Miscarriage Care and Facilities in Scotland: Scoping Report NHS Ayrshire and Arran

Dedicated facilities

Unexpected pregnancy complications at any gestation

The Scottish Government has committed to the provision of dedicated facilities for women experiencing unexpected pregnancy complications through the Programme for Government 2021-22^[7]. All sites were asked if they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation. Sites with an EPU were also asked to indicate if they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation within the EPU.

In NHS Ayrshire and Arran, University Hospital Crosshouse indicated that they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation both within and out with the EPU (Table 12).

Separate room/area/ward for women experiencing miscarriage

All sites were asked if they provide a separate room, area, or ward away from the labour ward for women that are miscarrying. They were also asked if they provide a separate room, area, ward or unit with dedicated services to admit women who are miscarrying. The number of separate rooms reported to be available for women who are experiencing miscarriage ranged between 1 and 12 rooms per site in Scotland.

In NHS Ayrshire and Arran, University Hospital Crosshouse reported that there are dedicated facilities for women experiencing unexpected pregnancy complications at any gestation. They also said that there are separate room/area/ward for women who are miscarrying. There are more than five rooms available in University Hospital Crosshouse, away from the labour ward for women that are miscarrying. These spaces are also available for use for women experiencing still births, termination of pregnancy due to fetal anomaly (TOPFA), ectopic and molar pregnancies. The facilities that are provided are set out in Table 12 above.

Scanning facilities

Scans are often performed to confirm a miscarriage has occurred. For this scoping exercise all sites were asked if a separate area was available to carry out complication or investigative scans separated from women with a continuing pregnancy.

Overall, eight of the 14 Health Boards reported having a separate area to carry out complication/investigative scans separated from women with a continuing pregnancy, either within or outwith the EPU.

In NHS Ayrshire and Arran, when asked about areas where complication or investigative scans are carried out all sites said that these are only carried out at University Hospital Crosshouse.

University Hospital Crosshouse reported that complication or investigative scans are conducted in the EPU during opening hours. If a woman presents with a suspected miscarriage out of hours at University Hospital Crosshouse A&E or at one of the other two sites and a scan is required, the patient would be referred to the EPU in University Hospital Crosshouse during opening hours or the next day if the patient was deemed stable. Scans are also undertaken within the Maternity Unit and Obstetrics and Gynaecology Department 24 hours a day, seven days a week, at University Hospital Crosshouse. When a woman presents out of hours and is not stable, an investigative scan would take place within the Maternity Unit or Obstetrics and Gynaecology Department by an appropriately qualified member of medical staff within University Hospital Crosshouse. Scans are also conducted during recurrent miscarriage clinics. All scans are carried out separated from other expectant mothers.

All three sites reported that no scans to confirm miscarriage are conducted at Community Maternity Units or A&E departments.