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?

@drinthehouse incredibly arrogant and ill informed posts by you, because even if you'd only read the op's posts you'd know that there WAS clinical reasons why op should have been treated earlier.

Seems to me sheer luck that she hasn't (as far as we know yet) developed any complications or infection as a result of treatment being delayed NOT for clinical reasons but because the hcps treating her prioritised their beliefs above hers.

Whether this was for religious reasons (which op was actually told this) or moral/conscientious objections is actually irrelevant.

Abortion is under certain circumstances legal in Britain and even if it weren't they would STILL have a duty of care to treat her based on clinical need. As has been pointed out many times on the thread hcps aren't allowed to object to treating patients or delay their treatment on MORAL grounds for ANY other reason. It's sheer hypocrisy and double standards! It's misogyny and discrimination and it needs to STOP!!

"doctors do have a choice (and thats never going to change)" why the fuck not? There's no reason why it cannot and should not be changed none!

"if something more important comes in they will be bumped down the list" but that's NOT what happened here. There WEREN'T more urgent cases op was denied treatment at an appropriate time PURELY on moral grounds - that is NOT how the Nhs is supposed to work even where hcps object to being involved in treatment relating to abortion they're supposed to ensure other hcps provide the treatment.

"I don't think many people on here understand the concept of emergency medical treatment." On the contrary it seems a certain type of hcp are the ones who don't understand! Or rather they prioritise a potential life over an actual one!

"I understand the argument that if doctors are uncomfortable with any aspect of treatment they shouldn’t go into it and I’d like to agree with it. However what do we do if it turns out the demand of this medical skills set far outstrips supply?"

If the rules were changed such that it was made clear to hcps that they are to carry out their duties with priority given to patient care and the law of the land and NOT their personal moral high horses then one would hope that people with such views wouldn't even enter healthcare, leaving vacancies for training and recruitment of people who DO understand that their job is to provide healthcare - not make moral judgments on women's choices!

"Anything short of that and you’re agreeing that women who have had, or are seeking, terminations deserve to be treated less well by the healthcare system as other women. Which makes you a shit human being." Hear hear!

"To all those slating doctors/nurses/nhs - you will miss it when its gone and youre needing to pay."

That has fuck all to do with this situation! Also I speak as an ex nurse myself, just as in any profession there are good and bad, putting people on a sainted pedestal JUST because they're an hcp is ridiculous!

Oh - and we DO pay for it just not at the point of use!

"As said already, I've had years of recruiting HCPs and am only too well aware of just how fast "objections" can vanish if there's a consequence to the HCP themselves, as opposed to their patients" totally agree. I've met many hcps with "moral objections" to certain things (mainly contraception and abortion it must be said) who when holding those objections means they may not get a certain job or promotion? Those objections miraculously vanish! It's utter bollocks in most cases!

This is what I don’t understand as a pro-lifer. A woman with retained products is not requiring abortion so there should be no objection.

I understand that a scan would be necessary but would a doctor really be looking for a reason not to perform a D&C on religious grounds? I’ve had to have surgery after medical management for a missed miscarriage and had absolutely no moral or ethical qualms about it.

I also think it’s really wrong of this doctor’s colleague to tell a patient something about his views or faith which may or may not be true which is leading to a lot of assumptions about the scan & delayed treatment.

Definitely worth pursuing.

Sorry I am assuming the scan doctor was male. Could easily have been a woman. Or did OP say it was a man?

But it seems odd.

I think that the hospital should have a statutory duty to provide at least some/one HCPs willing to provide all of the services provided by the department they work in at all times. Conscientious objectors should not be allowed to compromise service levels.

Trouble is that many doctors on O&G don’t want to do abortion after witnessing the procedure on their original rotation.

A 2011 survey on attitudes of medical students said this:

“Backing for a doctor's right to refuse to perform any procedure was highest among Muslim medical students, at 76.2%. Some 54.5% of Jewish students also thought doctors should have the right to refuse, as did 51.2% of Protestants and 46.3% of Catholics.“

Not very relevant stats Carol, it’s percentage of religious doctors. So not necessarily ‘many’ doctors overall.

I understand that a scan would be necessary but would a doctor really be looking for a reason not to perform a D&C on religious grounds?

I truly believe this was the case. I thought the whole way he conducted the scan at the time was odd. He at first said my womb was pretty empty and I had probably passed the retained product, then he spotted what he said was a collapsed sack, then he spent a further 10 mins looking and looking for something, which I now realise was that flicker that could be interpreted as a heartbeat. He never actually said ‘this is a failed termination as there is still a heartbeat’ he only ever referred to it as a ‘flicker’, and he showed me what he was looking at and tried to get me to agree that I could see it (I couldn’t). He then rushed out of the room without saying anymore to me and I saw/heard him discussing it with his junior doctor in hushed tones as I walked back to the ward. Yes his colleague was indiscreet, she probably shouldn’t have told me that he was a religious objector but I think she just felt righteous, and wanted me to know that more of the medical staff I’d had contact with viewed my perfectly legal and reasonable actions as abhorrent. After the scan though I was still added to the surgery list, so someone who reviewed it later that evening deemed it necessary. I get the sense that the junior doc who scanned wanted to give his seniors a get out as he knew they dint like dealing with termination, that is speculation by me though. Whether they would have treated a woman having a natural miscarriage the same I will never know.

It’s all absolutely fucking outrageous. I am incensed for you OP. Are you going to complain?

@Annasgirl Also, a woman in Ireland died from sepsis in a situation like yours

What a disgraceful thing to say to OP when she's in this position

“If the rules were changed such that it was made clear to hcps that they are to carry out their duties with priority given to patient care and the law of the land and NOT their personal moral high horses then one would hope that people with such views wouldn't even enter healthcare, leaving vacancies for training and recruitment of people who DO understand that their job is to provide healthcare - not make moral judgments on women's choices!”

Remembering all the arguments leading up to Brexit one of which was that we weren’t training up enough Doctors I can only conclude we have a skills shortage already (which we meet through immigrant doctors and nurses), so I’m not so sure that placing restrictions on recruitment can do anything other than squeeze that number further.

I quite agree hospitals themselves are failing as there should be procedures for this sort of thing to ensure both doctors rights to practice medicine according to their own ethics as well as meeting the needs of patients. Maybe if Barnstaple was shut down and the OP had gone to a larger hospital this need could have been met properly.

I don't know if things have changed dramatically but when I was A level/uni age medicine was very competitive and there were loads of people with good grades and relevant work experience not getting places. Would there really be a shortage if it was restricted to people actually willing to do their jobs?

@Tinyteatime The heavy bleeding and cramping is normal though op? I had to have a medical termination (for medical reasons - was devastated) and I had extremely heavy bleeding & cramping for 2 weeks after. That's how long it takes for everything to come out. It's not instant. I had to wear a nappy for nearly 3 weeks it was that heavy! I'm not sure why you even went to hospital? Unless you had actual signs of infection??? The last doc you saw probably removed the retained products out of precaution but it was perfectly normal for it still to be there. I'm amazed you weren't told all this when you had your termination

I think it depends where you study. Top universities for most subjects are fiercely competitive. Another issue to consider is say we ban conscientious objection. There is nothing to stop those people studying medicine getting the qualification and emigrating to a country with less draconian rules.

HappyLoneParentDay

I don’t think what you’re saying is true at all. I had a termination a few years ago and absolutely what you’re saying is counter to what I was advised. Bleeding heavily for 3 weeks is not a good sign. At all.

HappyLoneParentDay yes I just checked BPAS again and heavy bleeding is not normal for weeks after, it’s light bleeding for most, or spotting. Heavy bleeding for that long, is actually a danger in terms of blood loss.

@Dervel

It must vary but I knew several people who applied multiple times (during A level, post A level after gap year, post undergraduate degree, after another gap year) all with respectable grades and CVs.

I’m not saying you’re wrong @SnuggyBuggy just that it’s something to bear in mind. I don’t want to sleepwalk into a situation where general woman’s healthcare is adversely affected.

I am gobsmacked at the person saying heavy bleeding and cramps are normal. For me it was a sign of retained product and needed an urgent operation which they did in the middle of the night.

I am glad you are recovering Tiny. Do keep us posted.

Hope your supply gets back to normal in this heat and you get some R&R.

HappyLoneParentDay I was told by BPAS that if you are soaking more than 2 maxi pads per hour you must seek urgent medical help, as one of the small risks of an abortion is haemorrhage. In fact it says to call 999 in my booklet. I didn’t think it was necessary to call 999 as we were half an hour away from a hospital however by the time I got into a&e I was flooding my pad, my trousers were completely soaked and the pad on the wheelchair I was sitting in was flooded too. They rushed me straight into the ward so they clearly thought it was enough of an emergency. This was not within the realms of normal bleeding. My 1st pregnancy ended in a natural miscarriage at 12 weeks, so I had some idea of how things would play out, and knew this wasn’t normal.

Thanks everyone. My supply is slowly building back up with lots of eating and drinking. I feel nearly back to normal. It will probably take me a while to process everything and mostly I’m left feeling angry that this whole saga happened the way it did.

in general doctors are more religious than many other scientific professions, the number of doctors from certain groups which tend to be more religious is higher than the % of these groups in the general population
While religious affiliation tends to lessen with higher educational attainment it is not true in medicine
I think medicine is also an attractive field to those who are religious and draw to the caring professions
many doctors who do perform terminations stop doing so as they progress, religion may be a reason but others don't do then for non religious reasons

Recruitment and training of hcps is a whole other thread for many reasons but yea basically I don't buy that there's not enough people wanting to go into the profession that it would be a problem not welcoming those who would let their practice be hampered by their prejudices.

The problems with recruitment are manyfold but one major one is the lack of financial support to enable capable and willing poorer applicants to enter training.

*A 2011 survey on attitudes of medical students said this:

“Backing for a doctor's right to refuse to perform any procedure was highest among Muslim medical students, at 76.2%. Some 54.5% of Jewish students also thought doctors should have the right to refuse, as did 51.2% of Protestants and 46.3% of Catholics.“ *

a large number of applicants for medical school come from the above categories, medicine is very popular with BAME as it is seen as a high status job with good financial rewards and a route out of poverty and low status jobs
people who immigrated here and became shopkeepers and takeaway owners aspire for their children to become doctors / dentists /lawyers / engineers
The number of medical students that are Muslim or Hindu is going to be much higher than the number that are Catholic

quoted from British medical journal
"A third of all UK medical students are from minority ethnic groups, 1.6 times the proportion on other undergraduate courses, with by far the largest minority ethnic group being the Indian group (11%), followed by the Pakistani group (5%) (table 1⇓). In 2009, 36% of newly qualified doctors and 52% of all other hospital doctors working in the NHS were from minority ethnic groups."
so excluding people on the basis that their religious beliefs may influence how they practice is going to look very racist and/ or islamaphobic indeed

That’s interesting. In Islam it is believed that Allah has known people since conception but is also believed that a foetus doesn’t get a soul until 120 days (17 and a bit weeks) so up to that point a termination is completely acceptable.