You have had two miscarriages and you consider yourself lucky.
Obviously you consider yourself lucky because despite miscarrying you have two live, healthy and handsome children. But you also consider yourself lucky because you had your miscarriages at Chelsea and Westminster Hospital. And Chelsea and Westminster Hospital is pretty good when it comes to looking after miscarrying women.
This is worth mentioning. It is worth mentioning because good care of miscarrying women is not something that miscarrying women can expect. And it should be.
They want, we all want, we all should be able to expect:
- Supportive staff
- Access to scanning
- Safe and appropriate places for treatment
- Good information and effective treatment
- Joined up care
But what does that mean in practice?
Chelsea and Westminster Hospital has a special ward, somewhat euphemistically called the Early Pregnancy Unit* separate from the ante or post natal wards, so separate it is on the opposite side of the building and on a different floor, for women who have pregnancy of other gynecological or obstetric complications. This means that you were not forced, as others have been forced, to miscarry while surrounded by pregnant women or new mothers. Admittedly, you found out that your first baby had died while surrounded by pregnant bellies, but that was because you had a missed miscarriage which was only discovered when you went in for your 12 week scan. They let you hide out in the scanning room, though, while they booked you in to the early pregnancy unit, which given that the ante natal clinic of Chelsea and Westminster Hospital is busy busy busy was not an inconsiderable favour.
The staff at the Early Pregnancy Unit have clearly been trained in how to react to people who are miscarrying. For your first miscarriage they provided you with a room to sit in and cry, and when you were admitted to the ward for a D&C** they put you at the far end, drew the curtains, and left you alone as much as possible. For your second, you were even more grateful. You were only six weeks along, but the nurse announced the confirmation of your loss with the same weight and sympathy you would expect in the announcement of any family member’s death. That acknowledgement meant a lot and still does. And yet it is not something that everyone gets.
You also did not have any trouble getting a scan. Of course, you were sensible enough to have your miscarriages midweek, which helps. And since the point of a missed miscarriage is that nothing is happening, a scan for assessment purposes was inevitable. At the time you personally needed it to confirm that the nightmare was real. You were torn between hope that a mistake had been made and that the heartbeat would show up this time and dread that a mistake would be made and a D&C would be performed on a perfectly happy baby if you didn’t check and double check just one more time. The fact that there was no need to fight for that, as some people have had to fight for it, is something you are grateful for.
Given that your second miscarriage was so early that you had only a few days before let your GP practice in on the situation, it seems you were also lucky to be able to phone the unit up on the morning you started bleeding and get an appointment for first thing the next day. You were armed with the promise of a referral from the (sympathetic) on-call doctor at your local surgery, but given that you’d only just put the phone down to him when you phoned them, you were mildly surprised to find they were so accommodating.
The quality of information they gave you in order to help you choose what you wanted to do was similarly without reproach and they were careful, especially in the first instance, to bring the miscarriage support groups to your attention.
Unfortunately, you will say that after you D&C you had not realised, and nobody told you, that you would start getting contractions, and really quite impressive ones, when your body finally caught up with the reality of the situation. They did seem bemused that you were waving away the painkillers as you left, but it has been your experience that Hospitals are often a bit vague about what might happen to you once you are out of their care. It’s something you feel could be improved across the board for all types of health issues. As it happens you were able to ring up NHS Direct, who explained the fact of life patiently and reassure you that nothing had been damaged permanently. Still, a heads up would have saved you some anxiety, and you might have taken the painkillers they offered you home too.
As for the joined up care, for your second miscarriage, despite the trip to the Hospital and the call to the doctor’s, you still received all the letters booking you in for your first antenatal appointment, along with your free prescription card and a magazine-style brochure detailing every week of pregnancy and containing lots of jolly articles about what you could expect over the next 40 weeks.
You don’t know when you received it, though, as in an act of great wisdom and kindness, your husband hid all of these things from you and you didn’t find them all until some months later***. You are therefore going to assume that this was just an accident of the timing of your miscarriage so close to your initial GP visit. Certainly, unlike others, you heard no more about it when the appointment time duly rolled round. Still, you do feel that perhaps the notifications of miscarriage to the relevant departments could be given a higher priority.
That was your experience. But it seems that you simply won the postcode lottery this time. To help make the experience as bearable as possible for all women, join the campaign. Write to MPs, to the Health Secretary, to the local NHS trust, and even the local paper.
*The name could do with some work, it’s true.
**Which is what you have if you decide not to let nature take its course, when you have a dead baby inside you showing no desire to leave of its own accord. You are afraid you absolutely refuse to explain the procedure any more than that. You had to explain more times than you care to remember while you were waiting to have it done, as it seems to be standard practice to ask patients what they are in for every time blood pressure or whatever needs taking and you had neither learned the acronym nor thought of a gentle way to phrase it. This could be improved. Unfortunately, you are not sure how as undoubtedly there is some sound reason for checking the patient knows what is being done to her, and the alternative, having the nurse supply the prompt would probably look like this: ‘So you are here for a D&C?’ ‘What?’ ‘[Insert brutal medical description here]’. Still, advising miscarrying women to memorise the acronym quickly might help.
***It’s all still there, in an obscure corner of an obscure cupboard. I don’t think either of you can bear to remove it.