ER is the right place to deal with miscarriages: Eastern Health

WARNING: This story contains disturbing content

Barb Sweet bsweet@thetelegram.com
Published on November 7, 2013

Eastern Health says the emergency room is the appropriate place for women who are less than 20 weeks pregnant to be seen first, even though patients have expressed dismay at their experiences.
A spokeswoman also noted that the ER has direct access to the main operating room and diagnostic areas.

The Telegram heard this week from several women about their experiences in emergency rooms. Men whose wives had miscarriages also contacted The Telegram. While one woman said she was treated well in the emergency room, the others described lengthy waits and felt staff showed little compassion for the trauma of losing their babies through miscarriage.

Their comments were prompted by Tuesday’s edition of The Telegram, which featured a story on a metro area woman who said she was forgotten about in the Health Sciences Centre emergency department, suffered a miscarriage in the bathroom and was left alone in a room for hours to deal with it.

Overcrowding affected the expectant mother last August when, at nine weeks pregnant, she waited in the ER, told a nurse her bleeding and pain were getting worse and finally miscarried in a toilet.

Days later she said she found out a nurse on duty, backed by the opinion of a colleague, made the decision to flush the remains.

Meanwhile, she waited in a room for hours.

Some of those who contacted The Telegram felt the ER isn’t the right place for women to be treated for a miscarriage.

According to 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. Women, of course, are also advised to go to the ER for issues not related to their pregnancy.

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.

Eastern Health 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.

If immediate obstetrical care is needed, the on-call specialist will see the patient in the emergency room.

If there’s a chance the fetus will survive, the patient would be admitted.

But if unfortunately the fetus is not going to survive, the obstetrical team may decide to admit the woman to the obstetrical unit where bereavement supports will be offered.

None of the women who spoke of bad experiences in the ER with miscarriages said they were admitted.

Eastern Health said it’s continuously reviewing policies, including those related to services for pregnant women.

NDP Leader Lorraine Michael brought the issue up in the House of Assembly Wednesday.

“We are hearing in the media about women suffering miscarriages alone after long waits in the Health Sciences ER. I am also hearing from people with other horror stories of ER wait time experiences,” Michael said.

 “Despite the ER wait times strategy released last year, congestion is still an urgent issue, as this year’s Eastern Health accreditation report reveals. I ask the minister of Health and Community Services, how is she going to immediately address the critical ER overcrowding and long wait times?”

 Michael inquired about the progress of a strategy launched in February 2012 to reduce wait times in emergency.

“Mr. Speaker, I want to reference the first part of the statement first of all, and that having to do with the miscarriages that we have read about in the paper. Those are certainly very unfortunate, very emotional issues, and we are very concerned about those, Mr. Speaker,” Health Minister Susan Sullivan replied.

She said the province has put $400,000 into reducing wait times in the emergency departments, including a fast tracking system.

“We are also looking at increased hours of physicians and so on within the emergency departments and other health-care professionals within the emergency departments during times when we know there are peak times,” Sullivan said.

 

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