Parallel Pathways
Parallel Pathways Additional Guidance
The Parallel Pathways project explores how prior experiences of reproductive healthcare impact subsequent ones. This guidance relates to the questions about your experiences of different healthcare settings:
How your familiarity with consultations or procedures made you feel
How practitioners acknowledged and engaged with your history
Whether your were encouraged or discouraged from making connections between experiences
What could have been done better
Whether any outcomes could have changed if things had been done differently
You may find reflecting on these experiences challenging, if you would like some guidance you can review the examples below of experiences that others have shared. These include both positive and negative experiences. Small details often matter, so take your time and include anything you feel is relevant. For each healthcare setting, you can describe a single encounter or several, whatever feels right for you.
Practical care
“I had a really brilliant midwife with my first successful pregnancy after my losses, I explained how anxious I was and she suggested that we do the heartbeat check first before any other discussions. I couldn’t think straight until I had been able to hear it and I’m so glad she did that for me.”
“Everyone was a bit confused, they took me up to ultrasound department but then forgot about me and I spent hours in that waiting room, sitting quietly in pain, watching all the happily pregnant people passing in and out until it was time to close and someone asked me why I was there and I had to explain I was waiting for a scan to see if my miscarriage had completed. I constantly felt drawn back to the same corner I sat in every time I had to go back to that waiting room in my next pregnancy”
“The fetal medicine consultant I met during my pregnancy with my daughter had taken the time to read my notes before entering the consultation room, and demonstrated her knowledge of my complicated obstetric history from the get-go rather than asking me, as an opener, e.g. 'Is this your first pregnancy?' this was the first time I'd ever experienced this from a consultant (this was my seventh pregnancy).”
“At the scan the sonographer asked me if I would like to see the screen or if I’d rather not watch. It felt really helpful just to have a bit of control over this.”
“I was frustrated that I’d never see the same team more than once. After my next miscarriage I declined the follow up scan, I didn’t want to go through all of that again, even if it meant managing an incomplete miscarriage again by myself. I just didn’t want to sit there with someone new again, explaining what had been happening over the past two years again. I think if I’d have been able to see the same people I might have felt differently but as it was I just declined the scan and that meant I dropped out of the system.”
The environment
“I was so relieved to be able to go to the Early Pregnancy Unit and to be somewhere discrete where I wouldn’t see other people, especially other pregnant people. I was terrified someone would recognise me and know I wasn’t one of them. I think I expected them to laugh, of course it kept going wrong, what was I thinking, how could I possibly be a mother? At the Early Pregnancy Unit I didn’t have to worry so much.”
“I hated the sound of the radio, it was so wrong for the setting and I still find the radio station slightly triggering as it takes me back to a place of immense grief.”
“I had to quickly try to explain my history and concerns before the scan began, to two sonographers (one was interviewing for a job at the hospital) who were primed to deliver happy news and who delivered quite devastating news instead, before having to quickly usher me out. None of this was anyone's fault, but the mismatch between the setting and the outcome was distressingly dissonant, and in retrospect I should probably not have attended the appointment and instead pushed for a follow-up scan at the Early Pregnancy Unit, where I would have been received with a bit more understanding of my history.”
Communication and language
“When I received bad news at a scan, the practitioner delivered the news and then immediately moved on to telling my options, leaving me no time or space to process the information.”
“During the manual vacuum aspiration the consultant spoke with me throughout. It didn’t work for me, in some ways this was one of the worst part of my journey but I don’t see it like that and I think it’s because I don’t have any ‘what ifs’ about this process. What if we had tried a bit harder, would it have worked? But I don’t feel like that because it was my decision to stop too. Looking back now I am so grateful for the way this was handled as it enabled me to feel at ease with a part of my history that could have been a source of ongoing trauma and I was able to move on to the next part of our journey.”
“I assumed the practitioner had read my notes, so would know I was having a blood test as a check up because of my termination, but no, they asked me if my child was keeping me busy, which was really difficult to hear. This is one of the reasons I always told my story in full at each appointment. I didn't want to go through this again.“
“I went into the room and the GP said congratulations, I was shaking like a leaf and I just didn’t know how to respond.”
“The consultant briefly mentioned she had read my notes and asked if anything from my history was affecting me that day. I said no, and we moved on. It was a small thing, but it made the appointment feel smooth.”
“When I signed up for an antenatal class I noted I had prior experience of miscarriages and surgeries and asked if/how I could speak about these in the classes, I didn’t receive any response. I felt awkward in the sessions and unable to express myself or ask the burning questions I had about whether anything I had felt through these experiences would be the same or different to when I actually went into labour. I knew I’d had relevant knowledge - I’d had contractions, I’d had gas and air - but what did this all mean?”
“Generally speaking I felt there was little space within the antenatal class to accommodate complex obstetric histories or anxieties, and/or medicalised pregnancy and birth (both of my children were IVF pregnancies and ended up being delivered by C-section), and I felt I was an outlier both in terms of my history and my approach to pregnancy generally.”
Information sharing
“I had to visit a nurse at my GP surgery for a routine appointment, when I entered the room she exclaimed that she expected me to be seven months pregnant! It was very upsetting and I was not prepared for this, it seemed there wasn’t any particular system after the identification of my miscarriage for updating the surgery, I was shocked I would have needed to do this myself and I’m not sure how or when I would have been expected to communicate that.”
“I still have the blue folder, I don’t know what to do with it. I think I just wanted someone to take it away and for there to be a process of closure, but it’s too late for that now. I don’t want to keep it but I can’t throw it away either.”
Mental health support
“During my pregnancy I kept raising how anxious I was about something going wrong during delivery but there was never any opportunity to talk about my previous losses. The midwives seemed to be stuck and there seemed to be no options between being fine and needing a mental health referral. I was somewhere in between, I just wanted to talk about what had happened and whether the scary things that had happened to me before in early pregnancy could happen again later on or during delivery but nobody seemed to want to talk about that. Instead things just kept escalating. If I’d had more engagement with my history during my pregnancy I’m not sure I would have needed a referral for post-natal anxiety once my baby was born.”
“I felt so isolated during my pregnancy and different from everyone else who was happy and excited, I sought out some one-to-one hypnobirthing support from a local provider and finally I was able to talk about all of the things that I couldn’t share with “professionals” - the hypnobirthing support was the first time I felt anyone really understood, it gave me more confidence that everything would be ok than all the other appointments put together.”
Follow on care
“Being able to see the same midwife for most antenatal appointments was really helpful. Because she knew my history, and me more generally, she could tailor our appointments accordingly.”
“I had so many GP appointments and I was rarely able to see the same person twice, I dreaded the appointments as I knew I would have to waste so much time explaining what had gone before - the same painful stories and the same blank looks. It’s like I needed a first appointment to get that part out and the standard “that’s unusual… shall we just see how it goes first…” out of the way and then in a follow up appointment maybe then we could properly engage. But the follow up would always be with someone new and we’d have to start over. In the end I started ordering private tests from the internet, it seemed the only way to make progress.”