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S2: E2: The Rural Divide: Miscarriage, Isolation, and the Fight for Safe Care
200 Plays7 days ago
In this vital episode, Claire Brett, Pink Elephants' Rural and Regional Ambassador, offers a heartbreaking look at the reality of miscarriage and recurrent loss outside of metropolitan areas. Claire shares her personal journey through five losses (including a missed miscarriage) and the devastating lack of compassionate care and education she received.
Claire recounts the profound shock and isolation after her first loss. Seeking medical care, she encountered a specialist who callously dismissed her anxieties, claiming women "overdramatize." She was forced to hide her grief just to secure a necessary procedure, illustrating a painful survival tactic where the medical system minimizes a woman's pain and inhibits emotional healing.
For regional women, the logistics of loss and subsequent pregnancies are terrifying. Claire highlights a massive "equitable access" gap, sharing that she had a panic attack while driving 65km alone for a vital scan during her successful pregnancy. This anxiety is fuelled by systemic issues:
- Extended Waits: Weeks to see a GP and days-long delays for vital blood test results intensify Pregnancy After Loss (PAL) anxiety.
- Dangerous Travel: Accessing essential procedures often requires driving hundreds of kilometres to a city hospital.
Claire argues that rural patients "don’t choose to go to hospital and have no support"—they deserve the same standard of care. She calls for two critical changes to address this safety deficit:
- National Rollout of Early Pregnancy Assessment Services (EPAS).
- Specialized PAL Care with unique, consistent support.
Finally, Claire demands that hospitals treat a miscarriage with the same post-delivery accountability as a live birth, requiring mandatory mental health check-ins before discharge.
EARLY PREGNANCY LOSS SUPPORT
If you or someone you know has experienced miscarriage or early pregnancy loss, please know you are not alone.
- For crisis support, please call Lifeline - 13 11 14.
- Access all our support
- Connect through Live Chat with Peer Support
- Join Online Communities
- Call out Pregnancy Loss helpline delivered by PANDA
- Join the Circle of support
- Follow @pinkelephantssupport on Instagram.
STACEY JUNE LEWIS
You can follow our host Stacey on her personal Instagram account where she shares some of her lived experience.
Pink Elephants thanks the Australian Government for their support in funding this podcast series under the Miscarriage Support grant.
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Transcript
Introduction and Focus on Early Pregnancy Loss
00:00:04
Speaker
Welcome to the miscarriage rebellion. I am Stacey June Lewis, lead of the Pink Elephant Support Network group counseling program, Grief and Grace, and along with Pink Elephant's co-founder and CEO, Sam Payne, through this podcast, we will share the stories of many Australians who have lost their babies to early pregnancy loss.
00:00:21
Speaker
With evidence and empathy, we unpack the shame, blame and stigma and lack of support that they may face. This is a loss that has been silenced for far too long and we deserve better. We are here to normalise the conversation and to make lasting change.
Claire Brett's Personal Experience
00:00:36
Speaker
Today we're talking about the heartbreaking reality of miscarriage care for women outside of major cities. We're joined by Claire Brett, Pink Elephant's Rural and Regional Ambassador, who shares her personal journey through five losses and the devastating lack of compassionate care.
00:00:51
Speaker
Claire unpacks the massive equitable access gap. where rural women face week-long waits, dangerous travel time for scans and specialists who dismiss their pain. She calls for urgent changes, including the national rollout of e-pass as mandatory mental health check-ins before hospital discharge. Welcome to today's episode. Today we have a very special person indeed. We have Claire Brett with us on the Miscarriage Rebellion podcast. Claire, I have known for a number of years now through her dedication to supporting women who live in regional communities who go through the experience of miscarriage.
00:01:27
Speaker
Claire is Pink Elephant's Rural and Regional Ambassador and has done a number of amazing things for our community from holding fundraisers to raising awareness to even speaking at Parliament for us in October last year. Goosebumps remembering how amazing you were at that.
00:01:42
Speaker
So welcome Claire. If you could start by and sharing a little bit with our listeners on where you come to the experience of early pregnancy loss and what's made you do the work that you do. Yes, so I, um in between the birth of my first and second ah sons, I experienced my first miscarriage um and it turned out to be a a mised miscarriage.
Understanding Miscarriages and Emotional Impact
00:02:05
Speaker
um But i prior to that, had never heard of that term before. um I always thought a miscarriage was the type you see in.
00:02:15
Speaker
um in a movie where you know about it. And I went to a week scanning appointment um and it was there that I discovered um that my baby didn't have a heartbeat.
00:02:28
Speaker
um And that I was in the early stages of um having um a miscarriage. um After hearing that news, it was really devastating. I will always refer to it as um ah ah mind out of body matt um experience, but also just just that morning or even the week's prior to having that internal dialogue with that baby with um you know when it is due date might be or a boy or girl or you picture it playing with um your sibling or child already and um and then that morning having that same conversation within yourself and then by that afternoon it's silent um that was really devastating for me um and the shock of it all as well i was
00:03:19
Speaker
early thirties and I was a bit embarrassed that I was female and didn't really know of any other type of miscarriages. um and, um, yeah, I just felt really, really sad that, um, that had happened to me.
00:03:35
Speaker
Um, I went on to have a DNC a few weeks later, um as my body didn't process that loss. Um, and then, uh, We were advised that we could keep trying a month after that, um which we did.
00:03:52
Speaker
And then I went on to have um another four chemical pregnancies, which I had also never heard of before experiencing them. so much there in that what you're not aware i'm so sorry for those losses yeah so so sorry for each of those losses but there is a lot there in what you're not aware of what you're not told the lack of education on a woman's reproductive rights and her fertility and what it takes to make a baby and what can go right and what can also go wrong how we can lose our babies and like you said that language matters right understanding
00:04:25
Speaker
the different types of miscarriage. So you don't feel that sense of kind of almost shame that I'm not clever enough. I'm not knowledgeable enough about this and it's happening to me. It's definitely something we want to see changed. Absolutely. Absolutely.
00:04:38
Speaker
And acknowledging again, just how many losses you went through.
Challenges in Medical Care and Support
00:04:42
Speaker
There was a part of your story that I just want to unpack a little bit more there as well. So you said that you tried for what is sometimes referred to as an expectant miscarriage. And so for those of us listeners who might not know what that means, that is whereby a woman is given the option to go home and wait for her body to pass the baby herself.
00:05:02
Speaker
And then if that doesn't happen, you can have the option for a DNC. How was that framed for you as a woman who's in a regional community? Where did that conversation go? How did you land with that decision?
00:05:14
Speaker
um So i actually um went and saw my my GP after I got told that I had a mis miscarriage and she um referred me to the local specialist.
00:05:31
Speaker
ah He's now retired and since then we still haven't had someone replace him but that's a different conversation in a minute, but, um, I was lucky enough to go and see him. It was, um, I was urgently rushed, I suppose, into him because it had been also this two week period of finding no heartbeat, but my body wasn't um processing it, that I was able to see him quickly. um I let him know in that first meeting that my um anxieties, because I did already prior have anxieties around death. My dad died when I was little.
00:06:08
Speaker
um so I said, you know, if information isn't forthcoming or withheld, that's when I start to feel anxious that you're not telling me everything. in this um first scan that I had, and they did try to reassure me that maybe I had my dates wrong.
00:06:25
Speaker
so I was kind of always under the impression of, you know, it could be this, it could be that, it might not be. And it was always this miscommunication or not straight down the line information. And when I said this to him, um his response was that most women over-dramatise a lot of things or will go home and will Google stuff and will think in our own heads the worst case scenario. So that's why he likes to just not say too much.
00:06:53
Speaker
And then I said again to him, but I've just told you that's not me and you can't paint everyone with the same brush. um ah My anxieties are the opposite.
00:07:04
Speaker
um And he just said it is what it is. I was told also before I went to see him he's very blunt and to the point. But then i also just think if you're in that person um position, why Why be in it then? If you're dealing with women, that's your job.
00:07:21
Speaker
um He just said that ah because of my location, I live on a farm in Kentucky. um My nearest hospital is about 45 minutes to an hour away. um That if I did start bleeding over the weekend to go to hospital, otherwise turn up Monday morning, take your husband if you want, and they'll just have the procedure.
00:07:40
Speaker
They'll just take you in and do the procedure. It was very non-hospital. human experience. It was, I'm a client, a patient, and this is just the doctor world of what we, what you live in right now.
00:07:56
Speaker
I'm so sorry, Claire. And I think it's really difficult when you um advocate for yourself in ways where you communicate that there are particular needs that you have for very valid reasons.
00:08:09
Speaker
And then that is also denied in the face of you actually and finding the energy to somehow even articulate what it is that you need. ah wanted to ask you in this experience, did you have a gauge that there was,
00:08:24
Speaker
um that there was ah particular way that this was being treated in comparison to what could be the way or did you just kind of understand this was the way that people were?
00:08:35
Speaker
And when I say that in the context of your area, were you kind of thinking this can't be right or did you just kind of accept that this was essentially what the treatment was and and you kind of had to just go with it?
00:08:49
Speaker
Um, he did explain well what my options were. He explained i could just wait until my body processed it, but who knows when that could be. i was actually at that stage mentally, I didn't want to cope with it anymore.
00:09:06
Speaker
I had spent the last two weeks waking up every morning wondering if today is the day I'm going to get rid of this pregnancy. i also had to still go to work during that time without them. I hadn't told my employer.
00:09:19
Speaker
so um I had a one-year-old child at the time um and I was at the stage where um i actually wanted it to be over mentally.
00:09:31
Speaker
So he did explain the options to me, whether it that was to wait. um I could have taken the pill to process the pregnancy loss, but... um because my body hadn't started or wasn't processing it and my location of my home address that it might have been a bit dangerous if I had lost a lot of blood because my body was obviously not working properly.
00:09:56
Speaker
um So he wanted me to make sure it was the proper procedure, which did come like make me feel safe that he was that way inclined. um but um he yeah was just very um clinical um with it all and just um yeah very i actually once he told me um what his theory was around women i actually tried to really withhold my emotions even though wanted to cry I wanted to say I'm so sad like
00:10:33
Speaker
I wanted to explain why i had a croaky voice when speaking, but I didn't want him to then think I was a crazy person or that um I was dramatizing what was happening to me. So i actually remember, um and I'm a crier all the time. So I actually remember, I don't know how, but I was able to just not cry in that appointment purely because I didn't want him to think I was just um crazy.
00:11:02
Speaker
I think it's also really important to identify that tears aren't necessary. Like they can be um like when you say and state that generally you are a crier and the fact that somehow miraculously you were able to withhold your tears It suggests to me that there is a state of survival in that, you know, that in fact, in order for me to get the care that I need and in order for me to be heard by this person that is essentially going to help me in my time of need, I'm going to have to do what I need to do to be in line with the way he deems appropriate.
00:11:43
Speaker
And it is incredibly, incredibly dangerous when we start shutting off. Medical misogyny at its finest. And I think... It is an absolute example. Yeah.
00:11:53
Speaker
And I think in particular as well, what happens is is we don't present in a fully... a fully kind of um whole, our our whole experience isn't presented to the medical um practitioner, that now we have the physical aspects that are being presented and what that can do when we then start to look after our women that are going through this completely minimise but also not be able to even the
00:12:24
Speaker
the emotional and mental effects it's having because now then it's not safe to show them.
Rural vs Metropolitan Healthcare Discrepancies
00:12:30
Speaker
So then later on down the track, we wonder why so many women haven't dealt with their grief or don't feel safe to be able to grieve because they literally weren't shown to be safe. Emotions weren't deemed as a safe aspect of this experience.
00:12:45
Speaker
So I'm so, you know, I'm so sorry that that happened, but I think it's it's important to point out that when we go through this experience, the physical element and aspect is one of them, that actually we're presenting as we are as a fully a fully fledged person with a mind and a heart and a be and and and physical manifestations of our loss.
00:13:09
Speaker
um And it is ah in our right to receive care on all aspects of our health. Definitely. um I remember when I went in to make the appointment to see my GP, um I remember telling myself,
00:13:24
Speaker
just prepare for when you walk in there that she's going to refer to space for travel um and and and traveling and the time it takes to um to go anywhere. um and That's a disadvantage.
00:13:38
Speaker
When I um had to have my scan, when I did fall pregnant with but Jimmy, so I had, um after those five losses, I fell pregnant again and assuming I was going to miscarriage that as well.
00:13:53
Speaker
turned out to be Jimmy. And um I remember my first scan had to have to see if it was a viable pregnancy for them to be heavily medicated after that. um i My husband is self-employed and he had to go off to work and meet me at the um the scanning, at the scan. So he went to work And then um I met him there at 10 o'clock or something. And in hindsight, I probably should have got someone to drive me.
00:14:25
Speaker
um But I had an actual panic attack in the car driving to the scan. um i had one the night before, so I probably should have known i wasn't okay. But again, i just think you put up, if you have these experience prior and you try to tell yourself to be calm,
00:14:45
Speaker
to relax, you've had someone in your ear prior saying this is what women are like. So I tried to um calm myself, but I actually have never experienced a panic panic attack before the night before or driving.
00:15:00
Speaker
But that is a major difference as well as i have to drive. 65 kilometres to my closest scanning appointment, crying, i couldn't breathe in the car, um but that's my only way that I can get to these appointments.
00:15:13
Speaker
um The same as if you were to miscarriage at home um and you do need to see medical help, you'll be in the car driving while experiencing that.
00:15:25
Speaker
um So it was it was after my experience and after I had Jimmy that then I came across Pink Elephants and all of their work and support that they offer. And I wish i i wish one person in my whole interactions that I had, um even with with Jimmy, I experienced pregnancy after loss. Again, I never heard of that term before or what that meant or looked like.
00:15:48
Speaker
um And um even after having Jimmy, when I felt, better um i still wasn't offered if you don't feel better here's a phone number here's an organization like pink elephants to call or get in contact with it's just not good enough it's it astounds me that i still hear these stories i know your story i've known you for a number of years now but i still hear stories from women that we support in our online communities that share experiences like this today this is still happening
00:16:22
Speaker
I guess as your role as a rural and regional ambassador, could you shine some light on some of the other things that you hear outside of your own experience from women in regional communities in terms of accessing care or support after an early pregnancy loss?
00:16:36
Speaker
Um, well, ah ah The main thing is really what I've just talked about, that there isn't that um those touch points, easy touch points, that you don't have to repeat your story, um that there's a um I'm going to say the word wrong, continuality.
00:16:54
Speaker
What's that word? Continuity. Yeah, that's it.
00:16:59
Speaker
um of care um that oh yeah you're not so you're not repeating the same story over and over again that there is a simple and easy access to care if you need it um and it's not frowned upon and you're not sort of being crazy about it um where I feel women who live regionally and rural areas we are somewhat thought of to be stronger than those in the metropolitan areas because what we have to deal with with drought or at the moment we've got non-stop rains.
00:17:33
Speaker
We've husbands who've got ah jobs that rely on the weather and it's stressful and we are strong in a way but um my emotional difference isn't a difference to those that live in the in the city. So I just see that there is a ah big gap between what we're offered here um versus what's in the city.
00:17:59
Speaker
Definitely doesn't feel like there's an equitable access to emotional support throughout the experience of early pregnancy loss, yeah. and right And then even little things like blood tests, um getting into your doctor, um the wait times.
00:18:13
Speaker
um I don't know what it's like in the city, but here to see your doctor is a good three to four week wait. um And blood results, particularly when I went through this, was three to four days before you'd hear any results because of how far they have to travel Newcastle, Sydney area to get back.
00:18:33
Speaker
And it's all done by car. Yeah. And you take that theme, right? If I know myself, someone who lives in a metropolitan area that when I was pregnant again after loss, one of the things i did to reassure myself was to have a blood test every few days to check that the HCG was going up and I would get the results the same day, if not the morning after.
00:18:49
Speaker
That was just what happened. So I would never think to think that. Then you're left in this turmoil for days on end, wondering whether your HCG is increasing. And that almost compounds the anxiety of pregnancy after loss, right? If that's something that you want and need to know for your safety, that's probably the wrong word, but you don't have access to that because of where you are.
00:19:11
Speaker
Another side of the things that I don't think is, is most people are aware of is, and you touched on it slightly that like the 65 kilometers to get to your sonography practice, but it is things like people drag. We hear time and time again, heartbreaking stories of women who do not want to be in their words, a coffin for their baby.
00:19:28
Speaker
and they don't have an early pregnancy assessment service in their local hospital, which then means that they don't want to have an expected miscarriage where they wait to miscarry at home. They don't want to take, to your words, either the MS2 or the medication because the risk of hemorrhaging and what access to your care is greater if you're in that kind of regional setting.
00:19:48
Speaker
So we hear of women literally driving for hours on end to reach a metropolitan hospital to access the option of an elective DNC, basically, and elective is the wrong word, but... What do you hear in your community from women like that?
00:20:02
Speaker
I had a friend who had was experiencing um or knew she was going to be having a miscarriage, the same with the, she had a scan. um And it was actually on a Friday that she discovered this. And because of the time, um she wasn't able to get um that pill um available to her. So she had to drive to, so from Armadale to Tamworth, I think it's ah and over 100 kilometres.
00:20:29
Speaker
It's ah maybe 100. I always say not far to Sam, but it is far apparently. In country terms, 100 and something kilometres isn't that far. um but she had to drive from armadale to tamworth to be able to get that medication um because uh it had already closed and the pharmacy had already closed in armadale and she had to go to a different pharmacy um on hospital to receive that medication so um Yeah, there's stories like that. um Tamworth Hospital at the moment have very shortage of midwives.
00:21:04
Speaker
So they're actually referring women to Newcastle, which is 400 and something kilometres away. So um it's very, um it's scary.
00:21:17
Speaker
it's um And it's sad too, because um you're dealing with a lot of things, obviously, when you go through something like this. um The second you see those two lines on a pregnancy test, you're pregnant um and you imagine that that baby and that child.
Anxiety in Subsequent Pregnancies and Long-term Impacts
00:21:34
Speaker
um So it's really hard to then go through a loss at any um gestation and not receive the help that um you should be getting. I can imagine, Claire, too, off the back of that, then, you know, we um are also, we also touch on pregnancy after loss and how incredibly unique and challenging those experiences can be.
00:21:58
Speaker
And so if the shortage is in the hospitals and in the system around early pregnancy loss. But then it then continues through midwifery care and other cares around women's health and actually, you know, finding the right person to navigate the the system with you to be able to have your baby.
00:22:20
Speaker
noticed that that was also something that you then had to face that potentially the effects from your losses and then when you eventually did fall pregnant it kind of trans it continued with you Definitely. um My anxieties and fear actually escalated once I had a confirmed pregnancy with Jimmy.
00:22:43
Speaker
I thought beforehand, ah once I knew he had a heartbeat and he was okay at that six week, I think it was appointment. Prior to that, I thought, once I get that done, I'll be fine.
00:22:56
Speaker
But I actually got um really much worse in, my feelings and how I thought about the pregnancy. Every day was a ticking time bomb for me um for when I was going to lose that pregnancy. I never convinced myself that I was ever going to really meet him until I could actually physically hold him.
00:23:17
Speaker
So um i cried a lot. I was really anxious. I was scared to go at the toilet in case I would see blood.
00:23:29
Speaker
was scared to go anywhere or do anything case I was further away from a hospital. um i also wasn't, I don't think, a great mum to Roscoe as well because I was so um caught up in the emotions of being scared.
00:23:46
Speaker
um And I also was scar of how as i i was scared of how bad i felt that if something was to happen, I was scared of what was going to happen to me emotionally from that um and how I was going to deal with that. I was actually really worried about my my health um if something was going to happen.
00:24:09
Speaker
Luckily for me, um i got to meet Jimmy and he still... thriving and healthy and um perfect baby. But as soon as I had him, those anxieties and fears instantly left.
00:24:24
Speaker
And I knew that, I knew once I got to meet him, I would be okay. And luckily for me, that was the case. But I also know that that's not the case for a lot of women, that it does um extend um into afterbirth.
00:24:39
Speaker
um But, yeah, i just um I just panicked a lot. I was very – you couldn't – you could tell me everything's okay, this scan's fine, he's growing, his everything looks okay.
00:24:53
Speaker
um But I just wasn't convinced because of those previous losses. And sometimes I thought, you know, they were just – particularly those four after my mis miscarriage were chemical pregnancies.
00:25:05
Speaker
um Although i wasn't very far along when I had them and really if I wasn't testing, um i wouldn't have probably known I was pregnant. I probably would have thought I was just getting my period for that month.
00:25:17
Speaker
um But I think that's where the miscommunication comes from as well with not feeling those losses and feeling dis i should dismiss those because those smaller losses actually ignited that bigger feeling of loss.
00:25:33
Speaker
of loss um And I really had to digest that and um make myself understand that although they were early, they still meant something to me, um and which was why I was.
00:25:48
Speaker
Yeah, and I think that's where sometimes the conversation gets really missed is to you know Obviously, when we lose our babies and our dreams kind of crush around us, that loss is standalone. like there's the you know That is going to always affect women in a certain way.
00:26:08
Speaker
But when that isn't held or acknowledged and then the grief doesn't receive the mirroring we know, we have research to show supports the process from there then it I think it's underestimated just how impactful the rest of a woman's experience is, whether it's motherhood, whether it's life, whether, you know, you don't actually ever end up falling pregnant and you continue moving through experiences that will be challenging or surprising or scary.
00:26:40
Speaker
When we have something so powerful that happens in us and it isn't mirrored, our grief isn't seen, our grief isn't acknowledged, it might seem like something small and a language adjustment, something very minor to healthcare professionals or environments that work in this space.
00:26:57
Speaker
But in fact, we see and know the power it has on how it affects women ongoing. And it really does showcase that, you know, things like those environments that you're in, where it is 60 kilometres to get to a hospital, absolutely subconsciously would be contributing to that anguish and that that fear and that
Systemic Issues in Rural Healthcare
00:27:22
Speaker
concern. So these systems and these touch points that you spoke about that might feel small, you know, to people where they don't see the effect are actually long lasting and incredibly important, not just for the acknowledgement of the early pregnancy loss at the time, but women's mental health and wellbeing long term, I think is the part that
00:27:43
Speaker
we We really are not seeming to get in this conversation. I think ah someone hearing that, say, in the political world might say, well, you know, you chose to live on a farm or you chose to live in that rural area, which I did and I do.
00:28:02
Speaker
But I don't choose when I do enter the hospital system that I'm forgotten about and that's what's happening. So um it's not so much the um I ah do choose to drive this far every day to work or I do choose to drive have my kids in a different town to where I'm living right now, this house. My children are a different town for school.
00:28:24
Speaker
I choose all of that. I don't choose to go to hospital and children no um support. You still pay tax and contribute exactly the same as what I do in a metropolitan area.
00:28:38
Speaker
I don't see just say like you contribute probably more in some ways in terms of being on a farm. But I just want to acknowledge there as well because I feel like we kind of put a lot of words around that. But for me, what I'm hearing is this, you're not feeling safe.
00:28:52
Speaker
So where you are and when you need to access care, you don't feel safe that you can access what you need, when you need in a timely manner, which then exacerbates the anxious feelings, which is perfectly understandable.
00:29:07
Speaker
So you're already anxious because this loss has happened before. And again, and again, and again, i finally fall pregnant again. And then i now have all these other factors that I have to deal with because of where I live.
00:29:18
Speaker
And so it's an element of safety that's completely missing. I also relate to the pregnancy after loss. Again, Metropolitan, when I felt that anxiety, I went to my GP the same day. I got a referral to a psychologist. Within a week, I was in to a psychologist.
00:29:33
Speaker
I got medication. It all happened very quickly. And I got on top of it with my last pregnancy after loss. It doesn't sound like that's what's happening because if you're in a regional area, then you've got to wait to see a GP. You might not get into your GP straight away.
00:29:46
Speaker
then you have a wait. You've got that appointment. It's just like extended waiting times where you are being left at risk and nobody's checking in and giving you that support that you deserve.
Need for Policy Changes and Support Improvements
00:29:55
Speaker
That's what I'm hearing. Would you say that's fair?
00:29:58
Speaker
Definitely. And When I was in the hospital system for the DNC, I was told I would get a follow-up phone call. That never happened. um And ah maybe in that phone call then I would have said, um you know, i what if I need help in a couple of months' time or what if? And then they could have maybe helped me, but that phone call just never happened.
00:30:21
Speaker
um And, ah yeah, the GP way is um significant as well when you're I'm the type of person where if I can't really get in, you know, that day or that week, I'll probably just process it myself. Or obviously for me at that stage, I couldn't because my body wasn't processing it. But I know a lot of women who will just have a miscarriage at home and deal with it themselves because they don't want to rehash it.
00:30:49
Speaker
in three weeks time when you've almost got in use itself through it. And then you have to go in and have um that talk again. It's very um obviously telling on on your mental health in itself.
00:31:04
Speaker
It's fascinating. It's, it's so so, so there's just so much that still needs to be done. Like it's, it just does not feel anywhere near adequate still in the setting that you're in. And I guess with the theme of that and the theme of this podcast in terms of we want shine a light on what's possible, what's needed and within your own experience and that, that you get the privilege of hearing others now, what would you like to see changed for women that live in regional and rural settings who experience early pregnancy loss?
00:31:33
Speaker
um Two things. um One is, I know I've heard of it, um probably say it wrong, but is it EPAS or E something that um I'm not too familiar with? What is it?
00:31:46
Speaker
Early pregnancy assessment services. They're division in a hospital that look after pregnancy complications in the first trimester. Yeah. so again, that's something hospitals here don't have.
00:31:57
Speaker
um And I don't understand why that's not a national If it's in the public hospital system, then again, I pay my taxes. It should be in every single public hospital.
00:32:08
Speaker
um So I would like to see that rolled out nationally as well as obviously um make sure that we're not missing out on on that service. um And I would really like more attention on the pregnancy after loss as well. um I did get that early on care with the with the miscarriages. um But then I think once I felt pregnant, it was assumed that I was okay because I was pregnant in the medical world that um I wouldn't be affected by now being pregnant after so many losses.
00:32:43
Speaker
um And I didn't have that same continual care, seeing the same person. It was a different midwife um every every time I went to the hospital. um I think the experience after one miscarriage should be different um if you then fall pregnant afterwards, that your care from the start of that first scan until delivery um is under a different um program than what it would be as a regular woman going in um who hasn't experienced a miscarriage, because I do think the care is different and it needs to be different because of um the experience of what's happened to you prior.
00:33:25
Speaker
So there are two main things that would be great to have here. um and then simple things, which is, i mean, it's simple.
00:33:36
Speaker
Give me the care when I'm in your care. If I'm in the health system, um i don't see why it's so hard to not hand me a flyer, a paper with information on it, like with Pink Elephant's details to say, if I need help, and that's not saying you might need it now, but in six months' time,
00:33:56
Speaker
when you're not falling pregnant again or you've had multiple um recurrent miscarriages and you do need mental health help, um here's a number to call and to do it while I'm in your care.
00:34:06
Speaker
i When I spoke to the hospital later in my role um with Pink Elephants, I had a conversation around with them around why it's not happening. um when i When I do have a healthy baby, I can't leave without me being checked over um physically, emotionally, and the baby also can't leave the hospital. And we have to all sign forms, me and the hospital, to say I'm okay to leave.
00:34:33
Speaker
So why is there a difference when I have a miscarriage that there's no one ticking off, that they've spoken to me to ask, are you mentally okay? They've given me pink elephants details.
00:34:46
Speaker
um that
Role of Data Collection and Personal Stories in Policy
00:34:47
Speaker
stuff's not happening. I just don't see the difference in not delivering my baby to delivering my baby in the help and support that I need or we need.
00:34:57
Speaker
Well, you're the same woman. You're still the same person. We're all the same people. You know, it's like it's not it's it's taking away the humanistic approach, because at the end of the day, there's one person coming in for different things, but that's the same person.
00:35:12
Speaker
So it is completely and inhumane to not treat the person of the the actual needs that the human is going through, right? So you're treating it on one front this way and it's it's a bias.
00:35:24
Speaker
It's a misogynistic bias um that desperately needs to be corrected. And Claire, you've made some wonderful points. Some of those things I think, you know, would be useful across the board. But i I'd love to imagine a world one day that even if they registered in the system that this, you know, this patient had a miscarriage that somehow it shoots off the information to us and there is ah an opportunity for even there to be an automation check-in, yeah you know, where it it just doesn't feel like it's,
00:35:55
Speaker
something that should be so difficult? when um So after I had Jimmy, I um started to do my own research and support for women that lived here. And that was one of my things I came across was some stats or some data around how many women are presenting to local hospitals or GPs who have experienced a miscarriage and there is none because and it's not being recorded. So then how can our politicians um or anyone in power help when it's not being recorded. And then we're missing, still missing those people who aren't even going and experiencing this at home.
00:36:31
Speaker
um But if we can at least record the ones that do enter the health system, that will go a long way into realising that um we don't have any support or services here, um but also to be able to generate um funding or to help um ways because we've got a number to work with.
00:36:53
Speaker
So that would be great too. How do you advocate for an e-pass in your area if you don't know the number of women that need access that service? How do you provide the staffing levels if you don't know the numbers? And that's why Pink Elephants has obviously the Count Our Babies campaign. And there is hope there again. i want to acknowledge the work that the government, the current government is doing in that space in terms of looking at the data. We're working with an Australian Institute of Health and Welfare as a key stakeholder on how we can kind of capture better data.
00:37:22
Speaker
and have a better understanding to inform the health system to have more services for women that have and partners that have this experience. So there is change happening, but again, and probably feel like a broken record here.
00:37:34
Speaker
It's slow. And then there's still these women today who need this now. And we have to keep that pressure on. We have to keep telling these stories and sharing these experiences to make sure that this change really does happen and that it's long lasting, that it's not something that's just, oh, we've solved that problem. Off we go. We're going to go look at another women's health area now.
00:37:53
Speaker
There is so much work to be done here. I think, Claire, as well, to your point, to receive information, support and care whilst in their care was something that I've taken away from this conversation that, you know, these systems are going to take a long while to change. And even though, you know, we're all working so hard at that change.
00:38:16
Speaker
individually there are things that we can do if you work in the system, if you are a nurse, if you're a midwife, if you're a person that has experienced loss long enough ago that you feel like you might be able to step into an advocacy role ah because these things, small shifts can happen in our power right now too.
00:38:34
Speaker
um because that that statement of what goes on in your care, not after the fact or not later on down the track when someone feels better is, I think, a really important piece of the puzzle.
00:38:46
Speaker
You know, if if i I have to screen everybody in my private practice, if somebody looks like they're not doing so well, there is particular systems in order for me to keep my registration as a counsellor to ensure that their wellbeing is met.
00:39:00
Speaker
That's just, ah it's ah I have to adhere to that. But somehow with this particular topic, there seems to be some grey areas because as both as both of you have pointed out, if it's not noted, it's invisible.
00:39:11
Speaker
It can't be saying but isn't acknowledged. Well, when I um went to the hospital and had this discussion with them, that was the point I made with them was that they could see why I was in there.
00:39:24
Speaker
um So then why that does that not flag with their team that can help with um and emotional or mental health that I need to be seen before I'm discharged? Someone from that department, social worker,
00:39:42
Speaker
needs to come up and either introduce themselves to me, say hello, um I know you're here because you've experienced a loss. And I can say at the time, if that happened to me, I probably would have said, I'm okay, but thank you, I'll take it, whatever.
00:39:57
Speaker
But it was that six months later when I knew I was spiralling and I was not okay, that I would have been here at home in the comfort of my own home, ringing a number without the almost embarrassment or having to drag myself up the road to make an appointment, but have a wait, go in there, explain it all to someone who's also not in this field, at least if I'm calling a number like Pink Elephants or someone, they already know when they're answering what it's going to be about.
00:40:30
Speaker
So um if that had happened. Yeah, the difference would have made, right? Yeah.
00:40:39
Speaker
Today's episode may have brought up some feelings that you need some extra support around, and that's totally okay. Head to pinkalifans.org.au to access our circle of support, your space where you can be met with empathy and support through all of your experiences of early pregnancy loss.
00:40:55
Speaker
We're here for you. You're not alone.