Woman who had ectopic pregnancy speaks out about ER experience

Barb Sweet bsweet@thetelegram.com
Published on November 13, 2013

A woman who suffered an ectopic pregnancy says her condition was not treated as a medical emergency, but instead she was left waiting for hours overnight in the ER to find out what happened.
Numerous women as well as men whose wives were pregnant have come forward to The Telegram in the last two weeks to speak out about their miscarriage experience, in particular of going to the emergency room for treatment.

Overwhelmingly, they have expressed dismay at being treated in the ER where they say the emotional trauma of losing their pregnancy falls by the wayside.

According to Eastern Health policy, women who are fewer 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. Women are also advised to go to the ER for issues not related to their pregnancy.

Eastern Health has said a pregnant woman who presents with bleeding needs an assessment to see if it’s related to the pregnancy or not.

“In addition, bleeding and cramping can indicate medical conditions that are better assessed in an area with direct access to the main operating room and diagnostic areas, such as infections or ectopic pregnancies, which are medical emergencies,” the health authority said in an emailed statement to The Telegram last week.

But a St. John’s woman said she became upset when she read that statement in The Telegram.

“It got me so enraged,” said the woman, who wants Eastern Health to do a better job of communicating with and treating women suffering the trauma of losing their pregnancy.

According to protocol, emergency department staff can consult the psychiatric nurse on duty to support a patient who is in crisis. There are also full-time social work staff in the city hospitals.

Like many other women who have contacted The Telegram, she said she was not offered the opportunity to speak to a social worker or even given the number for the mental health crisis line.

The woman said there should be more concentration on women’s health services so that pregnant women have someone to reach out to for support and information in situations like miscarriages and ectopic pregnancies. The ER, where doctors and nurses are focused on a range of medical issues, isn’t the place where time can be taken to support pregnant women suffering that trauma, the woman said.

According to the Mayo Clinic, an ectopic pregnancy typically occurs in one of the tubes that carry eggs from the ovaries to the uterus. In some cases, however, an ectopic pregnancy occurs in the abdominal cavity, ovary or neck of the uterus. The fertilized egg can't survive, and the growing tissue might destroy various maternal structures. Left untreated, life-threatening blood loss is possible.

Two years ago, the St. John’s woman suffered some bleeding for more than 80 days and was unaware she was pregnant. She sought medical attention at clinics — as she did not have a family doctor at the time — and even went to the emergency room, but said she was told it was likely menstrual spotting and was sent home. The first time she went to the ER was 30 days after the bleeding began, she said.

Then one night she woke up with a severe pain in her side. She could barely walk and her boyfriend took her to the ER. She explained her situation to the triage nurse.

“They don’t seem to have compassion,” she said. “Maybe they are overworked or jaded by it,” she said.

Five and a half hours later, the woman saw a doctor, who consulted with another physician. She said she lay on a bed for another couple hours and after her boyfriend had to leave, was in the ER overnight with no one checking on her and then sent for an ultrasound the next morning.

“I was on a gurney waiting in the hallway. I still hadn’t changed. I was still in my old dirty panties just lying on a gurney in the middle of the hallway waiting for the ultrasound room to open up, people passing by. Embarrassing,” she said of the indignity of the situation.

After the diagnostic test, she learned that she had suffered an ectopic pregnancy and was given a needle to stop the cells of the embryo from growing.

The only information she received is to get repeated blood work.

She went home in shock with a number of unanswered questions about what the event would mean for future attempts to have children. She is still trying to have a baby.

“Nothing was offered to me. ‘These are your side effects… do you need some counselling?’ You think to yourself, ‘Did I do something wrong? Did I eat something wrong? Did I not take certain vitamins or did I exercise too much when I wasn’t supposed to?’ You feel it is your fault. You blame yourself. You need someone to tell you it’s a natural thing, your body is telling you that there is something wrong but it’s not your fault,” she said.

“You need someone professionally to go through that with you.”

The woman said out of a group of 20 women in a recreational league she belongs to, a dozen have had either miscarriages or an ectopic pregnancy.

“Maybe doctors think it’s a common thing, but to the person experiencing it, it is not common,” she said.

“The ordeal of all of this was so stressful, confusing, embarrassing, and emotionally draining, and not once did I get offered any condolences or help with my emotional well-being.”

The woman said she was able to eventually get a good, female family doctor, and has also become more assertive in questioning medical information.

NDP Leader Lorraine Michael again asked Health Minister Susan Sullivan Tuesday what she is going to do to address the concerns surrounding the treatment of miscarriages.

“The policy of not monitoring and supporting women who are miscarrying at less than 20 weeks has put some women at risk. I ask the minister: what is she doing to ensure that women under 20 weeks get the same treatment as other pregnant women?”

Sullivan reiterated Eastern Health protocol that women who are fewer than 20 weeks pregnant with a pregnancy related issue are first assessed in the ER.

Michael said the minister needs to investigate why the protocol appears not to be working and do something about it.