Wednesday 25 April 2018

Mothers-to-be were betrayed by the system

National Miscarriage Misdiagnosis Report provides evidence of our sick society, writes Emer O'Kelly

A woman is pregnant, and blissfully happy about it. She is going to be a mother.

Nature has fashioned her body for the purpose, and this is the 21st century. But the woman is nervous: things can go wrong. She won't be entirely happy until she has passed the crucial 12th week of pregnancy.

And then the fear takes on a gruesome reality: she starts to bleed and is rushed to hospital. She knows that when things look like going wrong, hospital is the place to be. Years of medical practice and skill are there to help her and the foetus she already thinks of as her baby. The medical staff seem concerned as they look at the results of the ultrasound. A kind figure sits down beside her. Maybe he (or she) takes her hand.

"I have bad news, I'm afraid. We haven't been able to detect a heartbeat. I'm very sorry, but your baby is dead." The medical consultant, registrar, or house officer has been very careful to say "baby".

They know that at six or seven weeks the foetus is a blob of accumulated cells but it has the potential to become a baby.

After the storm of weeping, after the disbelief, when the numbness of acceptance sets in, there are decisions to be made. Depending on the stage of the pregnancy, procedures are needed. It might be ERPC (evacuation of retained products of conception) a reality that must be even more terrible than it sounds; or perhaps a D and C (dilation and curettage), a procedure which medically mimics the stages of labour.

The numb, sad woman tries to concentrate on the future. She and the baby's father hold each other close, then sign the forms, and the necessary procedure is carried out. What was left of what could have been a baby is gone.

And then, years later, thanks to the bloody-minded determination of a few other women with ravaged bodies and broken hearts, the word "necessary" comes into question. Worse still, the word "dead" comes into question. A few women who refused to accept the sympathy of the medical staff, women who held out against omnipotence because their heartbreak wouldn't allow them to believe in it, demanded more: another ultrasound scan, another opinion. And tiny heartbeats were found. And months later small, squalling, beautiful human beings came into the world.

The parents possibly call their babies "miraculous." Other people may tell them that they have been extraordinarily lucky. But this was not luck, and it certainly was no miracle. This was what should have been normal procedure.

And after much shock, one imagines, there were many nervous consultations amongst the bureaucrats who had set down guidelines of: one woman, one pregnancy, one bleed, one scan, nice and neat. And an enquiry was instituted. The National Miscarriage Misdiagnosis Report was published by the Health Service Executive last week.

A number of cases had been investigated. It was found that 24 women in the review were given the devastating news that they had miscarried, when in fact the foetus (to be non-emotive) was still alive. Two of those women had the "normal" post-miscarriage procedures I've mentioned. The foetuses apparently survived the surgical trauma, but didn't survive to term. Four other women had the procedures, but delivered healthy babies (tough little so-and-sos, those four babies, clinging on, literally for dear life).

Of the 24 women who were wrongly told they had miscarried, 22 went on to have live births. But that doesn't excuse the horror they had to go through. Registrars made the miscarriage diagnosis in 13 cases, consultants in six, and house officers in five. Several of them, described in the report as "clinicians" reported "significant experience" in conducting ultrasounds in early pregnancy. But "formal training in early pregnancy ultrasound was reported by only three".

Women trusted the medical system, not knowing that ill-trained and inexperienced people were dealing with the potential lives of their babies. And in some cases, the possibility of much-wanted life was snuffed out as a result of the inadequacy.

The chairman of the review group is a brave man. Professor William Ledger had to tell the world that there was no way of knowing how many women who had undergone the horror of being told that a longed-for child would never be born, could have been spared the heartbreak if those treating them had been properly trained, and the equipment used had been up to standard.

And Professor Ledger was speaking only about test cases. There is no way of knowing how many "miscarriages" were no such thing.

When women are desperate, when little girls have been raped, we scream that life is sacred from the moment of conception. We refuse women in ghastly circumstances the right to terminate a pregnancy. But on the flick of a switch by an inadequately trained operator, we tell women longing for motherhood that their baby is dead.

And the Society for the Protection of Unborn Children has been silent in the face of this horror of fundamental dimensions. We truly have a sick society.

Sunday Independent

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