Miscarriage Care and Facilities in Scotland: Scoping Report NHS Western Isles

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 Western Isles, Western Isles Hospital indicated that they currently provide dedicated facilities for women experiencing unexpected pregnancy complications at any gestation (Table 9). Women presenting at Uist and Barra Hospital would be referred to Western Isles Hospital.

Barra Community Hospital does not have an EPU, Maternity Unit, CMU or an Obstetrics and Gynaecology Department, therefore, they were not asked these questions.

Separate room/area/ward for women experiencing miscarriage

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 Western Isles, Western Isles Hospital indicated that they can currently provide a separate room/area/ward away from labour ward for women who are miscarrying, however there are no rooms with dedicated facilities to admit women who are miscarrying away from the labour ward; this room is also available for use for women experiencing still births, termination of pregnancy due to fetal anomaly (TOPFA), ectopic and molar pregnancies. Western Isles Hospital indicated that they have two rooms for use for women who are miscarrying. Although these rooms are located in the maternity ward, they are away from the labour and main wards. (Table 9)

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 Western Isles, it was reported that scans are conducted at Western Isles Hospital. If a woman presents with a suspected miscarriage out of hours at Barra Community Hospital or Uist and Barra Hospital and a scan is required, the patient is referred to the Maternity Unit at Western Isles Hospital or to another available site such as Glasgow or Inverness. Scans are conducted in the Obstetrics Scan Department depending on the availability of an obstetric consultant or sonographer in Western Isles Hospital. There are currently no separate areas to conduct scans away from women with a continuing pregnancy in NHS Western Isles (Table 10).