Miscarriage Care and Facilities in Scotland: Scoping Report NHS Orkney

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 Orkney, Balfour Hospital indicated that they do not have dedicated facilities for women experiencing unexpected pregnancy complication at any gestation due to lack of space. NHS Orkney reported that they if requested women can be transferred to Aberdeen Maternity Hospital (Table 8).

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 Orkney, Balfour Hospital provides an early pregnancy service as a function of overall care rather than as a separate dedicated unit and this function is operated from the maternity unit, where patients within the health board are referred.

Dedicated facilities for women experiencing unexpected pregnancy complications are not currently provided at Balfour Hospital as the number of women presenting and the size of the service currently precludes a separate department or area as all services are run from the maternity unit. The is also one separate room available in the maternity unit away from the postnatal and labour section. Balfour Hospital indicated that although women largely prefer to access the support and expertise of the maternity team within the maternity unit options are available for alternative accommodation in the acute or day surgery wards if women prefer not to attend the maternity unit. Regardless, access to midwifery input is always available (Table 8).

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 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.

If a women presents with a suspected miscarriage out of hours at Balfour Hospital A&E and a scan is required they would receive scans within 24 hours, usually in the maternity unit where sonography services are based. When asked about areas where complication or investigative scans are carried out in NHS Orkney, scans are conducted in the Maternity Unit at Balfour Hospital 9:00-17:00 Monday to Friday with limited access on the weekends. In NHS Orkney, there are no separate areas to carry out complication / investigative scans separated from the area for women with a continuing pregnancy (Table 9).