Miscarriage Counts

I’d just like to start by saying that this is not a ranting post at the NHS, nor its staff. I, for one, am extremely grateful for the NHS. It provides employment for my husband and many of our friends and family members. It puts a roof over our family’s heads through the Key Worker Housing scheme. And, most importantly, it has been there to help us through every medical crisis, emergency and general medical wellbeing issue throughout our entire lives. We would be lost without the NHS and are grateful for everything it does for us. NHS staff are working with overstretched resources, staff shortages, budget cuts and increased demand on their services, and are doing the best they can with what they have. I see this for myself every single day, and want to make it clear that this post is not critisising them in any way.

However, my own experiences over the last few weeks make me feel the need to speak out, something needs to change. I am aware that different areas, different hospitals have different practices, and peoples experiences are going to vary from place to place. This post is about my own personal experiences of miscarriage treatment within my local hospital.

I shall start at the beginning…….

Christmas Eve 2016, I was taken ill with a nasty water infection that, even after a course of antibiotics, didn’t want to go away. After feeling ill all over Christmas, the day before New Years Eve, I realised that my period was a week late. I took a test and got an instant positive. After having a suspected Chemical Pregnancy the year before, I took another test a few days later just to confirm. We took a few days to get our heads around this news before sharing our news with the children and members of our immediate family. As soon as we had shared our news I had a feeling of dread in the pit of my stomach. “What if something was wrong?”, “How would we tell the children if we lost the baby?”. Call it intuition but I couldn’t shake that thought and instantly regretted telling the children.

I tried to tell myself it was just paranoia, I had no reason to suspect anything was wrong. But deep down, that thought still niggled. I decided to take another test, this time one that showed the gestation, just to reassure myself that everything was fine. At this point I had calculated myself to be around 6 weeks pregnant. The test said 2-3 weeks. With these tests you add 2 weeks to get the correct gestation, so that made it 4-5 weeks. Although slightly lower than I had expected, the dates weren’t far out so that reassured me that everything was O.K.

The next day, just over a week after finding out that I was pregnant, I had a small bleed with a small blood clot in it. It was a Saturday and the bleeding stopped as quickly as it started, I wasn’t in any pain, so I decided to wait until Monday before seeing the Doctor, hoping it was just spotting or implantation bleeding.

On Monday, the Doctor took my concerns seriously and referred me to the Early Pregnancy Clinic for a scan. He used the word miscarriage. My hopes began to sink.

On Tuesday, I arrived at the clinic for my scan. At first I was in a small waiting room just for the Early Pregnancy Clinic. I was a bit taken aback by a quite obviously pregnant woman also being in that waiting room. I heard her say she was 20 weeks, and was surprised to see her there. In my head, ‘Early Pregnancy’ is before 12-13 weeks, and it made me feel a little uncomfortable, but not as uncomfortable as I was about to feel. After going through a basic history in the Early Pregnancy Clinic, concluding that I should be around 7 weeks pregnant according to my dates, and a urine test, which they told me then had traces of blood in it, already heightening my fears, I was sent into the Ultrasound Waiting Room. Fearing the loss of my pregnancy, I was sent into a room filled with 20 week pregnant women all excitedly waiting for their gender scans to find out if they were having a boy or a girl. Most had multiple excited members of their families with them. It took every ounce of strength I had in me not to burst into tears standing there (yes standing, because despite going through a suspected miscarriage, there wasn’t anywhere for me to sit in that room amongst the established pregnant ladies and their excited families). Why couldn’t I have stayed in the seperate Early Pregnancy Clinic’s waiting room to await my scan? It was on the same corridor, I even had to walk past it to get to the scan room?

Thankfully I didn’t have to wait in there too long and was soon called for my scan. As it was so early in the pregnancy, it was an internal scan. The scan showed only a 5-6wk gestation sac and yolk sac. No fetal pole. I was told it was likely I just had my dates wrong, that I was earlier along than I thought and that it was simply too early to see anything yet. I didn’t question this as I wasn’t 100% sure on my dates, and that also tallied with the gestation pregnancy test I had taken 4 days earlier. I was told to come back in 2 weeks time where they would hopefully get a clearer picture. This all sounded fairly positive but then I was asked if I was O.K and if I wanted to sit in a quiet room. This confused me. I thought I’d been given fairly positive news, yet was also being made to feel like I’d been given bad news. I was also told that even if I started bleeding again, to hold off going back to the clinic until that repeat scan in 2 weeks time, as they simply wouldn’t be able to see anything until then. I left the unit that day just feeling confused.

I bled again that day, several times, but tried not to panic. I had read that internal scans can cause bleeding, and as it was darker blood, told myself that the scan had probably just dislodged old blood from the first bleed. They had reassured me, hadn’t they?

After feeling a little fluey all day, that night I went to bed feeling like I was really coming down with something. On Wednesday morning, I woke up with full-blown flu complete with Sinusitis (intense migraine-like pain in your sinuses caused by blockage). I ended up bedridden for the next few days. Believing I was still carrying a potentially viable pregnancy, I didn’t dare risk taking any painkillers or medication that could harm the baby, so suffered through it with only paracetamol to try and take the edge off the pain. I contemplated visiting A&E multiple times, but the thought of having to explain I was possibly miscarrying as well as being ill put me off and I decided to just ride it out at home. During this time, I had a few more spotting incidents which I largely put down to me being so ill. Then, on the Friday I started to properly bleed, more like an actual period. But, like before, it stopped almost as soon as it started, and throughout the rest of the two weeks between scans, I bled on and off, mostly just spotting, occasionally getting light cramps but nothing so significant as to think that the pregnancy was definitely over. People kept reassuring me that it would be fine. I even took another gestation pregnancy test to reassure myself, this time it said 3+ weeks (5+ weeks), the highest it goes up to. This was 2 weeks after the first one I took, so was what I expected. My hormone levels must have gone up since the first bleed, reassuring me that all was not lost.
After what felt like an eternity, the date of the 2nd scan came around. I returned to the Early Pregnancy Clinic and after providing another urine sample, was sent straight to the Ultrasound Waiting Room again. This time I refused to go into the room full of happily pregnant ladies, instead choosing to stand outside in the corridor, opposite the ‘oh so happy’ machine where you pay for your scan picture (complete with images of happy babies), really not what you want to see in that situation. I was called in for my scan, which sadly confirmed what I already knew, there was no baby. At this stage I should have been at least 7 weeks pregnant, if the first scan had been correct and my dates were just wrong. By my dates, I should have been around 8-9 weeks. They said themselves they should have been able to see a foetus by now. The gestation sac itself had indeed grown, but there was no foetus inside it, no fetal pole and not even the yolk sac that had been visible at the earlier scan could be seen. Instead, the sac was filled with nothing but blood. I tried my best to stay calm but my body betrayed me and I began to shake uncontrollably. Once a second sonographer had confirmed the loss, we were taken to a private room to await discussing what would happen next. After being left on our own for a while to take in the news, we were taken back into the Early Pregnancy Clinic where they went over the scan results and gave me my options for managing what was classed as an ‘incomplete miscarriage’. I was offered the scan picture but at the time refused, seeing no point in having a scan picture that showed an empty womb. I later regretted this decision. One of the main things that struck me about that conversation was the assumption that we would ‘just try again’. No advice was given regarding birth control. The general attitude seemed to be that to get over the loss, you simply try again until you get a successful pregnancy, regardless of your circumstances. I left the clinic that day with a handful of leaflets about miscarriage, which too talked about ‘trying again’ and gave the odds of going on to have a successful pregnancy, and sobbed. I didn’t want to ‘try again’. I had wanted this baby. I had hoped to leave with a reassurance that my baby was fine and could start enjoying my pregnancy. Instead, it was all over, there would be no baby.

Back home, we cried, and discussed our options, then cried some more. We were given very little information to go on.

The options were, to ;

1. ‘let nature take its course’, but, as by this stage, I had been bleeding on and off for over 2 weeks already without anything significant happening, it was looking unlikely that ‘nature’ would co-operate.

2. Have the miscarriage ‘medically managed’. This meant taking medication to speed up the process. I would still have to deal with the situation myself but in hospital. The main problem with this course of action was that our hospital only does this at the weekends, and with 5 children at home, this was not something that would work for us. There were other reasons for not wanting to take this option, but they are not something I feel able to share within this post.

3. Surgery. Be put under a general anaesthetic and have the ‘remnants of conception’ as it was so eloquently put, removed from my womb. This option terrified me. I’m scared of general anaethestics anyway and due to my weight, blood pressure, the fact that I have carried 5 full-term pregnancies, increased risk of haemorrhaging, tearing, and my added concern of my knee condition (my kneecaps dislocate regularly and I was scared that under anaesthetic, with my legs in stirrups, they would dislocate without anyone even realising, and I would wake up unable to walk because it), the whole idea left me petrified.

I didn’t want to do any, I wanted my baby, but that wasn’t an option.

After speaking with the clinic again, we were told that there was only one slot left for surgery on the following Tuesday, a whole week away. If I didn’t take that, who knows how long we would be waiting for a slot. They would only wait so long for ‘nature to take its course’ before insisting on medical intervention. We had already ruled out the medication option. So we made the decision to take the slot, and just hope that ‘nature took its course’ before then so that I wouldn’t have to go through with it.

The worst thing we’ve ever had to do was tell the children, and tried our best to make it as easy on them as possible. Explaining simply that there was no baby and that Mummy would just have to go into hospital to make sure everything was O.K. The older children understood, and asked a few questions which we answered honestly. They knew about miscarriages, and, while sad, they took it well. The younger children didn’t understand, and to be honest, that was a relief. They understand that there isn’t going to be a baby, but take it more as in, we made a mistake and that there isn’t a baby in my belly after all, which is a truth in itself, no matter how simplified.

Unfortunately for me, the week passed with only the stop-start bleeding of the previous 2 weeks. I was scared to go out in case something happened, but nothing did. I stayed home, and grieved.

On the Monday, I returned to the Early Pregnancy Clinic for a blood test before the operation.

On Tuesday, the children went to school as usual, although briefed on the fact that it was unlikely I would be home when they returned. We had plans put in place for the youngest to be collected and go to her cousins after school. Other youngest had a club after school so he would go to that as usual. The older ones are capable of letting themselves in so it was more a case of keeping them informed. We didn’t know exactly what would happen so based on experience with previous operations (although none of this type), we tried to cover all bases as best we could.

I had to fast from 7.30am for afternoon surgery, due to start at 1.30pm. I had to arrive at the hospital for 10.30am. I was told to bring a dressing gown and slippers. I was told I would go home the same day. This was literally all we knew.

At around 10am we headed to the Surgical Short Stay Unit where I was due to have my surgery. This is literally a series of portacabins tacked onto the back of the hospital. I had expected it to be only other women in my situation. I had expected a ward with a bed. I had expected my husband to be able to stay with me. I was in for a shock.

On arrival, there were signs everywhere stating that family members could not stay. They were supposed to drop you at the door then await a call to come and collect you when you were ready to go home, like some kind of day care. I was there because I was having a miscarriage. We had lost our baby. I needed support.

At first, hubby was allowed to stay. We were sent into a small waiting room, not with other people in our situation as expected. There were men and women there of all ages, waiting for a variety of procedures. This was not a room for grieving parents.

Despite being told to get there for 10.30am, we were sat there all morning, as the room got fuller and fuller. Partners and other family members were regularly told to go, but I couldn’t sit there on my own, terrified, I would have left with him, so he stayed. He asked the staff if he could stay with me, said he didn’t mind standing when they said they had a lack of chairs, explained the reason we were there, which he really shouldn’t have had to do, and they agreed that he could wait with me if I stayed in the main waiting area and not the womens waiting area where I was supposed to be once I was booked in.

When I was called into an office to get booked in, he had the door shut in his face. I wanted him with me but he was made to feel guilty about wanting to be there to support me. After going through booking in, I was given a gown and surgical stockings and taken into the tiny womens changing area where I was left to get changed. Trying to put surgical stockings on is hard work at the best of times, but try doing it when you’ve got stomach cramps and are hunched over on a wooden bench! There was no-one to tie my gown for me either. I put them on as best I could, then put my dressing gown and slippers on and went back out to join my husband who came back with me into the tiny main waiting room. In order for him to stay with me, I had to sit there in my hospital gown with other men and women waiting to be booked in themselves. The nurse came back to put my ankle tag on and redid my surgical stockings in front of everyone because I had apparently put them on wrong. It was embarrassing.

Eventually the room thinned as the other patients were booked in and went off to the other small, separate, men and women waiting rooms. When we were finally the last people left in the room, I got hubby to help me properly tie my gown.

The afternoons operations were due to start at 1.30pm. At around that time, the Consultant came to speak to his patients. There was no where for private conversations. Instead, a desk and a couple of chairs had been placed in a blocked off doorway with a surgical screen separating them from the rest of the corridor. Anyone nearby could hear the conversations. From where we were sat in the waiting room, we could hear every word of the conversation the consultant had with his first patient, and I’m sure everyone else there could hear it too, there was no privacy at all.

Next was my turn, and the consultant himself had no problem with my husband being there to support me, and seemed embarrassed by this doorway/screen arrangement. We had to sit in that doorway discussing the intimate details of my surgery, as well as the disposal options for our baby’s remains. This second part took me by surprise. Everything had been treated so clinically and matter of fact up until that point, that being given the choice for burial or cremation of our child hadn’t even crossed our minds. We chose a communal cremation, as the pregnancy was under 13 weeks, and it gave some comfort to know that the remains would be treated with some kind of dignity. Even if the assumption that we must not have a religion came as a slight insult, we simply corrected him there, and signed the paperwork. The consultant told us then that I was 3rd on the list, and would likely be the last operation that day. He told us that anyone after me on the list was likely to not get their operation that day owing to a lack of recovery beds. There were 6 of us on the list. He expected me to go into theatre around 3pm.

It was now almost 2pm and hubby hadn’t yet had lunch, so I sent him home to eat, expecting to be in theatre in an hour. We had been told the procedure itself would take around 20 minutes, that I would need to stay in recovery for 2 hours and that I would be sent home from recovery. We had expected to see each other again in no more than about 3.5 hours. As much as I would have rather had him stay with me, he needed to eat  and with everyone else now in the men/women waiting rooms, I was concerned about getting missed if I was waiting in a different room. So I sent him home and headed into the womens waiting room. This was literally a small room with 6 chairs and a small table with magazines on in, not even a TV, and if we needed the toilet, we had to walk back out into the corridor, again with the men and womens toilets right next to each other, not exactly ideal when you’re told to take your knickers off before you walk down to theatre!

I had barely sat down in the waiting room when the anaesthetist called me to speak to him before my operation. This time, the office was empty so I at least didn’t have to have that conversation in a doorway. I was given the chance to at least discuss some of my concerns regarding the anaesthetic, even if he didn’t fully understand my concerns, especially where my knees were concerned. He told me that including the time needed for the anaesthetics, I shouldn’t be in theatre longer than an hour. From there I returned to the womens waiting room, expecting to be there no longer than an hour.

There were 5 of us in the waiting room. The 1st lady had already gone into theatre. I got chatting to the other ladies in the room. Of the 5 of us there, 4 were miscarriages. The other 3 ladies having miscarriages were all told they were unlikely to get their operations that day, but they still had to sit there all afternoon in their hospital gowns ‘just in case’. We were told they had to stop operations at 6pm no matter whether they had recovery beds or not.

At 2.30pm, the 2nd lady was called down to theatre, but she came back a short while later, after being told they weren’t quite ready for her yet, before being called again, then she came back again, before eventually leaving, and not returning, at around 3pm. Well that was my predicted time already been and gone.

We sat there for another 45 minutes. Several enquiries were made with reception for updates regarding when we were due to go into theatre, whether the other ladies would get their operations that day etc. The staff were extremely helpful, trying their best to keep us updated but no-one knew what was going on. They brought blankets, it was cold sitting there all day in just a hospital gown and dressing gown. Some of the other ladies family members came back trying to find out what was going on, they had expected them to be going home by this point.

At 3.45pm the lady who had been told that she was last on the list and would be unlikely to get her operation that day, got called into theatre. She was a suspected ectopic pregnancy.

The order had been changed as they felt she was a priority. I agree, a possible ectopic is indeed a priority, she should never have been last on the list. But in my opinion, she also didn’t belong in day surgery. Removal of an ectopic pregnancy is a serious operation and she really should have been on a proper ward in a bed, with proper aftercare.

As much as I agreed with the consultant choosing to prioritise that lady, it now put me in the same position as the other 2 remaining ladies in the waiting room. She had taken slot 3, which meant that none of us were guaranteed to get our operations that day. The thought of having to come back and do this all again another day was hideous. Not to mention the fact that hubby had had to take 2 days emergency annual leave to look after me and the children due to the op in the first place, there was no guarantee he’d be able to do that again.

We continued to sit there and wait. The womens waiting room had a curtain across the doorway but this wasn’t pulled across, it was held back. Several times, male staff members came into the room to empty the bin, or just mill around by the reception desk that was directly in front of the doorway. Other staff members also regularly walked past, or stood in front of the doorway, not to mention the ones permanently sat in front of us on the reception desk. There was no privacy at all. Considering we were there because we were having miscarriages, suffering from stomach cramps, sickness and bleeding, it felt extremely undignified.

As the afternoon wore on, one of the other ladies partners came back to check on her, and as we were the only people left now, this time he was allowed to stay with her in the main waiting room where me and hubby had been earlier. By this time, the kids were home from school and hubby couldn’t leave to wait with me. We had expected me to be home by now.

Finally, at around 4.45pm, I was called to theatre. Whilst extremely relieved that I would at least get my operation that day, at the same time, the other 2 ladies were told that they wouldn’t. I was the last one, they were being sent home to have to come back and do it all again another day. My heart went out to them, and as I’m writing this, I sincerely hope that they have at least now had their operations and are not still being kept waiting. Being made to sit there for 8 hours, without any family to support you, shivering in a hospital gown, hungry and thirsty from being made to fast all day ‘just in case’, suffering with stomach cramps, sickness and bleeding, then getting sent home without even having their operations, having to come back and do it all again another day, is quite frankly disgusting treatment. And that’s without even taking into account the emotional aspect of what these ladies are going through. The fact that the people having other operations went first, that all the miscarriages were left until last, says to me that the hospital doesn’t take miscarrying women seriously at all. We’re seen as ‘lesser cases’, and that’s not ok.

I was taken down to theatre, where I waited for them to be ready for me. Once again, I can’t fault the staff here. They chatted away, keeping me calm, doing the best they could in the circumstances they found themselves in.

In theatre, my heart betrayed me, it started racing, showing my fear, I had to be given a sedative to calm me before being put to sleep.

I woke, gagging as the tube was removed from my throat. It was over. My baby was gone.

The first thing I did was move my legs to make sure my knees were ok. Thankfully they were. Then as I was wheeled into recovery, I searched around for a clock. 5.45pm. For an hour I lay in recovery trying to focus my vision as a nurse kept an eye on me. Once I was allowed a cup of tea, I asked for my phone so that I could let hubby know I was ok. No-one had phoned him.

Recovery had 4 bays. In one, was an elderly lady that had suffered a fall needing an op on her knee. She had been in there since 11am because they had nowhere else for her to go. She got embarrassed having to use a bedpan where everyone could hear her, I could hear her crying. It was now 6pm. She had been there for 7 hours. The 2nd bay held one of the elderly ladies that had been in the main waiting room with me earlier, she had also had an op on her knee. She was throwing up repeatedly, and apologised to everyone each time, clearly embarrassed. While I was there, she was moved to the private ward and her husband phoned so he knew to meet her there. The 3rd bay held a young man that had been hit by a car, he had a broken arm, he was in pain. He screamed and moaned. Then in the bay next to him, was me, the miscarriage. While there the nurse had to check my bleeding. I should not have been in a room with male patients. The flimsy curtains around the beds didn’t exactly give much privacy. The other staff didn’t know what I had had done and asked, probably expecting me to say knee op or similar, like the other patients in there. They looked awkward when I said it was a miscarriage.

I tried to choke down a sandwich in the hope that if I ate, I could go home sooner. But it was too dry for my sore throat. The tube had left it very dry and sore, it took a good 24 hours before I could really eat properly again. Instead, I drank, and drank, and drank. I don’t think I’ve ever been so grateful for a cup of tea ☕️.

Whilst in recovery, I had no idea what would happen next and was very aware of the time. I had been told I would go home that day, straight from recovery. Staff in the recovery room said the same thing themselves. So was surprised when, after an hour and a half in recovery, I was told I was being transferred to a ward in the women’s unit. But was told I would only be there for an hour or two, then once I’d been to the toilet, I would be allowed to go home.

I was taken up to the ward just before 8pm. I knew it was getting late and my chances of going home that night were getting slimmer. I hadn’t seen hubby now in 6 hours.

Up on the ward, the staff honestly could not do enough for me. Making sure I was comfortable and had everything I needed. I was given a private side room and was grateful to just have some time to myself, I admit my emotions got the better of me at this point. I just wanted to see my husband and my children, I wanted to go home. The staff helped me to the toilet and brought me another cup of tea. The only criticism I have of being on the ward is that, being in the side room, there was no toilet, not even in the corridor outside. I had to walk through the ward full of other female patients, into another room, that was supposed to be a Day Room yet also had patients in with just screens around their beds, to get to the toilets. Not ideal, especially when you’re bleeding, and still feeling weak from the anaesthetic.

It was on my second trip to the toilet that I saw the lady who had had her op before me, and stopped for a quick chat. She was waiting to be discharged too and I hope that she has had a quick recovery.

Finally, at 9.30pm, they agreed that I could go home if I wanted to at 10pm, so hubby was called to come and collect me. I had to have an injection to prevent blood clots, then I was free to go.

Whilst tired and sore, I have never been happier to get home. Whilst we knew from the start, that this would be a difficult day, we had not expected it to go the way it did.

What makes this situation all the more frustrating, is that it didn’t need to be like this. The Day Surgery Unit where I had my op actually has its own wards, a Male one and a Female one. Those wards were built specifically for the Day Surgery patients to go to from Recovery until they are ready to go home. Had we been able to use the wards, we could have been booked in and then got to wait in our own beds, in our own bays, with privacy curtains, where our partners could have waited with us. We could have gone from Recovery back to our own beds where our partners could have been waiting for us. We could have spent our 2 hours recovery there, then gone home, without needing to be moved from one place to another. So why couldn’t we use the wards designed for this use? Because they were full. Not with Day Surgery patients, but with in-patients that the hospital had no room for anywhere else. Primarily elderly patients.

The hospital knew that they didn’t have these beds, yet they continued scheduling surgeries knowing there was nowhere for these patients to go. They knew they had a full list of surgeries, like the miscarriages, that really couldn’t wait, yet continued scheduling non-emergency routine ops, knowing there was nowhere for those patients to go either.

And this is what is fundamentally wrong with the NHS today. They are overstretched, under-funded, under-staffed, under-resourced, yet still expected to hit targets for waiting list times or face penalisation. This is why hospitals, like ours, keep trying to treat patients even though they know they simply don’t have the resources to do it properly.

Like I’ve said before, this is not the staffs fault. They do the best they can with the situations they are stuck with. With the exception of the odd, over-worked, over-stretched staff member that has probably faced the same dilemma time and time again, making them more abrupt than they would probably usually be, I was treated with kindness and compassion, every step of the way. But the system is flawed, and it is getting worse. Going into hospital is an unpleasant experience for anyone, let’s face it, it’s not where we want to be. But when you’re there because you have lost a child, when you are in pain and grieving, you should not be left sitting in a waiting room with no privacy, no dignity, all day long. You should be allowed the support of a family member or friend. You should be safe in the knowledge that you will actually get the operation that you’re in there for. This is a fundamental right. After all, we’re grieving, haven’t we suffered enough?