Many miscarriages happen in ERs, where care is often ‘suboptimal’: report

Up to 20 per cent of pregnancies end in miscarriage in Canada, forcing many to seek help in overcrowded emergency departments where they often face long wait times.

Up to 20 per cent of pregnancies end in miscarriage in Canada, forcing many to seek help in overcrowded emergency departments where they often face long wait times and a lack of compassionate support, a new report reveals.

The report, published Monday in the Canadian Medical Association Journal (CMAJ), argues that the absence of timely diagnosis and compassionate care for those experiencing miscarriages in the emergency room can result in significant and lasting psychological effects.

“This is a huge problem. One in four pregnancies ends up with a miscarriage, therefore, the care has to be better,” said co-author Dr. Modupe Tunde-Byass, an ob-gyn at North York General Hospital and associate professor at the University of Toronto.

“A perceived lack of compassion can lead to negative experiences and anxiety, depression, post-traumatic stress disorder … which can go on for months and even years after a miscarriage,” she told Global News.

Early pregnancy loss is defined as an empty gestational sac or a gestational sac with an embryo without fetal cardiac activity before 13 weeks gestation, the authors said. Common symptoms include bleeding, cramping, abdominal or pelvic pain, passage of tissue or a combination of these.

Tunde-Byass and her colleagues argue that not only are miscarriages common in Canada, but they are also poorly managed.

The CMAJ review aims to guide physicians on better diagnosing and managing the condition, advocating for referrals to outpatient early pregnancy assessment clinics (EPACs) and emphasizing the need for a more compassionate approach to care.

EPACs are pregnancy clinics that provide urgent and sensitive care to women who are less than 20 weeks pregnant and experiencing complications such as nausea, vomiting, vaginal bleeding, abdominal pain or cramping. These clinics provide an alternative to the emergency room, allowing patients to receive timely care without the need to wait in the ER.