Australia lacks national guidelines on bereavement care for miscarriage

Australia doesn't have any national guidelines on bereavement care for miscarriage despite evidence that up to one in five women who know they are pregnant will have a miscarriage before 20 weeks.

Co-lead of Miscarriage Australia Dr Jade Bilardi said women were often dissatisfied with the emotional support they received from healthcare professionals after a pregnancy loss.

"We don't have national guidelines around bereavement care for miscarriage at the moment in Australia and that's something that we absolutely need," she said.

"Women often feel upset because overly-medicalised terms are used that are quite insensitive. Referring to their babies as 'products of conception' [which] women often find very hurtful."

It comes as Queensland's premier Annastacia Palaszczuk shared her own experience of miscarriage.

"It is heartbreaking, it is very hurtful, you're in shock and you don't know what to do," she said.

Palaszczuk's comments emerged after allegations a woman was traumatised at a Queensland hospital when she was made to allegedly hold her fetus in a biohazard bag in a hospital waiting room.

In response, Queensland Health minister Shannon Fentiman ordered an urgent internal review.

Queensland Health director-general Shaun Drummond said work was under way to improve guidelines.

"We have not developed a comprehensive statewide model for compassionate and trauma informed care or integrated these into our clinical guidelines," he said.

"However, we will now develop these care models to ensure integration into our clinical guidelines and then roll out the implementation of these into practice."

Advocates say womens' experiences of miscarriage care in hospitals could be emotionally difficult.

"This is not across the board, but it probably does happen far more often than we would like to see. And the worst experiences women report are in emergency departments where miscarriage is often triaged as low priority unless somebody's bleeding very heavily," Dr Bilardi said.

According to the State of Early Pregnancy Loss in Australia report 2022, an overwhelming majority of women received support from their personal networks immediately following an early pregnancy loss. Only half accessed support from health and medical professionals.

Pink Elephants Support Network CEO Samantha Payne said healthcare professionals were ill-equipped to handle the emotional distress of pregnancy loss.

"The health system is meant to support you. It's not meant to further traumatise you," she said.

"The psychological effects of miscarriage and the grief that follows a miscarriage is often not comprehended both by society and healthcare professionals.

"Miscarriage is a distressing and life changing event causing intense pain for both parents.

"So it's great that Annastacia shared her story, but what we'd really like to see now is a dialogue with Queensland Health on how we change this within hospitals so that more women are not presenting in emergency departments and being dismissed because it's not a medical emergency."

Research has shown that anxiety, depression and suicide were strongly associated with miscarriage.

A study of 537 women published in The Lancet found that nine months after a pregnancy loss, 18 percent of women met the criteria for post-traumatic stress disorder.

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Women who experience miscarriage and their partners are entitled to two days bereavement leave under the Sex Discrimination and Fair Work Act.

Federal assistant minister for health and aged care Ged Kearney said miscarriage could have a devastating impact on women and their families.

"Our government is committed to supporting those in our community who experience miscarriage to receive timely and appropriate care," she said.

Monash University has been awarded a contract to update the Pregnancy Care Guidelines that are used by health professionals to provide consistent, high-quality, evidence-based maternity care to pregnant women.

As part of the updates a new topic on miscarriage prevention and support will be introduced by May 31, 2024.