ER experience left Labrador woman cold

Barb Sweet
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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.

Organizations: The Telegram, Health Sciences Centre, Health Care

Geographic location: Labrador

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Recent comments

  • Vickie
    November 23, 2013 - 02:10

    Is there grief support for anyone after losing a loved one at HSC? Or even after receiving a bad diagnosis. None that I have heard of. How hard is it for a nurse or doctor to give a name or number to call after a tragedy? My heart goes out to anyone who has lost a baby. At least someone is talking about it.

  • the hurting never stops
    November 22, 2013 - 15:00

    So we can't go to the labour and delivery department, we are left to fend for ourselves in the emergency room...where it is plugged up with people with head colds, minor cuts and scrapes and constipation from eating salt beef suppers..........where do we go??? There is NO place for us!! We are only trying to get help!!

  • Susan
    November 22, 2013 - 14:05

    The labor and delivery unit is just that, a labor and delivery unit. We can't be plugging it up with more people having problems who's baby isn't viable yet.

    • the hurting never stops
      November 22, 2013 - 15:03

      How insensitive of you Susan....Obviously you never experienced the devistation or heartbreak of losing a child.......... My baby was viable at 14 weeks, you are talking about very vulnerable and hurt group of women here.!!

    • sheila brown
      November 23, 2013 - 13:09

      Susan: your attitude is the very reason LeeAnne was forced to endure the treatment she did. It's the job of the hospital staff to provide compassionate care to patients, not stand back and judge whose problems are bigger. Shame on you.

  • In the same boat
    November 22, 2013 - 11:19

    Something has to change. Services for women experiencing pregnancy loss are severely lacking. And sensitivity training for front line staff is very much needed. It`s time for the regional health authorities to put something in place comparable to what`s available in other provinces. We`re still a `have not` province when it comes to this. In the meantime, any parent experiencing pregnancy loss, stillbirth, or the loss of an infant is welcome to join Pregnancy and Infant Loss Newfoundland and Labrador. It`s a Facebook-based peer support group where you can meet others who have been through similar losses - to talk, share, and heal together. It is a closed group, so that only group members can see posts.

  • Really?
    November 22, 2013 - 10:57

    It shouldn't matter how far along a woman is in her pregnancy. They all should go to the labor and delivery for assessment, no matter what. That is a serious situation period, someone could not know they have a bleeding disorder, a torn placenta, they should not even been seen in emergency. Our Canadian Health Care system is really horrible, the wait lists are so long, and just here in Newfoundland we have a 2 Neuro Surgeons for children, and the Psychiatry wait lists are 1-3 yrs of waiting when people are suffering. And they say that's not bad. Doctors should be able to help people, but yet they are so busy in the hospitals, over worked and same with the nurses and personal care aides. And this my people is how the government treats its people.

  • Sarah
    November 22, 2013 - 09:52

    While my heart goes out to these women, the ER is not neseccarily the right place to be seeking emotional counselling regarding miscarriages. With patients piled up in hallways, what is ER doctor or nurse supposed to chose when they have both a patient having a heart attack in one, and a woman having a miscarriage in another? I think the solution lies in increased access to primary care so that women having miscarriages can see a doctor who has the time and expertise to provide them with much needed counselling and mental health referrals.

    • The hurting never stops
      November 22, 2013 - 10:51

      And the wait time to see that doctor would be???? Plus its fact that the majority of miscarriages does not happen during "regular work hours", so where do we go then?? The emotional rollercoaster that follows a miscarriage needs care immediately!! If we do not go to the emergency at the HSC (as St. Clares will send you to the HSC) where else can we go?? We are not allowed up to the maternity ward because we "are not far enough along" so we are like lambs to the slaughter and left to the igonrance of the front end staff and left to wait....lots of times covered in blood and going through labour as an emotional wreck wondering why this is happening and blaming yourself for it happening in a waiting room, hallway or such.... a nurse taking you into a room and giving you a little encouragement isn't too much to ask, no one is asking for a doctor to be pinned to their bedside as they pop in for a minute and is gone again, and you are left with nurses not doctors......nurses should be trained to talk to you and be able to give out the counselling information that is needed following a traumatic event in a womans life..........oh and comparing a miscarriage to a heart attack.... women die from miscarriages as well.....I almost did with my second miscarriage leaving my 3 year old without a all actuality a part of you dies at that very point in time.... your baby died!! Apparently there are a few things that occurs throughout the year for those who have experienced the loss of a child through miscarriage and I haven't heard a peep from anyone on first miscarriage fetus was sent to genetics....I never heard back from them either, and that happened in January.......we go in, experience loss, pushed out the door and then are forgotten about, wiped under the rug and never thought about again.........

  • Jacky
    November 22, 2013 - 03:41

    The health care in NL is very substandard. I work in health care and I have worked in other provinces. I am reluctant to seek help in this province. Sorry, it is just bad.

    • Jane
      November 22, 2013 - 11:36

      Unfortunately many people are not aware that the rate of miscarriage for a healthy female is 50% before 12 weeks gestation. It is common and can often be managed at home or under the care of the family doctor. While the ER is often the only place for care after hours, the primary care doctors are the main resource for patients in this scenario.