Better care needed for pregnant women

NHS watchdog The National Institute for Health and Clinical Excellence (NICE) has drawn-up guidelines stating that the NHS in England and Wales should offer a dedicated service seven days a week for women who have had a miscarriage during the first trimester (13 weeks) of their pregnancy or an ectopic pregnancy, with a 24-hour helpline available for women who experience any bleeding or pain.

Those behind the guidelines argue that doctors could be more sympathetic when dealing with women who are at risk of miscarriages or ectopic pregnancies and that these women are currently not being provided with sufficient information or offered enough support. Arguments have been made that doctors, nurses and even receptionists, are all under-equipped to deal with the huge emotional trauma that the women are going through.

Now though, women with early pregnancy complications can rest assured that there is seven-day service should they require it, where they can speak to specialists and scanning can be carried out. The aim is to stop vulnerable women from feeling afraid or alone and like they have nobody to speak to.

Julie Orford, chair of the Birth Trauma Association, was involved with the creation of the report. She herself has tragically suffered two miscarriages in between giving birth to two healthy children. Julie argues that there needs to be more sensitivity showed to the women from health professionals. She says: “For me there didn’t seem to be any sympathy, it was very much a procedure, you were given a cup of tea, you were given a leaflet on your choices, taken through to a room and no one really acknowledged the fact you’d just been given devastating news and that you’d lost your baby.”

Adding to Julie’s comments was Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, who said in a press release:  “It can be very distressing and, in some cases, frightening to experience a miscarriage or be told your pregnancy is ectopic. It’s vital that women and their families receive good, consistent, timely and effective care and support that addresses their needs and enables them to make informed decisions. We know that not every woman is receiving this level of treatment at the moment but this guideline will address that inconsistency and ensure all women receive excellent care, no matter where they live.”

Estimates say that one in every five pregnancies end in miscarriage in the first 23 weeks, with 168,000 women affected each year in England alone. In addition, approximately 11 women in every 1,000 who become pregnant will have an ectopic pregnancy – where a fertilised egg implants itself out of the womb, 95% of the time this is in the fallopian tube. This is because either the tube has become damaged or it is failing to function properly.

Between 2006 and 2008 there were 35,495 confirmed ectopic pregnancies and tragically, six women had died during the first trimester due to their pregnancy. Nice warned: “About two-thirds of deaths caused by ectopic pregnancy are associated with substandard care, due to missed or late diagnosis.”
In their guidelines, NICE say there should be much better training offered to GPs so they can spot symptoms of either event in order to help detect an ectopic pregnancy earlier, as this could potentially avoid any problems later on in the woman’s pregnancy and reduce the chance of death.