Women's

COVER STORY A Ha ven of Compassion Women experiencing miscarriage find quick access to diagnosis, timely medical care and emotional support at the Early Pregnancy Assessment Clinic. By Helena Bryan Photography by BRIAN HOWELL P regnancy is an emotionally charged time for an expectant mom – equal parts joy and stress. There's a lot to think about – Am I eating enough? Too much? Should I stop exercising? And then there are the periodic nausea, mood swings and insomnia. On top of this, about 30 per cent of pregnant women experience complications such as bleeding and cramping during the first half of pregnancy – complications that while common, are sometimes an indication that something is wrong. In fact, 10 to 20 per cent of women miscarry in the first trimester. Women with these symptoms typically go to their local ER, sometimes waiting hours to be seen. Some are referred elsewhere for tests to wait for what could be the worst – or best – news of their lives. Dr. Stephanie Rhone, Medical Director of the Reproductive Medicine program at BC Women's Hospital, knew there had to be a better way to support these women. The answer came in 2007 with the opening of BC Women's Early Pregnancy Assessment Clinic (EPAC). Custom care Based on a best-practices model in the UK and offered only at BC Women's Hospital in British Columbia, EPAC is an interdisciplinary clinic devoted entirely to providing medical and emotional care to women in the first trimester of pregnancy who are experiencing complications. Everything these women need is under one roof: assessment, diagnosis and management of complications and pregnancy loss, as well as supportive counselling. "With specialized nurse clinicians on staff, as well as obstetriciangynecologists who are ultrasound certified, patients don't have to wait for answers," says Rhone. "We share what we see on an ultrasound as we see it." quickly – often on the same day. If the news is not good and a miscarriage is imminent, they have nurses on staff who help patients decide how they would like to resolve the pregnancy. If medical or surgical interventions are required, they're done right on the premises. Emotional Support Counselling is a key part of the process, says Rhone, who adds that there's generally a real lack of acknowledgement of the emotional impact of miscarriages: "People tend to say, 'Oh, it's early on and you'll get pregnant again.' "They minimize it. That's why we've made sure the care here is emotionally, as well as physically, supportive." "If I'd been in an ER, it would have been treated as an unfortunate medical issue," says one young woman, who was referred to the clinic after an ultrasound and blood tests revealed that her six-week pregnancy was no longer viable. "But the EPAC staff acknowledge how disappointing a miscarriage is, how heartbreaking. They support you through part of your life story. It certainly had an effect on how I was able to move on." The care provided doesn't stop once the patient leaves the clinic. "We touch bases with all our patients at regular intervals after they leave to make sure they're okay," says Marierose McDonnell, a long-time nurse clinician at the Clinic with postRN certification in prenatal nursing. "Our focus is TLC." "All of our patients tell us that we've made a bad situation better," says McDonnell. "Now we have women coming from as far away as Chilliwack and Squamish." Invaluable resource One of the keys to the success and importance of the clinic is the speed at which it is able to deliver healthcare to women experiencing miscarriage. Where women often wait up to 10 days to resolve a failed pregnancy through an ER, the clinic is able to provide compassionate medical care and closure Over the past five years, the Clinic has evolved into a top referral centre for women from throughout the entire region. "The Early Pregnancy Assessment Clinic is a fantastic resource for us," says Dr. Lyne Filiatrault, an ER physician at Vancouver 6 WOMEN'S SPRING 2013 BCW-Spring 2013.indd 6 13-04-30 11:51 AM

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