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?

It's fascinating how attitudes change. One of the major pressure groups pressing for legalised abortion back in the day were doctors and midwives - because they had to deal with the aftermath of botched backstreet abortions, they were the ones who saw women dying from haemorrhages and infections.

Precisely. My DGM was a theatre nurse in the fifties and said it was horrific. She then moved to district nursing which apparently included giving contraceptive advice (mainly caps / diaphragms in those days). She was also one of the most religious people I know and for her nursing and her faith were inextricably linked. I often wondered whether it was because her own mother had died of an infection after giving birth to my DGM that nowadays would have been treated with a simple antibiotic. She was also way ahead of her time in terms of her thoughts on end of life care. I never really got the chance to ask the questions that I would now, and I don’t know whether her views on abortion were widely shared in the nursing community.

I haven’t RTFT in whole but I hope the OP at least got antibiotics pending seeing a reasonable medical professional.

I worked in gynaecology as a HCA for many years and the doctor that objected was possibly just doing a stint in gynae as part of their rotational training as opposed to specialising in obs and gynae. I'm Not condoning it just trying to explain possible reasons for it. I doubt the op was ever in danger of being sent home untreated.

Yes. Delaying the treatment by a day.

This is not acceptable within a modern 21st century healthcare setting.

Medical history has to be taken into account when dispensing reproductive healthcare and any care with the female reproductive organs. I wonder how many women choose not to disclose they have had an abortion for fear of judgemental attitudes that could result in sub standard care, which clearly the OP had.

Depends on her observations no temp etc and her blood loss as to whether a patient is rushed to theatre or whether they are put on the operating list for the following day.

Cushion read the full thread!

Like any good HCP, read the notes and listen to the patient.

point taken. It's a huge thread.

Jessica,I do not argue that women often have a tough time having NHS treatment.I am 60 and have been there.
What I was saying was that I hoped the OP would put in an official complaint.Most people who have a tough ride don't,they winge about it to the media,pop to say how bad service have been when there is a crisis but never put in an official complaint.
You may get a bland reply but every single complain is logged and patterns picked up ,things may change then.But if you don't complain then as far as the NHS is concerned it didn't happen.
Sorry OP ,my post wasn't to criticise you during a difficult time.I am glad you got suitable treatment,clinics have the necessary skill ,staff and time which is needed in your situation.And yes,I know about sepsis and because of your experiences you are anxious about it and the clinic did the right thing giving you antibiotics after the procedure.
And to those of you giving Drs a hard time noone denies that women have right to terminations but no one has the right to force someone to have one or perform one.This is why there are specialist clinics and we do almost no terminations in general hospitals.
Yes Drs could train in other specialities if they object but given that the numbers are somewhere over 90% there would be almost no gynacology service so there would be no one to do abortions or deliver your babies ,deal with life threatening bleeding(so I for one would be dead)or treating cancer.

The OP didn't have a termination at the hospital!

This is about the management of the retention of products from the uterus following a medical abortion. The patient OP was being judged! As PPs have pointed out, it might have been better for the OP to say she was miscarrying.

I think a lot of you have really misunderstood the situation.

OP presented as an emergency. She would have been treated as an emergency if she had remained one, however she stabilised and so no longer needed emergency treatment.

She had a scan during this time, at which the doctor thought he could see a heartbeat. Any further removal of the pregnancy with a live (albeit non viable) fetus would be considered a TOP. The doctors were therefore within their rights to state they would not be performing a D and C at that time because of the OP's non urgent status and the live pregnancy requiring TOP, rather than removal of RPOC.

All the posters stating she was refused emergency care and that the doctors refused to remove retained products are wrong.

For all those stating that there are no other circumstances where doctors can refuse to do a part of their job, you are also wrong. You can object on religious grounds (or conscientious grounds in TOP) because religion is a protected characteristic. When I was pregnant I refused to do night shifts, and I could do this because pregnancy is part of a protected characteristic. When I broke my leg I refused to do walking ward rounds on the grounds of temporary disability/health grounds, and didn't lose my job over it.

For those asking, I cannot object to treating a paedophile because "not liking paedophiles" is not a protected characteristic.

I could do this because pregnancy is part of a protected characteristic

So is being a woman,

The op had a legal medical procedure and needed treatment as a result of complications. Everything else is frankly irrelevant.

Clinical need should be the priority.

But @Graphista clinical need was met. She had the procedure as a non urgent elective, which was what her situation called for.

No, there is something wrong with the treatment the OP received. She was sidelined for a day because of various medics' beliefs. That shouldn't be so.

@Tuktuktaker but that's a completely different argument. Whether or not medics should be allowed to opt out, doesn't change the fact that they are allowed to and that the OPs care was within guidelines in this instance. They didn't do anything they weren't legally entitled to do and I'm not sure encouraging the OP to complain will get her very far, although there is likely to be an apology for upset feelings (which is pretty par for the course in the NHS no matter what you complain about)

All this talk of negligence and malpractice won't help

She had the procedure as a non urgent elective

The OP did not have this procedure as a non urgent elective

Have you actually read the thread?

Direct me to the 'guidelines' within this instance just I'd be interested to know.

Hint. It isn't the Equality Act.

Yes I've read the entire thread. Non urgent surgery is known as elective surgery. Elective doesn't mean "I choose this", it means it can wait ie not an emergency

I'm not talking about guidelines for conscientious objection, @placemats , I'm talking about NICE guidance for management of her presenting complaint

Okay.

Ignore those who have posted who have had to be stabilised before emergency surgery, like myself - this isn't ER, Casualty or Holby City. And not everyone is sent for a CT scan for a bump on the head or a fall on the floor either.

well said justchecking. You have however forgotten that the MN population believe that they own drs and we aren't allowed to have opinions, religious beliefs, families that might interfere with our ability to work full time or antisocial shifts, or in fact any life at all outside a hospital. I think they would actually have us sleep in empty body drawers in the mortuary so that we are on hand the second they step through the door to attend to their every whim. I tried to explain way upthread that the OP was treated appropriately (i.e. wasn't an emergency and didn't come to harm), but I got nowhere.

So, I'm not allowed to present a completely different, though surely relevant in the context, argument, justchecking1?

Guidelines.

That's the rub here isn't it?

Guidelines.

Abortion is bound by Law. The OP had her abortion under the strict legal parameters set by Law. Basically, the OP was presenting with a miscarriage post abortion.

Her clinical management after this abortion took place, which is her legal right, was disgraceful.

@Tuktuktaker yes of course you are. I'm just pointing out that those who are riling up the OP with talks of negligence and malpractice, and encouraging her to sue for the above are wrong.

@drinthehouse and breathe....

Basically, the OP was presenting with a miscarriage post abortion.

This is the absolute crux of it. She wasn't presenting with a miscarriage, she was presenting with a threatened miscarriage following TOP ie a live fetus. Therefore further management to end the pregnancy would have involved further TOP.

If the fetus hadn't been live, there likely would have been no issue

drinthehouse - what I am concerned about is that when the OP was initially seen by doctors, they thought she needed treatment asap. Then, it seems, a radiographer who had religious objections to abortions and knew of their close colleagues' religious objections to abortions, did their utmost to find a foetal heartbeat which probably wasn't there, in order to hand off the OP's treatment to a different ward so that they wouldn't have to be involved at all in the OP's post-abortion complications, thus delaying her treatment by a day and leaving the OP and the baby she was breastfeeding in a very uncomfortable position.