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

Miscarriage management and information

The Lancet series on Miscarriage Matters stated that women should be presented with the available evidence about miscarriage management and be free to choose the management approach that suits their needs and preferences.

Choice of management option

All Health Boards in Scotland reported that they ensure that women can choose their preferred method of management of miscarriage. However, the geography in Scotland has implications for women in terms of how they can access their chosen approach.

Sites in NHS Ayrshire and Arran reported that all management options are carried out in University Hospital Crosshouse only. Arran War Memorial Hospital suggested that due to the need to travel to and from University Hospital Crosshouse on the mainland, if women experience any complications or if treatment is not successful more than one journey may be required, with this in mind very few women from Arran chose expectant management as an option for their care.

Written information

All Health Boards in Scotland said that they provide written information about the treatment options for the management of miscarriage and what to expect in terms of miscarriage care. However, not all sites where women may present for miscarriage care said that they provide written information on treatment options or what to expect.

All sites in NHS Ayrshire and Arran stated that the same pathway of care for miscarriage treatment is followed within the Health Board area overall, however there is some variation in what is provided by each site in terms of information provision (Table 14). All miscarriage guidelines are available on the intranet for professions within the Health Board, to aid decision making for referral.

University Hospital Ayr reported that written Information about the management of miscarriage or what to expect next is not provided, with patients receiving written information once transferred to the University Hospital Crosshouse. University Hospital Crosshouse and Arran War Memorial Hospital both responded that written information about treatment options and what to expect is provided at their sites. Similarly, written information about mental health and bereavement support is provided at University Hospital Crosshouse and Arran War Memorial Hospital, with patients from University Hospital Ayr receiving this information once transferred to University Hospital Crosshouse.

Information about management options

As well as written information, all three sites in NHS Ayrshire and Arran strongly agreed that information about what will happen during and after the chosen method of management of miscarriage and what happens in terms of follow-up after the management of miscarriage is fully explained to women. However, this was done once the pathway of care for the Health Board had been followed and the patient was at the site that would offer treatment for miscarriage. See Table 15.