A Labrador woman who had been studying in St. John’s said she made repeated trips to the emergency room before finally suffering a miscarriage, and on none of those occasions did she receive a referral for support.
That’s despite the fact LeeAnn Toomashie said she found herself crying in the Health Sciences Centre emergency room on some of those occasions in early September. Yet she was never offered as much as the phone number for the mental-health crisis line.
“I was really let down,” said Toomashie, who has a child, but knew nothing more about what to expect from a miscarriage than what she was told by a friend who had lost her pregnancy in August.
“I was only seven weeks along, but this was a baby I just found out about, a baby we were trying for, and I was out of town (in St. John’s) dealing with this on my own. If they took two seconds to ask me how I was feeling, they would have seen just how much emotional pain I was in, and maybe they would have cared a little more.”
After that friend told her own August miscarriage story to The Telegram this month, more than a dozen people came foward to express dismay about their own experiences being treated in the ER, where they say the emotional trauma of their pregnancy ending falls by the wayside.
The woman in August, at nine weeks pregnant, waited in the ER, told a nurse her bleeding and pain were getting worse and finally miscarried in a toilet in the ER area.
Days later, she found out a nurse on duty, backed by the opinion of a colleague, made the decision to flush the remains, the woman had told The Telegram. Meanwhile, she waited in a room for hours.
Among those who came forward after that initial story was a woman who made a complaint to the then St. John’s Health Care Corp. a decade ago.
After that complaint, the corporation, recognizing the psychological impact of pregnancy loss, acknowledged in writing that the ER isn’t the ideal place to treat miscarriages and said it was establishing an early pregnancy unit.
It also promised changes that included patients being given a phone number for a nurse in the women’s health clinic they could speak to for advice, and the offering of bereavement and counselling supports. The corporation was amalgamated into Eastern Health in 2005.
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.
The health care authority also operates an early pregnancy assessment clinic for women fewer than 20 weeks pregnant. It isn’t intended to treat miscarriages, but patients can be referred there.
But that didn’t happen to Toomashie. She has never even heard of the clinic. And like most of the others who contacted The Telegram, she didn’t receive the crisis line number.
Toomashie’s experience in the ER left her feeling like her loss was no big deal to the staff, she said.
“They kind of just brushed it off like it was a regular thing that happened to everybody,” said Toomashie, who had gone to the ER because she had no family doctor in St. John’s, as she was only doing a two-month study term here.
Her average wait was six hours over those repeated visits, she said. One wait was as short as an hour, but Toomashie said she just got sent away with instructions to obtain bloodwork.
And never did anyone use the word “miscarriage.” Even on her last visit, Toomashie said, staff referred to her experience using medical terms and telling her the pregnancy-related hormones were down, which is a clue to miscarriage.
“That was really strange,” she said of the technical approach, which left her with questions.
“What does this mean to a woman who has never miscarried before? Nothing. I was never told what was happening to my body, what would happen, what I was to expect, who I should see. Nothing.”
On the first visit, she went to the counter when her symptoms worsened to severe back pain and intense bleeding, but said she was told to sit back down.
“It was the worst experience I ever had with a hospital. I come from Labrador, a place where we have less of everything, especially when it comes to our health care, but that don’t stop the staff from being considerate to your situation or actually taking the time to talk to you,” Toomashie said of the whole experience.
According to current Eastern Health policy, women who are less than 20 weeks pregnant are first assessed in the ER; women who are 20 weeks or more along in their pregnancy are sent to the labour and delivery unit for assessment. So are women who don’t know how far along they are.
All patients in the emergency room — where cases run the gamut of injuries, viruses, illnesses and trauma — are triaged to ensure the most urgent are seen first.