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Pregnancy Loss Review

Emma Ayling 14 Nov 2023

Emma Ayling reflects on the impact of the report on early pregnancy care.

In July 2023, the Government released an independent report on Pregnancy Loss Review led by two independent experts, Zoe Clark-Coates MBE BCAh and Samantha Collinge RM detailing 73 recommendations to improve the safety and care for all those who experience pregnancy loss before 24 weeks gestation. The report makes poignant, reflective reading and while we, as healthcare professionals pride ourselves on giving high quality standard of care, there is still much work to be done to improve the services we provide for those going through early pregnancy loss.

As a Gynaecology Matron with a strong clinical background in early pregnancy and the Bereavement Lead for our Early Pregnancy Unit, I undertook a gap analysis using 8 workstreams to analyse, benchmark and identify how we could improve our services. We are making good progress, with more to do, given time and resources to be able to do so. The workstreams focus on education, training and information, service provision, early pregnancy assessment units (EPAUs), gynaecology services, clinical care quality, bereavement care and support, patient records, IT and data and finally the workplace.

Being involved with the RCN Gynaecology Matrons Network I have liaised with many passionate, dedicated healthcare professionals who are fighting for funding and resources to ensure the provision of care to women, including staffing in order to meet  recommendations set out in the report. We collectively work to learn from each other, look at other services’ practices to improve our own and it is through collaboration that we all hope and strive to do the best by our patients.

In my own experience of reviewing patient complaints, the key themes are dignified environment and care, compassion and understanding from healthcare professionals and how to approach sensitive conversations. An emerging important role is of the Early Pregnancy Bereavement Nurse/Midwife – whilst not a new concept in maternity services, it has taken time to highlight how essential it is to publicly acknowledge that women undergoing pregnancy loss under 24 weeks gestation feel their loss as keenly as women going through a late trimester loss and deserve to receive the same level of support. It is through our patients’ experiences that we learn what they need from healthcare professionals, to hone our skills, knowledge and compassionate care.   

As a woman who has experienced pregnancy loss, I have great empathy for the emotional trauma experienced and I recognise how  essential it is that we get this right including providing a dignified environment for women to receive care from nurses with the specialist skills to support them through a difficult and vulnerable time. However, it needs to be acknowledged that NHS Trusts are faced with varying challenges in being able to provide the space and resources needed to ensure they are providing the level of care we should be able to expect to provide to women.

On 6 December, the RCN Women’s Health Forum will be undertaking their first face to face annual conference since COVID to highlight the health inequalities faced within women’s health and within this programme, one of the topics focuses on how we can support women facing pregnancy loss. Please join us this year for an educational, supportive programme and become a part of the movement to be a catalyst for change in Women’s Health. We each have passion, a voice – let’s use it to empower ourselves and the women we care for. 

Emma Ayling

Emma Ayling

RCN Women's Health Forum

Gynaecology Matron, Cambridge University Hospitals NHS Foundation Trust

Gynaecology Matron supporting both inpatient and outpatient care with a passion and clinical background for Early Pregnancy Care.

Page last updated - 13/04/2024