Miscarriage Care and Facilities in Scotland: Scoping Report NHS Lanarkshire

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. 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 Lanarkshire, University Hospital Wishaw indicated that they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation both within and out with the EPU while University Hospital Hairmyres provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation within the EPU only (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 Lanarkshire, University Hospital Wishaw and University Hospital Hairmyres reported that there are dedicated facilities for women experiencing unexpected pregnancy complications at any gestation. They also said that there are separate room/area/wards for women who are miscarrying. At the time of answering the questionnaire, there was one room in the labour ward, although away from labouring women. As of 17 August 2023 there are two specially designated rooms housed in a ward away from the labour ward which are part of a wider bereavement suite within the maternity services at University Hospital Wishaw. University Hospital Hairmyres have a counselling room within the EPU that can be used for women who are miscarrying, however this should only be used when the woman is in need of treatment immediately and cannot be transferred to University Hospital Wishaw for treatment. The spaces in University Hospital Wishaw are also available for use by 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 in Scotland were asked if a separate area was available to carry out complication or investigative scans separated from women with a continuing pregnancy. Overall, eight 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 Lanarkshire, University Hospital Wishaw and University Hospital Hairmyres reported that they conduct scans in their Early Pregnancy Unit during opening hours in an area separate from other expectant mothers (Table 13).

NHS Lanarkshire reported that they have facilities to conduct scans within the Obstetrics and Gynaecology Departments at University Hospital Wishaw and at the Maternity Unit at University Hospital Hairmyres. Both of these services are provided during opening times (09:00-17:00 Monday to Friday and 09:00-13:00 on Saturdays). When a woman presents at University Hospital Monklands out of hours and is not in a stable condition an investigative scan would take place in A&E immediately by an appropriately qualified member of medical staff. No investigative pregnancy scans are offered in A&E at either University Hospital Wishaw or University Hospital Hairmyres during the night. However, if deemed necessary then the consultant on call would perform a bedside scan with a maternity portable scan machine at University Hospital Wishaw.