Government announcement on Miscarriage Care

[KatieMumsnet]

Hi All

Just wanted to point you in the direction of this announcement today - new info. on named midwives, better training for Health visitors on PND, but especially relevant to our Better Miscarriage Care campaign the government will, for the first time ever, monitor how well the NHS looks after parents who have miscarried or suffered a stillbirth or cot death.

One of the things we have found since launching the Better Miscarriage Care campaign is how patchy local information is and therefore how difficult it is to see who's implementing our 5 point code of care.

So hopefully finding out who's doing what will be the first step in improving care for everyone .

Do let us know your thoughts

Best

MNHQ

[harrietlichman]

And moving the EPAC out of the generic maternity area of hospitals!?

[VictoriaWould]

It sounds great, especially the named midwife and one to one care in labour bit. Theres no explaination as to how their going to acheive it though.

[PestoPenguin]

Great news! Can you sort out 1-2-1 care from a named midwife in pregnancy please too? We used to get that round here, but now get team care, which means because there are so few routine appointments for low risk mums with kids already I'll likely see a different person every single time . V disappointing.

[PestoPenguin]

Oh yeah, thunderbolt! I didn't see it in the news report, but it is mentioned in the press release

How stupid that my local area abolished this system since I last gave birth 2 years ago, and yet will now have to put it back in place again. Shame they're not going to get it sorted in time for me to benefit . I do hope they won't get round it by just naming one midwife on your notes as the 'lead' or something

Also, how will the Govt deliver all of this, given the NHS reforms that give most of their power away to GPs and the private sector??

[Taffeta]

Its good in that it getting headlines again, but monitoring the care isn't actually making any policy changes is it? Or providing any funding or training or additional wards to keep women having miscarriages separate from labour wards.

But its good as a first step I suppose.

[Taffeta]

That post makes me sound very ungrateful. I am not - the campaign has had a big impact in my area, the Code of Care is now high on the agenda.

[Consort]

About time. No one ever checked on how my husband and I were coping after our daughter was stillborn. We coped as best we could, but what if we hadn't? There was never any offer of help, in that event. I hope this is more than lip service for a glaring problem that leaves many unable to carry on very well, and divides families.

[KatieMumsnet]

Hi there

On the naming, as luck would have it, I had a meeting yesterday with the Miscarriage Association and the Association of Early Pregnancy Unit's who we worked with when we did this survey.

The results were in - and showed great support for 'surgical treatment of miscarriage' however, there was also significant support for an alternative term 'surgical management of miscarriage'. As this wasn't one of the options that was in the original consultation (but suggested by respondents), they want to re-survey to be absolutely sure the right term is picked. A little bit of a pain, I know, but will at least then have big support without people being able to say 'oh but hang on what about my suggestion'.

I also found out a bit more about what happens when new term is chosen. Basically it's then up to the leaders in this field to make sure it's used. For new Drs and Obs and Gynae people that's a bit easier as something called the curriculum committee can adopt it and it will be in all new training (including for GPs) but for those in existing jobs, the message is disseminated through academic papers, literature, conferences etc, so there is some lag.

And while the members of the AEPU were very keen to ensure this happens, they did suggest we also have to follow up with GPs.

We also touched on the fact that the term abortion or spontaneous abortion was still used in relation to miscarriage - some of them were quite shocked. This could be due to older staff who haven't 'refreshed' their training, but they were also discussing a wider issue with WHO nomenclature (there's a word I haven't used for a very long time) which is used to code patients on a world wide basis. Many NHS systems use this (have to use I think) and they do still use phrases like that. So even if the care you're given reflects the most sensitive language, it is possible your notes will then be coded in such a way.

The AEPU member really recognised this as a problem and are trying to work through at official levels - but I said we'd be happy to help.

We'll of course put the new survey up and make a song and dance about it when it's ready so we can all respond again.

On the monitoring Taffeta you're right - only a start - but one thing we've realised is that some areas will focus on this, others will pretty much ignore it, but it's sooo difficult to work out who's doing what - so it will at least help to kick start some action.

[klaxon]

I don't think the words matter as much as the attitude that miscarriages are just an inconvenience that needs dealing with. That needs a lot of effort to change so women aren't told 'well we can probably squeeze you in for a scan next week sometime maybe but it's not priority so it won't be today' :( Hopefully this is a good first step though.

[caramelwaffle]

Good steps forward.

[reikizen]

what a bloody joke. If anyone believes that load of tosh they have a rude awakening. One to one care in labour? We used to do that in my old unit and they closed it down in favour of a 'supercentre' where you get stuck on a CTG and end up with a crash section. You get a 'named midwife' now but it is simply that, a name on your notes. Maternity services are not likely to improve in any real sense for many years if ever. Midwives and Health Visitors already 'work together' and are fully aware of the evidence, but are so stretched (for Health visitors that means dealing with the massive amount of safeguarding work that is now 90% of their job) that basic, routine care is all women get (if that). They (as usual) make no suggestions as to how this will be achieved with a shortage of 4,000 midwives nationally, bigger and bigger cuts to the NHS and creeping privatisation. Rant over. For now.

[VictoriaWould]

I agree entirely, reikizen. An 'announcement' ain't gonna change a thing.

[klaxon]

Ironically I did get one on one care in labour, in fact I had two midwives the whole way through, on a ward with three midwives and ten labouring women, which I think means there was one midwife to nine other ladies. I know I was high risk but I wasn't that high a risk surely? I'm very skeptical about any 'guaranteed service level' because it's all weasel words. Appoint enough midwives, make the provision adequate so it's not ALWAYS above 90% capacity and things will work better.

[MmeLindor.]

Well, it all sounds very promising, but have they actually announced the training of the 5000 new midwives needed to implement this plan?

Sorry, MNHQ, don't mean to rain on your parade. It is great that there is movement, and you are achieving so much. I am just sceptical if they will see this through.

The term "missed abort" was still being used in Germany a few years ago, so the WHO thing makes sense. I hope the language used will be reviewed in other countries too.

[Havingkittens]

I brought this up a couple of times in the original thread and was never acknowledged, rather like the white elephant that sits in the room with me when I am frank about my experiences, so doesn't come as a big surprise. Although rather disappointing from Mumsnet.

Yes, it would be great to have better care for those who have lost babies to miscarriage, still birth and cot death. Wonderful to invest more care for those suffering with PND. But still, why do those who have lost a baby, albeit down to them having to make the painful decision themselves to terminate the pregnancy, due to a life threatening condition or life limiting chromosomal anomaly, not deserve the same care. Not even the acknowledgement. These circumstances of pregnancy loss are just as upsetting as the others mentioned but, in some ways, more lonely, confusing, isolating, devastating because all the other sad circumstances are not taboo to talk about where the 'unmentioned' reason for the loss of a very much wanted pregnancy is.

I would be thrilled to get better care for miscarriage sufferers as I have had 4 miscarriages myself, but I've also lost 2 pregnancies in a row to chromosome anomalies so it is something I feel really strongly about. The second time it happened the NHS decided to contract out terminations for this reason to Marie Stopes clinic where I was treated really shockingly. It traumatised me for a lot longer than any of my miscarriages have. But still, despite this, and the fact that there are 7 huge threads on Mumsnet of people who have suffered similar losses over the last couple of years, we still don't deserve to have our circumstances included in this campaign.

[Tee2072]

I think it all sounds good. But so did the campaign about disabled nappies and I think that never went further than a lot of hot air, i.e. no extra nappies were ever actually allocated to those who needed them for an older double incontinent child.

So they are talking the talk and walking the walk? Or are we all just getting patted on the head and sent on our merry way?

[KatieMumsnet]

Tee2072 agree that there's a BIG tension between saying nice things and seeing any change - and monitoring something is a long way from action. TBH it's a big challenge we face - especially as services are more devolved, but we'll carry on doing what we can - and trying to keep the pressure up.

[KateMumsnet]

Hello Havingkittens

We're so sorry to hear about your experiences, and that you're feeling so left out of this campaign. We do understand, and we're sure that there are other MNers who've gone through this or other very sad situations who might feel similarly. 

When we discussed the campaign on the boards, there was a feeling we should have a focused approach primarily on miscarriage, to try to make it more likely that we'll be heard and understood. It's such a difficult one, and we readily acknowledge that there's no satisfactory answer.

However, we hope that some aspects of the campaign - particularly the increased awareness of parents' sensitivities - will eventually help to make experiences like yours, and others which fall outside the miscarriage remit, a bit more bearable.

MNHQ

[Havingkittens]

Thank you Kate. I'm pleased that you are making headway in this campaign and only hope that we can see actions rather than just words in response. I don't feel left out as such as the miscarriage issue is one that hasaffected, and still is affecting me. I was just a bit bothered by the fact that as the matter progressed it seemed to cover (almost) all aspects of pregnancy loss apart from the one which is "taboo" to speak of, where people need to be treated with a similar amount of understanding and tact. A lot of the same guidelines apply with regards to TLC, such as being scanned or seen for follow ups in separate areas to those heavily pregnant or in labour, the continui of care which guarantees not being asked insensitive questions etc. So, not necessarily a whole new campaign, just to be acknowledged as another group/situation to be treated with the same tact and tenderness.