WARNING: THIS STORY CONTAINS DISTURBING CONTENT
A woman who complained a decade ago to health officials about the handling of miscarriages is alarmed at Telegram stories detailing pregnant women’s experiences in the emergency room.
The woman now worries her complaint may have been made in vain.
Warning: this story contains graphic content
“There are so many women out there that have gone through an ordeal of this nature, and we have to be the voices for those women that remain silent,” said the Mount Pearl mother of two.
“However, there are so many more women who will suffer miscarriages, and I think the health-care system needs to make vast improvements to the policies and procedures women endure while going through something as horrific as a miscarriage.
“I tried to make a difference 10 years ago and I am truly disgusted that the assurance of change made to me by our health-care system has not come into play. I read this stuff (in The Telegram) Monday — honest to God, obviously nothing ever got changed to help women like myself that go in there. … They can’t keep doing this to women.”
She’s not prepared to have her name used because she didn’t share her experience with all who knew her and doesn’t want to revisit the emotional pain.
“It’s not a place I want to go back to now,” said the woman, who still finds each January to be difficult.
She was reacting to Telegram stories in the last two weeks in which women and their spouses spoke out about their miscarriage experiences, in particular of going to the emergency room for treatment.
At least a dozen people have personally contacted The Telegram with their stories.
Overwhelmingly, they have expressed dismay at being treated in the ER, where they say the emotional trauma of their pregnancy ending falls by the wayside. Most were referring to the Health Sciences Centre, but two recounted experiences in Carbonear and one in Burin.
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.
In January 2003, the Mount Pearl woman, who then had a toddler and was 19 weeks’ pregnant, went to the ER, where she encountered a compassionate doctor, but was sent home awaiting test results.
The next day she was called back for an ultrasound through the women’s health clinic and found out her baby was no longer alive.
She said she was prescribed the drug Misoprostol — which starts labour — and was sent home with little information on what to expect. The woman wrote the disturbing details of what happened over the next days in a subsequent letter to the then St. John’s Health Care Corp.
The letter describes labour contractions, excessive bleeding — so much so that her mattress and carpet were saturated beyond saving — and the discharge of the dead fetus in her bathroom.
She removed what she thought was the placenta from the toilet. She says she could make out the features of the baby, which she also recovered.
“That morning was one that will stay with me forever like a picture that will never be erased from my mind. I took his arms and folded them on his chest and wrapped him in a tissue and placed him in a small jewelry box,” the woman wrote of the remains, which were eventually buried in her grandfather’s grave.
Days later she was back at emergency and was told to keep taking the drug.
“When I finally got into a room, there was so much blood and blood clots that it went through the bed and started to collect in the pan beneath me. I got off the bed and went into the bathroom where blood trailed behind me and clots as big as my fist were pouring out of me,” she said.
Back home again, she said, she continued to bleed heavily and passed out. During a return visit to the hospital, she found out the placenta was still inside her.
Maternity floor nurses did treat her with dignity, she recalled.
But she wishes she had initially demanded a dilation and curettage (D and C) — a procedure to scrape and collect tissue in the uterus— instead of taking the prescription drug.
“I really blame the health-care system for what I had to go through and I just hope that someone can make a difference. Women’s health should not be ignored as it is today in our health system,” the woman said in that 2003 letter, which she said prompted a meeting with then health-care officials and doctors.
A decade later, she’s horrified women are expressing similar dismay about recent miscarriage experiences, but she’s glad they are speaking out about it.
“It’s like a silent hurt no one talks about,” she said. “I’d like to see it become a huge deal.”
The woman said during her experience, waiting after the ultrasound, she buried her face in her husband’s chest while sitting in the clinic waiting room and doesn’t think anyone in that situation should have to suffer their loss in public view, so she was disturbed to read of women waiting in the ER while suffering miscarriages.
“They are bleeding. They are cramping. They are an emotional wreck. Have them in a separate room, lying on a bed until the (specialist) comes in ... not out in a waiting room, not standing up against the wall or sitting on a gurney in the hallway. That’s not right,” she said.
She’d also like to see the policy changed so that women suffering a miscarriage can go to the labour room when they are at least 10 weeks pregnant.
But regardless of what unit they are treated on, the women should be in a private room with a bathroom, and be checked on periodically, she said.
“To have a room set aside is not a big deal,” the woman said.
“Miscarriages happen every single day. It doesn’t matter how many weeks you are along — it’s always an emotional event. I don’t feel the health-care system looks at it serious enough.”
As for the drug she was given, she said she feels women should not be sent home with it.
But an Eastern Health spokeswoman said Misoprostol is approved in Canada for medical management of pregnancies complicated with fetal death and is considered the safest drug for that type of use.
The drug causes contractions in the uterus and may take anywhere from one to four days to take effect, which means it’s an outpatient treatment across Canada, according to Eastern Health.
But the spokeswoman said while it is prescribed here, patients are given specific instructions to return to an emergency department if they experience excessive bleeding.