Medical journal urges streamlined miscarriage care in Canada, more early assessments

An editorial published in the Canadian Medical Association Journal says it’s time to invest in early pregnancy assessment clinics that can provide proper care during and after a miscarriage, which can have devastating effects.
The paper and an accompanying review of medical literature on early pregnancy loss say miscarriage affects one in five pregnancies in Canada, but patients seeking help in emergency departments often receive “suboptimal” care.
The CMAJ says one study found a disconnect between the medical view of early pregnancy loss as something that is easily managed, and the reality of the patients’ own traumatizing experiences.
The editorial argues that early pregnancy assessment clinics would be better equipped to provide a tailored, patient-centred experience, with a greater understanding of early pregnancy complications and loss.
Dr. Modupe Tunde-Byass, one of the authors of the literature review and an obstetrician/gynecologist at Toronto’s North York General Hospital, emphasizes the need for compassionate care that accounts for the psychological impact of pregnancy loss.
Tunde-Byass says patients should be referred to early pregnancy assessment clinics when possible to address the grief, guilt, anxiety and post-traumatic stress disorder that can persist for a year after a miscarriage.
While North York General Hospital and a patchwork of other health-care providers have clinics dedicated to miscarriage care, Tunde-Byass says that’s not widely adopted– and it should be.
The CMAJ says pregnancy assessment services “remain a pipe dream for many,” especially in rural Canada.