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Pregnancy Care and the Emergency Department

Entrance to Sinai Health's emergency room

Most pregnant people, when picturing the interactions they will have with their healthcare team, envision meetings with an OB, or a midwife, nurses, and ultrasound technicians. Few anticipate a visit to an Emergency Department. Yet the reality is that Emergency Departments plays crucial roles in caring for pregnant people during early pregnancy. Sadly, the reasons for this care are often early pregnancy loss, or miscarriage.

Four in five people experiencing a miscarriage are cared for in Emergency Departments in Ontario. This means emergency department doctors and nurses must be equipped to provide not only physical care, but emotional and mental support for people experiencing pregnancy loss.

As a result, the staff in an emergency room need guidance on how to care for patients facing uncertainty or loss in early pregnancy. And Mount Sinai Hospital’s emergency department sees a large number of pregnant patients. This is because of its world-class Women’s and Infants’ program, and it acting as the referral resource for patients from the nearby hospitals and doctors’ offices. The solution? Developing province-wide best practices to ensure pregnant people who are in the midst of early pregnancy loss can receive the best possible care, despite their circumstances.

It’s this issue that Sinai Health’s Dr. Catherine Varner focuses her work on. Alongside collaborators at North York General Hospital, Dr. Varner is leading education training sessions for both hospitals’ emergency and obstetrical providers. She’s also pursuing research and advocating for additional research funding to allow further exploration of the relationships between pre-pregnancy health and pregnancy outcomes. But these aren’t Dr. Varner’s only partners in this work.

“Many patients find themselves in an emergency department with pregnancy loss, and their experiences are almost universally negative. They tell us they came to us because of our world-class Women’s & Infants’ program, and yet the experience they have in an ED isn’t great. So we take that experience, their input, guidance, recommendations and suggestions, and ask them to be partners in our research program. As a result of their partnership, as well as the close relationship we have with our Early Pregnancy Clinic, we’ve become leaders for emergency medicine, in terms of teaching others how to take good care of these patients. We know emergency departments are Canada’s number one early pregnancy care providers, and we want to provide women with early pregnancy loss the best care possible.”

But it’s not just pregnancy loss that brings pregnant people and new parents to an Emergency Department. Many new parents seek Emergency Department support during their immediate post-partum days. From post-partum depression to challenges with breastfeeding and infants who won’t sleep, Sinai Health’s Schwartz/Reisman Emergency Centre has seen it all. The doctors and nurses have become troubleshooters, working with new moms and families to find solutions for any and all problems. Dr. Varner again credits the other services offered under Sinai Health’s Frances Bloomberg’s Women’s & Infants’ Health Centre that allows our ED to best support new parents. “Mount Sinai Hospital has incredible expertise in so many areas of women’s health. And because we learn from each other, we’re able to change and adapt our care delivery so that we’re continuously improving.”


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