Miscarriage Care and Facilities in Scotland: Scoping Report NHS Forth Valley

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^[6]. 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.

Within NHS Forth Valley, Forth Valley Royal Hospital indicated that they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation both within and outwith the EPU (Table 12).

Separate room/area/ward

All sites in Scotland 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 Forth Valley, Forth Valley Royal Hospital reported that there are dedicated facilities for women experiencing unexpected pregnancy complications at any gestation. They also said that there is a separate room/area/ward for women who are miscarrying. There are 12 rooms available in Forth Valley Royal Hospital in total comprising: two triage rooms and seven single rooms on the Gyneaclogy ward; two dedicated quiet rooms in the ultra sound scanning area in the Maternity Unit, and a berevement room within the Maternity Unit. 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.

Patients from the entire Health Board area are referred to Forth Valley Royal Hospital through a variety of pathways: self-referral, GP or allied healthcare staff, family planning, sexual health, in vitro fertilisation (IVF) units, or private ultra sound scanning clinics.

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, 7 out 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.

When asked about areas where complication or investigative scans are carried out in NHS Forth Valley, they reported that scans are conducted in the EPU at the Royal Hospital during opening hours. Forth Valley Royal Hospital reported that if a women presents with a suspected miscarriage out of hours and a scan is required this would be arranged through the EPU service. Depending on the clinical picture this may be deferred for up to 72 hours. Scans are carried out in the EPU between 8:30 and 12:30 Monday to Friday.

Scans are also undertaken within the Maternity Unit between 8:30 and 20:00 Monday to Wednesday, 8:30 to 16:30 Thursday and Friday and 8:30 to 12:30 on Saturdays. In the Obstetrics and Gynaecology Department scans are carried out between 8:30 and 18:30 Monday to Friday, 8:30 and 14:30 on Saturdays and 8:30 and 12:30 on Sundays dependent on the skill set of the consultant on call. All scans are carried out separately from other expectant mothers. Within the Maternity Unit at Forth Valley Royal Hospital, there are two dedicated quiet rooms.

No scans to confirm miscarriage are conducted at Community Maternity Units or A&E departments.