The Early Pregnancy Assessment Clinic - A Haven of Compassion

July 24, 2013

In this newsletter:

The Early Pregnancy Assessment Clinic - A haven of compassion.
My friend has a baby in the Newborn ICU - how can I help?


The Early Pregnancy Assessment Clinic - A haven of compassion. 

Women experiencing miscarriage find quick access to diagnosis, timely medical care and emotional support at the Early Pregnancy Assessment Clinic. 

Pregnancy 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 percent 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 - 20 per cent of women miscarry in the first trimester.

Women with these symptoms typically go to their ER, sometimes waiting hours to be seen.  Some are referred elsewhere for test 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 (pictured above) 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 inter-disciplinary 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 obstetrician-gynecologists 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.”

One of the keys to the success and importance of the clinic is the speed at which it 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 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 Dr. 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 Marie Rose McDonnell, a long-time nurse clinician at the Clinic with post-RN certification in prenatal nursing. “Our focus is TLC.”

The response from patients confirms that the supportive approach to helping women deal with miscarriage is meeting a very real need.

“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

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 General Hospital. “We regularly refer women there, and we know they’ll get the care that a fast-paced ER can’t give them.”

Ruth Comfort, a midwife at BC Women’s, has also referred women to the Clinic: “I know my clients will get all the answers and attention they need from an incredibly caring team of professionals.”

Today, after five years in operation, they’re operating at capacity. Open Monday to Friday, from 8 am to 4 pm, it averages between 30 and 40 patients a week. Dr. Rhone’s vision now is to expand the clinic’s hours.

“Ideally, we should be providing care seven days a week, into the evening hours,” she says. “In the UK, these clinics operate like mini emergency departments.”

Meanwhile, in keeping with BC Women’s leadership role in developing women’s health programs that can be replicated elsewhere, Dr. Rhone is currently sharing the EPAC model with other hospitals. Ultimately, she’d like to see clinics like this become the standard of care throughout BC, meeting the needs and greatly reducing the stress of early pregnancy for women everywhere.

More information about the Early Pregnancy Assessment Clinic at BC Women's.

Originally published in the Spring 2013 issue of Women's Magazine.  Free subscription here.

Written by: Helena Bryan Photography by: Brian Howell


My friends baby is in the Newborn ICU - how can I help?

The Newborn ICU is a special nursery, where the most critically ill + premature babies born in BC receive the highest level of life-saving care.

Babies are placed in the NICU because they're premature, or have medical issues such as respiratory problems or undiagnosed health concerns.  Some babies stay for a few hours; others stay for months.

In addition to helping babies heal, the NICU staff actively support families during what's often an emotionally charged and stressful time.  As a friend, you may be wondering what you can do - here are a few ideas on how to help your friends while their baby is in the NICU.

Emotional Ways to Support Parents
  • Ask if it’s a good time to talk, and respect the parents’ response.
  • If they don’t want to talk about what’s going on, let them be – remember that other friends and family might also be asking the same questions.   Parents might not have the emotional energy to talk with everyone.
  • Expect parents to have different emotions on different days.
Practical Ways to Support Parents
  • If you know the parents well, you might volunteer to be a channel of information for other friends and family members. 
  • Another way to support parents is to ask if they might like a ride to the NICU so they don’t have to go alone. 
  • Offer to bring a picnic lunch or snacks, or cook a meal for parents to take home for later. After spending eight hours at their baby’s bedside, they probably don’t have the energy to go home and cook.
  • If the parents have other children, you could offer to set up play dates.  You could ask them if you could babysit or if they’d like you to pick the kids up from school.
  • Giving gift cards for groceries or gas can also be helpful. If both mom and dad are off work, money can become a significant issue for some families.
  • The important thing is to ask them what they need.  It’s better than making assumptions and is a great place to start!

Healthy women.  Healthy babies. Healthy families.  

This is the driving spirit behind every program, every equipment purchase and every act of care at BC Women's Hospital + Health Centre.

From pregnancy to birth to mature women's health, BC Women's is the only facility in BC with a provincial mandate to meet the comprehensive healthcare needs of women and newborn babies.

Find out about the programs at BC Women's


Featured Donors

Kevin England, Executive Hotels, Harbhajan Khera, Dr. Ken Lim, Annie Lin, Onni Property Management, Pacific Blue Cross, Pollock Famly Philanthropic Fund, Purple Spa & Yoga, Joseph Zuckerman

BC Women's Hospital thanks Odlum Brown for 15 years of continuous support.

The content provided in Women’s Health eNews is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.



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