Personal views: Last on the list
Authors: Ann Rosen
Journal: BMJ (1998)

As I lay on the hospital bed during the scan for my fourth child I was full of apprehension. The doctor was moving the probe around for a long time and the image on the screen did not resemble anything identifiable. Eventually he spoke. 

“Are you sure about your dates—around 16 weeks?” 

“Absolutely,” I replied. 

“The picture I’m getting isn’t very clear. We’ll have to scan it from another angle.” 

The second scan showed a mass of deformed cells, no identifiable embryo or definite organs. 

“I’m sorry,” he said. “You’ll have to stay in hospital for a dilatation and curettage. One of my colleagues will come and deal with you shortly.” 

My husband held my hand reassuringly and asked if I was okay. I was fine, disappointed, of course, but these things happen and we were blessed with three healthy children. 

Eventually, I was admitted to a ward and told that the operation would be done at the end of the other day cases. There was no indication of when this would be, but I was told not to eat or drink. 

There were two other patients in my ward. There was Amy, who was in her 80s, a childless widow, riddled with cancer, yet positive and chatty. On the other side was Irene, a teenager who had just had a miscarriage and had already had her D and C. She would probably have had a termination anyway, she told me gloomily. She hated hospitals and wanted to get out, but she was not allowed to leave on her own. No one had talked to her about her experience or given her any support or advice, but I sensed that she was deeply depressed and in obvious need of help. I had not received anything in the way of comfort or support either. On the other hand, I reflected, they probably thought I would be all right—I was a consultant’s wife. The junior doctor who took down my particulars was kind, but either rushed off her feet or just eager to get away. 

I was eventually wheeled down to the operating theatre at midnight, 14 hours after my scan and 16 hours after my last meal. Nobody explained the procedure to me or offered any word of comfort. A nursing sister complained about my husband’s presence, totally oblivious to me or the distress she was causing. 

When I came round I felt an overwhelming feeling of loss and wept uncontrollably. That feeling lasted a few minutes, and I was left with the residual drowsiness from the anaesthetic. I spent an uncomfortable night and tried to sleep, but was frequently roused by Amy who was struggling with her bed pan. 

During the morning ward round I was seen by an uninterested registrar for less than 30 seconds. 

“How do you feel?” she asked, looking at the notes and so avoiding any eye contact. 

“Actually, I feel weak and sore—worse than after any of the births of my children.” 


“You shouldn’t feel like that, perhaps you have an infection,” was the reply, as she walked away. 


“Being married to a doctor did not make me immune from feelings of fear”



I left hospital later that morning relieved to have the experience behind me, but angry about the lack of humanity with which I had been treated. It was not that I had wanted anything special. All that was needed to make the situation more tolerable was a small degree of communication from the medical or nursing staff. An explanation as to why I had to be starved for 14 hours and what the operation involved might have reassured me. Being married to a doctor did not make me immune from feelings of fear and vulnerability as I lay on the operating table. 

My experiences are not unique. I was in a large London teaching hospital with a good reputation yet I was offered no counselling or follow up appointment. Both of these are offered routinely in other hospitals and I did not feel I needed counselling, but what about Irene and all those women who struggle to get pregnant and look hopefully at the screen during their scan only to be told, “I’m afraid it’s not viable.” It must make economic sense for the NHS to deal with both the emotional and physical consequences of such events. Perhaps with a different attitude the subsequent infection and haemorrhage which I experienced might have been avoided. 

We all know that miscarriages are common. When they occur early they limit the heartache for the mother. This is something that we can accept. What is harder to tolerate is being treated as an unwelcome addition to someone’s work- load.