHOOSES to be an OB/GYN doctor knowing they won't care for women who need this treatment has suspicious motives, in my mind." Absolutely!!

I reckon time to go nuclear! Social media, formal complaint, press whatever it takes. SHOULDN'T be necessary in Britain in bloody 2019 though!!

Although at this point I'd be naming and shaming the particular hospital! I for one would be more than happy to contact on your behalf.

"These people don't give a shiny shit about actual babies - the lack of concern for the bf baby is absolutely vile. So clear that anti-abortion actually means anti-woman" appallingly accurate

"Time for the law to change.
No more opting out.
Treat all your patients, with severe consequences for your refusal. If you can't, become a dentist instead." Hear hear!

@fermerswife so sorry you went through that. Outrageous that we still have a part of the U.K. Treated differently! Utterly ridiculous!!

"and I say sue the bastards" me too! Amazing that often when their livelihood and money is threatened people like this (religious bigots) often "change their minds" or don't feel as strongly!

"Treatment has gone from bad to worse." Omfg!!

"They are saying I can go, but have no guarantee that I have a place booked for tomorrow" this is emotional blackmail wtf do they think they're playing at?!

Seriously if at all possible get a lawyer representing you asap!

Disgusting behaviour!!

"They will be christian or catholic where its against religious beliefs to terminate pregnancy" it's absolutely not just Christian/Catholics that object!

"If we stop allowing health professionals to have their own ethics, and morals, and make them simply slaves that do what the patient wants, and is legal, I think we'll be in trouble." Rubbish! Morals and bigotry are not the same thing!

"Bigglesworth you're not pro-life, you're pro-forced-birth. Be honest." Damn straight! And anti woman too. "No, I'm not pro-forced birth at all." Yes you are because that is the consequence of not providing abortions! "I'm pro choice." Only when it's your choice! But whether a patient continues a pregnancy or not isn't your choice to make!

"that the procedure was no longer urgent, which looks like an after-the-fact justification to me." Absolutely! It's a bullshit arse covering excuse!

"Put simply, because religion is a protected characteristic" there are legal exemptions for the equality act for lots of far less important reasons eg not being made to cast a male actor for a female character in a bloody film! No reason why this can't be done regarding which Hcps are recruited for certain areas of medical care.

"trainee doctors should be asked to confirm that they understand that by choosing gynaecology they will be faced with medical events that are currently entirely legal but which may conflict with their personal beliefs." These are intelligent well educated people they know exactly what they're doing! I'm with the pps saying that people who have religious/moral objections to abortion, contraception etc specifically going
into areas of medical care where they KNOW they will have to deal with such things have ULTERIOR MOTIVES in doing so! It's disgusting! And shouldn't be supported and those HCP's shouldn't be protected/supported in doing so.

"Unless of course it's an emergency, which you were considered as for a while, then down-graded as" to accommodate the hcps religious objections! I strongly believe that's what's happened.

Don't agree with abortion? Great don't have one! But if you're a hcp in this country where abortion is to all intents and purposes legal you have no right to enforce YOUR religion/morals onto patients!

I didn't see the objecting radiographer thread but did recently comment on a thread re pharmacists refusing to supply map and the same applies there.

DON'T AGREE WITH KEY ASPECTS OF A JOB - DON'T DO THAT JOB!

Doesn’t this also make the case for clinics like BPAS & MSI to beef up their aftercare and put in place emergency provision?

I agree with this. Surely if it’s a failed TOP and the woman is stable, the clinic the woman went thorough should provide follow up care?