Saturday, 18 October 2008

Miscarriage for the Uninsured

What do you do when you suffering from a miscarriage, and you live in the US, but you are not covered by your insurance? Simple! Just go to bed and pretend you are having a big period.

That's what Gina from Missouri did (thanks to Meagen Bohne for highlighting such a case).

But not only is a miscarriage extremely traumatic psychologically, it can also be a very dangerous time for the woman, who has to, in effect, go through labour, and all the risks with which that is associated.

Let me tell you another story, in contrast, of a lady who was 18 weeks pregnant when she experienced a slight bleed. She called her local family practice just to make sure that it was nothing to worry about and was invited straight down to the surgery where she was given immediate attention, as a precaution. The doctor listened for a heart beat and could not find one. He showed genuine concern for the lady, although did his best to reassure her that he was not very experienced using the doppler. He called the hospital to see whether she could be given an immediate scan; the hospital told her to come straight away.

At the hospital she was treated with the utmost dignity. Since they did not want to distress the lady by leaving her to wait with the other pregnant ladies, she was taken straight to her own private room. A consultant doctor came almost immediately to give the scan, and at her side was a nurse, holding her hand the whole time to give her support. It was a complete shock for her to be told that there was no heart beat and that the baby had indeed passed away. The lady was given all the space and support that she needed at this emotional time, was brought a cup of tea and was then consulted regarding the options on how best to deliver the baby. After discussing the pros and cons of the different options in as much detail as she wished, she decided to deliver the baby by natural methods with the help of a tablet that would turn off the pregnancy hormones. She was able to decide when would be the best time for her, and when she returned to the hospital later that evening to begin the process again she was treated with great care and sensitivity.

Even though she had to deliver in the labour suite she was given her own private room from start to finish and she was never confronted with having to face any of the other pregnant ladies or babies that had been delivered successfully. She was given the exact same attention as if she had been delivering a live baby, with a midwife to attend to her personally from start to finish and regular visits from the doctors. The midwife was able to answer all of her concerns and helped to mentally prepare the lady for the actual event.

Before the baby was delivered she was consulted as to how exactly she would like the events to proceed, every step of the way, and was given time to hold the baby for as long as she wished. After the process was complete, in her own time, she was consulted on what she would like the hospital to do with the body, and given booklets explaining her options. The lady had a personal point of contact to help her through the process in the coming weeks, which included an autopsy of the baby and genetic testing in accordance with her wishes, as well as liaising with the hospital and undertakers to arrange for a burial in the local cemetery, in an area specially allocated to babies that die in the womb. She was also given aftercare, from a community midwife who called at her house, by the local doctor to ensure that she made a good recovery in the following months, and a visit back to the hospital to discuss everything including the autopsy results with the OBGYN consultant doctor.

The whole event of loosing your unborn child can be psychologically very painful and can carry many of the same risks as delivering a live baby. This hospital did everything it could possibly do to help keep the pain, and risks, to a minimum, and provided follow-up care to ensure a good recovery, and testing to see if there was anything that could be done to prevent a recurrence of the miscarriage in the future. They made what was a very difficult event somewhat easier to bare.

And the cost of the the whole treatment from start to finish, including the autopsy, genetic testing and burial? Well, nothing actually, at least not directly to the lady, since everything was paid for by the NHS.

1 comment: