"It only takes a few extra seconds to make the experience for the woman that little bit easier to bear"

About: Southern General Hospital / Maternity care

(as the patient),

I attended an 8 week scan last week at the Southern General EPU and received the unfortunate news that my baby was only measuring 5 weeks. I was informed that I would need to return a week later to confirm whether or not the pregnancy had ended. I attended this morning and both my partner and I have been left astonished by the lack of human kindness displayed by the midwife. Firstly, a student midwife called me into the ultrasound room and I sat down at the desk next to the qualified midwife. The qualified midwife then turned to me and asked me to get ready for the scan. After a very challenging week and the possibility of facing a third miscarriage, I could not believe the midwife did not even attempt any pleasantries or explain what the aim of today's scan would be.

I began to get ready and then lay on the bed waiting for the awful process to begin. The midwife was about to begin the scan (internal) when I plucked up the courage to ask her if she knew why was having this scan today to which she replied yes and that she'd read my notes. I could not believe she showed no understanding or empathy and did not think it was important to verbalise what she understood the purpose of today's appointment was well before this point. Sadly a miscarriage was confirmed and the midwife then went about form filling in silence to arrange my D and C. All the time the student is there, observing this completely sub-standard, frankly inhuman service provision.

What did this student learn from watching this experience? How many other vulnerable women will be on the receiving end of such cold, clinical treatment?

As we left the room, before we had even closed the door I heard the midwife tell the student that they were busy today with a lot of appointments to squeeze in. What seemed absolutely apparent was that this midwife was thinking only of the workload she had to face that day, which I understand may have made her feel snowed under. However it only takes a few extra seconds and some eye contact to make the experience for the woman that little bit easier to bear.

During a previous miscarriage I received excellent care from one of the other midwives and the Southern General EPU. What is a great concern is the inconsistency in care delivered and more worryingly, that some midwives who frankly are not well suited to dealing with this kind of patient experience are demonstrating a lack of compassion to the midwives of the future.

I intend to make a formal complaint about this as I feel that many other women could be left feeling as angry and alone as I feel today if this issue is not addressed swiftly.

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Responses

Response from Paul Cannon, Head of Administration, Acute Services Division, Greater Glasgow & Clyde NHS

Dear Angry and Let Down

Thank you for taking the time and trouble to provide your feedback. We have received comments from our Head of Midwifery as follows.

We would wish to offer unreserved apologies to you and reassure you that we educate all our midwife-sonographers and those others who provide the service to be sensitive to the emotional needs of women and their partners faced with the potential news of the loss of a much wanted pregnancy. Key to this is their professionalism and the ability to share empathy when such bad news is given.

Student midwives need to observe the enhanced communication skills as well as the technical skills staff should be demonstrating. Your feedback regarding the service will be shared with all involved in order for them to gain some insight as to how they come across to women like yourself.

Thank you for taking the time to send this communication particularly following your recent loss.

Kind Regards

Paul Cannon

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Response from Craig White, Divisional Clinical Lead, Directorate of Health Quality and Strategy, Scottish Government

picture of Craig White

Dear Angry and Let Down

I was so sad to read of your very poor experience of care and want to add my apologies to those already conveyed to you by colleagues at NHS Greater Glasgow and Clyde. I can only imagine the apprehension you and your partner experienced while waiting for this scan - and as you so rightly point out this is all the more concerning that a student midwife observed this happening.

I am pleased the Head of Midwifery is personally involved as it is vital that there is reflection and learning to ensure consistent compassionate and emotionally supportive care takes place when such a distressing situation is experienced.

Scottish Government is committed to supporting NHS Boards to deliver person-centred care for everyone across the country. We have suggested to the Nurse Director of NHS Greater Glasgow and Clyde that she encourage the midwifery staff in this area to link with others involved with local learning and improvement work on person-centred care - using your feedback to think about how everyone who faces this upsetting scenario can be confident they will get a consistently compassionate response.

The Cabinet Secretary for Health and Wellbeing has been encouraging NHS Scotland senior leaders to explore how Patient Opinion can support transparency, learning and quality improvement. We appreciate that you have taken the time to share what happened and take a keen interest in hearing how Boards use this to support improvements for other people.

I hope that despite what happened to you and your partner experienced that you have had support with the pain of your loss,

Your respectfully

Professor Craig A White

Divisional Clinical Lead, Quality Unit, Scottish Government & NHSScotland

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Update posted by Angry and Let Down (the patient)

Thank you to both Paul Cannon and Craig White for their understanding responses.

It seems very clear that a greater awareness of how miscarriage sufferers feel during clinic appointments will be fostered through this online dialogue. I can only hope that anyone who is unfortunate enough to experience pregnancy loss in the future can have their trauma eased by a more sensitive approach by health professionals.

A miscarriage is an awful, dark and distressing experience, but staff in midwifery have the ability to make the delivery of such traumatic news somewhat more bearable. I have received this devastating news twice. Once it was handled sensitively, and once it unfortunately was not. The difference between the way I felt in those two moments of my life is hugely significant, and that is something that the staff at the EPU, Southern General should never underestimate.

Thanks to those midwives who made me feel less alone during these dark appointments. To those who did not I hope you can be successful in developing your understanding of this very difficult life event.

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