Expectations and experiences of women presenting to emergency departments with early pregnancy bleeding

Objective: To explore women's expectations and experiences when presenting to the ED with early pregnancy bleeding. Methods: We conducted a qualitative study where women presenting to the ED with early pregnancy bleeding participated in two semi-structured interviews. An initial interview explored expectations of care and was conducted prior to ED treatment. A follow-up interview about experiences with care was conducted after discharge from the ED. Women were recruited from three EDs in suburban Melbourne: one tertiary referral centre and two urban district hospitals. Results: Thirty women with early pregnancy bleeding completed the initial interview and 22 completed the follow-up interview. Eleven participants were primigravid women and 21 participants had never experienced early pregnancy bleeding prior to their ED presentation. Four themes relating to the patient experience were identified: (i) Acknowledgement of patients' concerns by hospital staff, including informing patients of progress and explanation of investigation results; (ii) Early pregnancy bleeding as a distressing experience, with most participants expecting that this would be acknowledged by ED staff, and privacy provided to allow for grieving; (iii) Prolonged waiting time for an urgent medical condition; and (iv) Ongoing care and support, such as providing recommendations of available services to support patients on discharge from the ED. Conclusion: Early pregnancy bleeding is a distressing and anxiety-provoking experience for women attending the ED. Appropriate emotional support is critical to the holistic care for those seeking emergency care.