Tuesday, October 28, 2008

Miscarriage: must doctors make our grief worse?

Belinda BentonInsensitive health workers compound the suffering caused by miscarriage, but a Mumsnet campaign aims to change matters

Belinda Benton's second pregnancy was going swimmingly - or so she thought - until she went to hospital, at 12 weeks, for a routine ultrasound scan. “On my way to the appointment I realised that I was bleeding,” she says. “When I got there they said they would go ahead with the scan and see what was happening.”

When the ultrasound equipment was switched on, says Benton, “there was just silence. No one said anything until I said, ‘There's nothing there, is there?' And the doctor burbled and eventually said, ‘No, there's no baby'.”

Ten steps to a caring NHS

The Mumsnet recommendations

1 GPs, early pregnancy units (EPU) and A&E staff should be trained in communication techniques (including things not to say to women who are miscarrying).

2 Access to ultrasound scanning facilities in cases of suspected miscarriage should be easier.

3 Women undergoing miscarriage or suspected miscarriage should be separated from women having routine antenatal and postnatal care, and women terminating an unwanted pregnancy.

4 Waiting times, especially for women who need surgery, should be kept to a minimum and women should not have to wait in antenatal or labour wards.

5 The surgical procedure “evacuation of retained products of conception” (ERPC) should be renamed to be less confusing and upsetting.

6 Women having a miscarriage should have the different options explained to them: “natural” miscarriage; medication to speed up the natural process; and surgery.

7 Where miscarriage occurs in hospital, doctors should discuss with the parents what they wish to happen to the foetus (ie, it should not simply be disposed of routinely).

8 Follow-up appointments and/or counselling should be routinely offered after miscarriage.

9 Information about pregnancy and miscarriage should be held centrally so that all pregnancy-related appointments can be automatically cancelled.

10 Consideration should be given to routine blood tests for any conditions that could cause miscarriage.

Full article:

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