An estimated 1 in five pregnancies end in a loss, and 80% of those are in the first trimester. Miscarriage, as we often call it, is so very, very common. So why is it hard to talk about? And why is it hard for our health care providers to know what to do?
In Canada, the province of Ontario is working to change that by creating quality standards for health care providers. What this means is that whether you seek care at a large, teaching hospital on University Avenue or a small, rural hospital in Northern Ontario, you should expect how you are treated to be similar.
Miscarriage is an often-silent, unexpected and heart-wrenching experience for many. For clinicians, a quality standard offers guidance on the diagnosis, follow-up, and management of the physical and emotional aspects of care for patients experiencing early pregnancy complications or loss.
It’s accompanied by a draft patient guide, to help patients ask informed questions of their health care providers.
Health Quality Ontario and the Pregnancy and Infant Loss Network (PAIL) are now seeking feedback on these materials.
I had two early pregnancy losses, one at 12-weeks and one at 10-weeks. They were both awful. In my first one, it was just six months after the death of the twins. I was already so incredibly vulnerable, and terrified. We went to the emergency room, not because I thought they could stop the miscarriage from happening, but because I wanted to know the truth. I didn’t want to spend days lying at home, not knowing whether I was going to lose my baby.
The doctor was not particularly helpful. He had no concerns for my emotional well-being but was eager to get me out of his ER. When I saw my family doctor a few days later, he was much more sympathetic. He knew my history. When he told me I had a blighted ovum, that no baby had ever developed and so I while I was losing my hopes and dreams, there hadn’t been any baby to feel pain, that was comforting to me. I hadn’t done anything wrong.
My second early loss was 9 months later. My family doctor had scheduled an earlier ultrasound, so I knew earlier that things weren’t developing as they should. It still sucked, but somehow it hurt less because the care I’d been given was compassionate. Even if our doctors can’t change the outcome, we all need and deserve compassionate care.
Please take a look at the draft guidelines, especially if you’ve had an early pregnancy loss. What would you like to have known? Is there anything your doctor, nurse or midwife should have done? What would make an awful situation a bit better?
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Interested in learning more about quality standards? Visit the Health Quality Ontario web site