Former miscarriage patients look forward to promised changes

Barb
Barb Sweet
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Some women who told their miscarriage stories to The Telegram are glad to see Eastern Health has taken action, but they are cautious about the promise.

The entrance to the emergency department at the Health Sciences Centre in St. John’s.

Eastern Health said Tuesday it has asked staff to make sure psychosocial support is offered to women who miscarry.

That request was made as the health authority discusses the concerns of women who have gone through the experience. Numerous women and their spouses — nearly 20 people — have contacted The Telegram, and the newspaper has been telling some of those stories over the past month. Most of them involved the Health Sciences Centre ER in St. John's.

I hope it does change. I really do have high hopes, but not necessarily high expectation," said the first woman to contact The Telegram about her miscarriage experience.

"It's something that needs to be talked about. The situations and the unfortunate circumstances need to be in the forefront, need to be talked about constantly."

In August, at nine weeks' pregnant, the woman waited in the Health Sciences ER, told a nurse her bleeding and pain were getting worse, and finally miscarried in a toilet.

Days later, she found out a nurse on duty, backed by the opinion of a colleague, made the decision to flush the remains, she said. Meanwhile, she waited in a room for hours.

The woman said the health-care system is reactive rather than proactive, but she hopes change will finally occur.

"You can have all the protocol you want. None of it matters if you don't follow it," she said Tuesday.

When she first emailed this reporter in November, she said she didn't expect any interest in her concerns, let alone the issue to be pursued and responded to by many more who'd had similar experiences.

"I didn't expect it to be on the front page with a graphic-content label. But I am so glad it was there. It brought shame to Eastern Health like it should," she said.

Overwhelmingly, those who have contacted The Telegram about their personal experiences have expressed dismay at their treatment in the ER, where they say the emotional trauma of their pregnancy ending falls by the wayside.

Women 20 weeks pregnant or more suffering miscarriages go to the labour unit, while those under 20 weeks are advised to go to the ER for assessment. Many of those who told their stories described the treatment as emotionally harsh, as they left the ER with no information about their recovery.

Some women who had ongoing physical symptoms — such as the passing of the remains of their pregnancy — felt they had not been adequately prepared for what was happening to them.

Eastern Health's existing policy when a miscarriage occurs suggests emergency department staff can consult the psychiatric nurse on duty to support a patient in crisis, and there are full-time social work staff in the city's hospitals.

Patients are also supposed to be offered the number for Eastern Health's mental-health crisis line, where support can be provided and a referral made for counselling.

But many who contacted The Telegram said they did not receive as much as a phone number.

Monday, The Telegram asked if any changes were being made to address the patients' concerns.

Eastern Health said Tuesday it is discussing women's care and trying to ascertain why the protocol was not always followed previously.

"Discussions around the care of women experiencing a miscarriage are currently ongoing; however Eastern Health has asked its staff to ensure that psychosocial support is offered to women following a miscarriage," Eastern Health said in an emailed reply.

"On a regular basis, Eastern Health reviews its policies and protocols to improve the quality of care for its patients. It should be noted that changing a policy or protocol may require extensive discussion and research and, as such, can take time."

Among the people who contacted The Telegram in the past month was a Mount Pearl woman who'd complained a decade ago to the then St. John's Health Care Corp.

At the time, she attended a meeting and received a followup letter that acknowledged the ER isn't the ideal place for patients to be treated for miscarriages.

It also acknowledged the psychological impact of the ordeal and promised a number of changes.

That woman said she lost faith in the health authority after reading The Telegram's stories.

"The only way I can gain trust back in the system we have is once I start hearing stories that they have changed and they are making a difference," she said.

"I have heard this before. Are they going to do something about it or is this just a tactic right now?"

She hopes women will come forward in six months or a year's time to tell about their experiences, good and bad, and that Eastern Health will be open about any changes it makes to services for patients who suffer miscarriages.

"I am actually really happy with all the women who have spoken out. It takes a lot of courage to come forth with this kind of tragedy in their lives," she said of Telegram coverage.

"I had a chance to tell my story and I am glad so many other women did."

Another woman, who had a miscarriage in September, said she'll believe change has happened when she sees examples.

"I really hope they follow through. No one should have to go through that again," she said.

Candace Piercey of New Harbour contacted The Telegram this week about her 2009 experience at the Carbonear hospital, because she hopes things will be easier for other patients in the future.

"That day and night was the worst night of my life and I had never felt so unimportant in my life," she said.

"It's a horrible experience to go through, and to feel like you shouldn't even be there in the hospital ...

"I didn't see no compassion. ... Health care needs to change their policies."

 

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•••

(Tuesday story)

Eastern Health has asked its staff to make sure psychosocial support is offered to women who miscarry, a spokeswoman told The Telegram today.

That request has been made as the health authority discusses the concerns of women who have gone through the experience. Numerous women and their spouses have contacted The Telegram and the newspaper has been telling their stories for weeks.

 A common thread among the stories is their concern about having to go to the ER for treatment — women pregnant 20 weeks or more suffering miscarriages go to the labour unit — and the lack of support they were offered in the wake of their losses. Many described the treatment as emotionally harsh as they left the ER with no direction as to their recovery. Some women who had ongoing physical symptoms — such as the passing of the remains of their pregnancy — felt they had not been adequately prepared for what was happening to them.

Eastern Health’s existing policy when a miscarriage occurs, suggests emergency department staff can consult the psychiatric nurse on duty to support a patient in crisis, and there are full-time social work staff in the city’s hospitals.

Patients are also supposed to be offered the number for Eastern Health’s mental-health crisis line, where support can be provided and a referral made for counselling.

But many who contacted The Telegram said they did not receive as much as a phone number.

Monday, The Telegram asked if any changes were being made to address those concerns.

Eastern Health said this morning it is discussing women’s care and why the protocol was not always followed previously.

"Discussions around the care of women experiencing a miscarriage are currently ongoing; however Eastern Health has asked its staff to ensure that psychosocial support is offered to women following a miscarriage,” Eastern Health said in an emailed reply.

“On a regular basis, Eastern Health reviews its policies and protocols to improve the quality of care for its patients. It should be noted that changing a policy or protocol may require extensive discussion and research and, as such, can take time."

 The health authority also said anyone who has questions or concerns about the care they received can contact their client relations office toll-free at 1-877-444-1399, or at 709-777-6500.

 •••

(Earlier story)

Women implore Eastern Health to act on miscarriage complaints

Two more women who have contacted The Telegram about their miscarriage experiences want to know what Eastern Health is doing to ensure all women who lose their pregnancy are treated with equal compassion.

“I don’t know if they’re trying too hard to be professional that they end up coming off as cold,” a

St. John’s woman said of the health-care staff she encountered.

“But there is absolutely no compassion.”

The woman contacted The Telegram after reading of similar experiences — at least 15 people have raised concerns directly as a result of the initial story of a woman suffering a miscarriage in a bathroom outside the Health Sciences emergency room this summer.

Among the latest to come foward, a woman who said she miscarried in 2010, went to the

St. Clare’s emergency room and was referred for an ultrasound at the Janeway. She thought she was around 11 weeks pregnant at the time. While having the diagnostic test, a student technician was in the room, which the woman found jarring when the technician pointed out an abnormality to the student.

Next, a doctor informed her the scan showed an eight-week-old fetus with no heartbeat.

“I am still appalled at the cold, callous treatment I received, and the fact that, like so many of these other women, nothing was given to me — no crisis number to call, no visit from a counsellor or nurse even though I was literally breaking down in that exam room, no information on what to do. My husband and I left the exam room and had to walk past several very pregnant, happy-looking mothers in the waiting room as I sobbed the whole way back to my car,” the woman said.

“Care in both the ER and the Janeway ultrasound clinic seriously needs to be reassessed, as these are two places in the health-care system where expectant mothers, no matter how far along, can literally have their hearts broken.”

The woman said she will never forget the starkness of the experience, along with the grief and said every woman who goes through it should be handed an information packet on miscarriages.

Sure women can Google some information, but they may not know what websites are trustworthy and coming from the doctor, it is a measure of care and following up on the situation that takes little of the physician’s time, she said.

When women give birth, she noted, they receive a package that tells them what to expect and the same should be done when they lose their pregnancy.

“For a woman trying to have a baby, the second you see a positive on the pregnancy test, there’s a baby inside of you,” the woman said. “When you take a loss, whether it’s full term or six or seven weeks, you’re grieving it the same way. (Nurses and doctors) don’t look at you that way. It’s another ailment.”

According to Eastern Health protocol, women 20 weeks pregnant and over are referred to the labour unit, while those less than 20 weeks along are advised to go to the ER for assessment.

In the woman’s case, she had a wait of weeks to see her family doctor, so went to the ER when she experienced some bleeding.

For another metro woman, the ordeal started out in St. John’s in 2011 and ended at the Grand Bank hospital.

Her boyfriend brought her to the Health Sciences Centre and she was given a referral to the women’s health clinic for the next day.

The doctor informed her the fetus was dead and gave her three choices — take a pill to speed up the process, have a dilation and curettage (D and C) — a procedure to scrape and collect tissue in the uterus — or let it happen naturally. The woman decided to let nature run its course and had been planning to visit family on the Burin Peninsula and was told to proceed with her trip.

But then she experienced unbearable pain for which she was unprepared and her father called the Grand Bank hospital.

“I thought I was bleeding to death,” the woman said. “I was totally blindsided.”

She passed what she thought was the baby’s remains and then was told to wrap it in tissue, which she brought to the hospital. But she said she recalls seeing the remains on the table next to her being put in the garbage by staff “as if it was nothing.”

“Through this ordeal I felt the doctors and nurses failed me and didn’t take the time out of their day to explain what I was about to experience,” said the woman.

“To doctors and nurses when you are not in your second trimester, you’re not really pregnant. … If you are pregnant, no matter how many weeks along, you should go to the caseroom.”

The woman said she and others like her deserve an apology from Eastern Health and assurances the treatment will change so there is compassion and a recognition of the emotional effect of the loss.

Eastern Health’s current policy, when a miscarriage occurs, suggests emergency department staff can consult the psychiatric nurse on duty to support a patient who is in crisis, and there are full-time social work staff in the city’s hospitals.

Patients are also supposed to be offered the number for Eastern Health’s mental-health crisis line, where support can be provided and a referral made for counselling.

But most of the women who contacted The Telegram said they did not receive as much as a phone number.

Organizations: Janeway, Grand Bank, Google Health Sciences Centre

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  • Brittany
    December 05, 2013 - 19:10

    I had no idea that women were treated this way. I had a miscarriage @ 13 wks. The doctor I had was amazing. She provided me with all the information about the type of miscarriage, told me about support group, and said to call her when I get pregnant again. She was also very compassionate. It's so sad to hear that not all women are getting this treatment. I really hope that there is something done because it is such a hard thing to go through and women need all the support they can get.

  • Reena Edwards
    December 04, 2013 - 13:12

    I too had a miscarriage in August 2012, by the calendar I was 1 7 weeks, On a Monday I went into the ER with cramps and light spotting. I was waiting for over 2 hours before I was seen even when I went up to the desk and explained my bleeding was getting worse. Finally I was brought into a room where a exam was done and the nurse said my cervix was still closed and that was a good sign, I had my hopes up, about 20 mins later the doctor and nurse came in and told me there were 98% sure I was miscarrying, I was heartbroken in between my crying I was trying to ask questions like what about the other 2% if there was any hope it would be shattered because the stress I am in now would not be good for the baby if I were lucky enough to beat the odds. I was told unfortunately they could not give me any answers until I had a ultrasound to confirm. They gave me the ultrasound appointment for 12:00 Tuesday. I had to go home with no knowledge of if my baby was actually gone or not, my mind was all over the place I had so many unanswered questions. I went back the next day for the ultrasound appointment I was just waiting to hear the most devastating news a woman can receive. The lack of compassion was ridiculous! I had to wait there obviously I was upset at what was to come and I had to sit there and watch all the other women come out with their pictures with smiles on their faces saying if they were having a boy or a girl. I had my ultrasound the technician didn't say a word I knew the result I didn't have to hear it from the doctor. As the doctor came in he confirmed that I had indeed had a miscarriage he told me the fetus stopped growing at 12 weeks, he gave me 3 options I could get a needle to make the fetus pass, I could let nature take its course or I could get a DNC. I picked the DNC, I was told to fast but they couldn't guarantee that the procedure would be done that day or the next because the way these procedures work is at the end of the schedule if there is enough time to do it then it would be done so I was basically on call. I went home again to wait for the phone call, early Wednesday morning at around 5am it passed on its own I was in so much pain and had no idea what to expect I was in the bathroom the fetus got stuck so I reached down and held it in my hand as I was waiting for the remainder to come out. I was so unprepared for this experience, it was horrible. I seen what was my baby it had a little face and legs and arms the position of the hand look as if it was sucking on its thumb. That is a image I will have with me for the rest of my life. I got a call later that morning to go in to have my procedure done, I explained how it had passed but they encouraged me to have it done anyways to insure everything was out. I had the procedure done after lunch on Wednesday afternoon. I am blessed now to have a son I was pregnant again 3 month later. I was almost discouraged about trying again because of the horrible experience I had with my first pregnancy. I believe that this is a very sensitive matter and all women in this situation should be educated, and prepared for whats to come during their miscarriage. The lack of compassion and consideration I had at the Health Science is haunting. I endured 3 days of horror. If a women is going through this they should do what needs to be done ASAP and not make them wait and wonder. Even the little things could of made my experience a little less horrible, they could of easily given me the last ultrasound appointment of the day instead of right smack in the middle of the day. If a woman is going through this I believe it all should be done and taken care of the same day so we can try and move on not make the painful experience linger. The treatment I received at the Health Science was disgusting! I wouldn't wish what I had to go through on anyone, they should be ashamed of themselves for the way they treat these women who are experiencing a life shattering situation.

  • Jan
    December 03, 2013 - 18:26

    It is also important too, that a woman also be encouraged to talk to Pastoral Care. As this is also a spiritual issue. There is grieving associated with a miscarriage, similar to that of losing a loved one. This too is extremely important

  • Jan
    December 03, 2013 - 18:25

    It is also important too, that a woman also be encouraged to talk to Pastoral Care. As this is also a spiritual issue. There is grieving associated with a miscarriage, similar to that of losing a loved one. This too is extremely important

  • Sue
    December 03, 2013 - 10:58

    Earlier this year it was determined at the ER that I had miscarried. I was in the first trimester. I was not given any information about support lines, mental health support, follow up treatment etc. In fact, my only information was what I would later research on my own via the internet. There was one nurse working that night who was particularly supportive during our 12 hr ordeal. I must acknowledge that. I am once again pregnant and have had to unfortunately (and with great hesitation and reservation I will add) visit the ER.. Since this was after the Telegram's article on the topic I expected an improvement. After waiting for several hours I was seen in a shared room where I was told that I was miscarrying. The doctor was wrong. Her assessment was incorrect and based on her lack of understanding regarding HCG levels (amongst other things). I was also given an internal exam using a lamp from the 1960s which was pulled from the hall somewhere. Luckily this time I was referred to the Women's Health Clinic. I was fortunate to receive great care at the Women's Health Clinic and then from the Fertility Clinic. I will also mention that several professionals who I encountered during this time advised me not to go back to the ER unless I felt I was going to bleed to death. The ER is not the place to treat pregnant women! ER staff are for trauma and really are incompetent for the most part when dealing with complex pregnancy related issues. Where are women in early pregnancy supposed to go for help? Family doctors send them to the ER, it's near impossible to get in to an OBGYN, and any specialists require referrals. I'm not sure Eastern Health really cares.

  • david
    December 03, 2013 - 09:50

    Collective bargaining agreement: Nurse enters patient room, holds patient's hand with left hand, strokes gently with right, while repeating: "There, there". Repeat up to 6 times.

    • Anon
      December 04, 2013 - 10:09

      That's got to be about the most ignorant and disrespectful thing I've read in a long time. You've clearly never had to go through losing a child in such a way. Hopefully you never will, but if you do, I hope you remember the comments you've made.

    • jason
      December 04, 2013 - 12:20

      Wow David Grow up man. You obvisiouly have not been in this situation with your partner or else u would not be making this comment. No doubt you are an advocate for hospital staff and probably encompassed within there collective agreement. Until you go through this situation with your spouse, I suggest you keep your comments to yourself

  • Purple Haze
    December 03, 2013 - 09:37

    Heartbreaking and disgusting how these and other women and spouses have been treated. To experience such trauma with no on the spot and followup mental health support is unspeakable. And that staff have to be asked to make sure this happens? It should be part of protocals just like taking blood or any other health care practice. Good mental health is only a joke in this province. It's the luck of the draw with health care practitioners...like most professions...sometimes you strike gold - sometimes you hit rock. Isn't there a women's health section at HSC? For women by women...maybe experienced survivors might have a role to play.

  • Lynn L.
    December 03, 2013 - 08:01

    Reading this article was heartbreaking.I can only imagine what these women had to go through at a time when their dreams are coming true. Then having to witness their dream being thrown in a garbage!! Have some compassion people you are suppose to be professionals!!!! Treat your patients as you would want to be treated! Losing a baby is There is support available through the Mental health crisis line.It is professionally staffed by Nurses and Social Workers 24 hours a day seven days a week.

  • Jean
    December 03, 2013 - 07:57

    These women were treated with such coldness because the fetus is not considered "a baby" by the society we live in today. It is a sad commentary on our health care professionals when women are treated in this manner. A fetus put in the garbage is such an insult to human dignity. Money cannot fix this treatment. What we need is compassionate, caring individuals working in these areas.

  • Me too
    December 03, 2013 - 06:43

    I too had a miscarriage. Mine was at the beginning of my second trimester. I did not receive a phone number, an information package, or access to a social worker or other counsellor. The devastation was more than I could have imagined and lasted for weeks. More support should definitely be available.