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?

I didn’t want this t become a debate. I now realise I should have asked for a 2nd opinion on the scan. The doctor said he could see a collapsed sack at first, then he said he thought he could see ‘some flickering’. I now realise that this wasn’t really conclusive but have since learned from the other gyne that the doc that performed my scan also objects to abortion. I thought his manner was odd, because he was trying to get me to agree I could see it, when actually it looked very different to the other early scans I’ve had. I feel like they have almost conspired to stop me having surgical management. I’m out if hospital now and just hoping that I feel ok overnight, as I’m really not convinced that I have a live foetus at all.

" You can’t keep dragging the one willing doctor in when they’re meant to be off duty-"

So then the rota needs sorting out so that this sort of situation doesn't arise.

I had retained infected placenta after my first birth at the Portland, who shunted me off to A&E.

I had an ovary removed at the Portland and was admitted to the Royal Free after sepsis. The Royal Free saved my life and I had two of my babies there.

was this a departmental scan by Sonographer, or done out of hours by a junior, conscientiously objecting, Doctor?).

Just seen this. X posted. This is exactly what has happened. I’ve no doubt that it is not currently a viable pregnancy, ‘collapsed sack’ and possible flickers sound like two different interpretations could have been concluded.

Go home OP and get the proper treatment you deserve.

for your recovery. xx

OP, so sorry you are having to go through this and you have done amazingly to keep a level clear head throughout. I do hope you can get back to breastfeeding your baby soon.

Do take note of quince2figs posts (3 so far I think) who as a consultant gynaecologist is very well informed and has given excellent advice

You learned from a doctor that their colleague objects to abortion?

That sounds like a terrible breach of confidentiality. Isn’t it down to the doctor themselves to tell you this when you ask for abortion?

And no informed doctor regardless of religion would object to removal of retained products if there was no viable pregnancy. They wouldn’t just say “hmm there might be a heartbeat so I refuse”, surely, especially if you were at risk?

It sounds like a really unprofessional department.

@Tinyteatime

Please make sure the Care Quality Commission are informed of your experience of this hospital. Especially mention you being told that nurses could refuse to care for you. This is categorically untrue, no matter the religious/political affiliations of specific nurses.

www.cqc.org.uk/contact-us

Tiny - sorry your going through this it’s awful.
You should have the right to be treated without judgement.
I am past the point of sympathy for doctors nurses or pharmacists that object based on anything to providing women’s health care. Which is what they are doing. They shouldn’t do the job if they won’t do all of it. What happens if this balance tips further and further. I can’t believe how many staff tiny has had to deal with that have been or seemed like objectors during this thread. There should be some visual indication on their bloody uniform so everyone can see they won’t look after women. Ans they should not be on a staff rota in one department at one time. Hope you are ok Tiny.

I hope things are ok overnight

Yes thanks quincetofigs, your posts have been rather insightful. I wish I’d had you treating me. Thanks everyone else too for their input and the poster who gave me the BPAS contact, that’s really helped move things along with the hospital.

Im so sorry you’re going through this. I haven’t rtft yet, just the first and last couple of pages so forgive me if I’m saying something that’s already been said or repeated. I should also say I’m a GP and although I’ve done a fair bit of obs/gynae and do additional women’s healthcare now, it’s been a while since I worked in a hospital gynae ward.
As Quince says the decision for how urgently you need to go to theatre should be based on clinical need alone. If the decision is that you need urgent surgery within X amount of time because of your clinical condition then it is up to the hospital to ensure you get that treatment in the necessary time frame. If the doctors rota’d on object to doing the procedure because of their own beliefs (not always religious) then it is mandatory that this does not affect your care and it is up to them (or the hospital) to ensure that someone else is able to provide the care you need. It is not acceptable for them to object but no alternative provision is made and their position would be indefensible under current best practice guidelines should your condition deteriorate because of their failure to find appropriate cover.
If the decision is that clinically there are other cases which are more urgent than yours and that is the cause of the delay then this should have been explained clearly to you and the risks of infection should be minimised. I assume from what you’ve said that as you have ongoing bleeding this would be IV antibiotics (through a drip). I might be out of touch on that but it was certainly standard practice that women who were going through similar situations to yours were given at least antibiotic tablets as a standard when I last worked on a gynae ward.
In terms of what you can do, ask to speak to the Consultant on call if you haven’t seen them and if you have or they are objecting ask them why they aren’t providing alternative care for you.
for you and your family

So sad and outraged you are having to going through this Tinyteatime*.

The doctors and staff have behaved cruelly and unprofessionally. Its a disgrace. You deserve so much better.

and take care. Thinking of you and your family. Hope the organisations suggested will help to support you as time goes on. And there will always be women here who will listen and care

Yes religion is a protected characteristic but it's not a free pass

You're right, but there's the potential for it to be used as one and that will go right on unless it's stopped - preferably, for me, by removing all religions' protected status

A PP mentioned medics being asked about this at the application stage, but even if this was possible experience teaches that some will lie to avoid their chances being harmed and then go ahead and object anyway ... because they can, which brings me right back to the point above

Barnstaple hospital is failing. As I said up thread, the maternity dept has failed it’s recent inspection. It’s known to be a bad hospital. See if you can get to Exeter, it’s a far better hospital.

Dont let righteous indignation get in the way of actual medical need here.

The OP is currently not an emergency. Appropriate clinical care is being offered tomorrow and there's no reason she can't wait. Medical TOP is very different to a normal MC and there can be a lot more bleeding, so don't let this worry you unnecessarily. This is normal. Medical TOP can also take a couple of weeks to work so the fact OP is being told she won't get surgery at her local hospital until this time period is up is also normal procedure.

I know everyone has jumped on the whole conscientious objector band wagon, and that is a valid debate, but in the OP's case I can't actually see that the care she has had has been lacking (although the bedside manner may have been).

I know everyone has jumped on the whole conscientious objector band wagon, and that is a valid debate, but in the OP's case I can't actually see that the care she has had has been lacking (although the bedside manner may have been).

She is having to wait another day and night, not because of medical reasons but because two Drs have refused to treat her today.

Sorry but my care has been lacking. I now realise that the doctor who scanned me was searching for a ‘flicker’ that could be interpreted as a heartbeat, and he had to look hard. What he could see for definite was a collapsed sack, so it’s a miracle that he then went on to see a flicker after about 10 more mins of searching. I’ve had 3 prior scans at 7 weeks pg and a viable pregnancy is completely obvious at this stage, especially with a vaginal scan which is what I had. Im sure that what I have is a failed termination with retained products, I’m then kept in a night and whole day away from a breastfed baby, being told I’d have surgery tomorrow as I’m at risk of infection (as told by 2 sets of doctors). When tomorrow comes I’m just a pregnant woman seeking an abortion and all the on call doctors refuse to proceed the op I’ve been told I’m having. If that’s not lacking I don’t know what is. No my life isn’t at risk currently. I can tell you my mental state is in tatters. I feel foolish that I didn’t see from the start that they were conspiring to block my treatment, but honestly it never entered my head that doctors working in the nhs would do something like this.

If the decision is that clinically there are other cases which are more urgent than yours and that is the cause of the delay then this should have been explained clearly to you and the risks of infection should be minimised

This isn’t the case, as I’ve had it explained by the consultant exactly why my surgery was delayed, she did at least have the decency to tell me in person. The ward manager has tried to lie to me and tell me the reason was that they were too busy after I had cross words with her. Tbh, they'd have been better off lying from the start, then I wouldn’t question the decision as I totally accept I’m not emergency. Instead the consultant has told me that I’m not worthy of her treatment because she places judgment on the actions I have taken. I can’t think of another scenario in medicine this would be acceptable.

She is having to wait another day and night, not because of medical reasons but because two Drs have refused to treat her today.

Yes but she doesn't need treatment today. There is no medical reason she can't wait until tomorrow. This is an elective procedure

OP this isn't necessarily a failed TOP though. It can take up to 2 weeks to complete, occasionally longer. You may just need to wait a bit longer for it to happen on its own

In fact, if you've only just started passing clots and having cramps now, it may be that things are just getting started in terms of passing the pregnancy. If you wait you may not need surgery at all. Conservative management at this point is quite reasonable

I feel as a women seeking any sort of care for at risk early pregnancies we should have a right to know that the person we are trusting to treat us conscientiously objects to termination so we can at least ask for another opinion from the start. If my pregnancy were viable I would be 8 weeks now and it would be totally obvious from a vaginal scan. This isn’t the case. The doctor has ‘interpreted’ flickers in the screen. I’ve no doubt that the outcome would have been different if I hadn’t induced the miscarriage of my pregnancy. Let this thread be a warning to other women to always ask for a second opinion.

I'm appalled at the OP's management.

She may not be bleeding heavily, but is still at risk of infection.

Her treatment decisions have been affected by the staff willing to treat her, not directed by clinical need.

She has had an extended hospital stay - at additional cost - when it was unnecessary.

As a breastfeeding mother she has not been given priority. Not my area of knowledge, but does the equality act have any bearing here?

I hope you get sorted soon OP.

" I feel like they have almost conspired to stop me having surgical management."

It does sound like a conspiracy as the sonographer happening to think that he sees a heartbeat gives the other objectors a get out from having to be involved at all with Op's care.