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"Pregnancy and Appendicitis"

About: Bunbury Hospital / Bunbury Paediatric Ward Bunbury Hospital / Emergency Department

(as the patient),

I was admitted into Bunbury hospital mid-2021 with excruciating abdominal pain while being 28 weeks pregnant. I got sent up to the Maternity ward to get the baby checked over. I had an examination where I was told they couldn’t find anything, but my appendix felt slightly enlarged. I then got sent down to ED and had to sit in the waiting room until there was a free bed. After waiting for just shy of 4 hours, a bed finally became available, and I had to re-explain my situation and the excruciating pain I was in.

ED attempted to send me back to the maternity ward as that’s where pregnancies are looked after. After pushing for pain relief that was safe for my baby the doctors organised for an ultrasound, with the results coming back as ‘appendicitis’. With a lot of miscommunication between staff and no one informing me of what was happening next, I was left in the short stay bay for 36 hours without food, or even any water. It was explained to me the reason behind this was they didn’t know when I was getting transported to a metropolitan hospital. Finally, after 36 hours in Bunbury Regional Hospital, I got flown to that other hospital via Royal Flying Doctor Service who had to give me a drip to rehydrate me, and then I got taken in for surgery to remove my appendix.

As I understand it, the stress of the surgery caused me to go into preterm labour and I had to be given a dose of steroids to stop the labour progressing. I had to stay in the metropolitan hospital for 7 days to ensure that my labour had stopped and my baby would stay inside. The surgery then caused further problems and from 28 weeks onwards I lost all feeling and sensation of my pregnancy and had to have weekly checks on my baby to make sure there were no further complications.

The complications I encountered caused a lot of issues with my mental wellbeing, which led to being admitted back into hospital for 2 weeks on ‘watch’, being 36 and 37 weeks pregnant, as my mental health took a turn for the worse. I then pushed the doctors and nurses to allow me to have an elective caesarean section at 38 weeks because not only my mental health but it seemed my body couldn’t deal with the complications and stress caused by the pregnancy.

The doctors agreed it was in the best interest of me and my baby that I be booked in for a caesarean. The day I was booked in for a caesarean section my waters broke, I was 38 weeks. My waters broke in the early hours of the morning and I was admitted back into Bunbury Regional Hospital to the Maternity ward an hour later. After arrival I wasn’t once checked over to see if I was dilating. I told 3 nurses that I felt I was having contractions and the sensation to push. I kept being told to wait and speak to the nurse when they come to take me down to theatre. I still wasn’t checked to see if I was dilating and I felt invisible as a patient. It got to morning (more than 2 hours after I arrived) and I told the next nurse that I was having contractions, they were getting closer together and I could feel a pushing sensation. The nurse then told me to go and have a shower, and to shave ready for the caesarean. As I stood in the shower, I told my partner I felt the urge to push and asked if he could talk to the nurse on my behalf. He informed the nurse of my situation and was told that the nurse will be coming to take me down to theatre and to tell me I only had to wait 2 more hours.

By the time that happened the contractions were about 2 minutes apart. Since arriving over 4 hours earlier not one nurse had checked to see if I was dilating, even after me mentioning the pains and sensations I was having. When I was on the theatre bed talking to the Anaesthetist, I told them I felt like I was about to have my baby. They told me I need to sit up and wait for the spinal block. It took 10 minutes for the spinal block to be administered as the contractions were too close for me to be able to sit still enough. Once the spinal block was administered, the ice block test was conducted for the results to be that I still had all feeling. I was then given a double dose of morphine to ‘numb’ everything in order to proceed with the caesarean. I could still feel everything but felt time was running out. I laid down again once instructed and the doctor got me into position.

I then insisted the doctor do a check of my vagina to see if I was dilating and to their apparent surprise my baby's head was already crowning. The plan changed, 20 minutes of active labour, four pushes and my baby was born. The vacuum was needed as my muscles weren’t quite strong enough to fully push due to the spinal block and morphine

This experience has traumatised me and left me with negative feelings in regard to being treated as a patient at Bunbury Regional Hospital. My voice wasn’t listened to, I felt unseen and suffered severe anxiety. My birthing experience was so traumatic I feel I won’t be having another baby, if I do then I will not be delivering at Bunbury Regional Hospital for fear of further complications.

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Responses

Response from Dr Lauren Megaw, Head of Department, Obstetrics, WA Country Health Services about a year and a half ago
Dr Lauren Megaw
Head of Department, Obstetrics,
WA Country Health Services
Submitted on 4/10/2022 at 4:39 PM
Published on Care Opinion at 4:39 PM


Dear zebracb78,

Thank you for taking the time to write to Bunbury Hospital and provide feedback on the healthcare provided for your appendicitis and your following birth experience after a challenging pregnancy.

My name is Dr Lauren Megaw, I am the Head of Department for Obstetrics. I am very sorry to read the effect the complications have had on your wellbeing. A significant complication in pregnancy can be frightening – especially when a transfer to another hospital and surgery are needed. In addition, that you did not feel supported or cared for, and your mental health suffered is an added burden. Finally, to have an experience of birth where you felt dismissed and ignored that has left you feeling traumatised, I am truly sorry for your experience.

To experience a pregnancy that is complicated by appendicitis is uncommon, affecting less than 1% of pregnancies. It is challenging to diagnose appendicitis in pregnancy and carries a risk of preterm labour – as you experienced. Contractions following surgery are very common and the treatment with steroids and medication to stop labour is a safe and appropriate course of care.

Your care in late pregnancy, where you were labouring after your waters broke but were not examined, is unusual, and not the standard of care we aim to provide at Bunbury Hospital. That you were examined prior to the caesarean section, and your baby was safely delivered by assisted delivery is reassuring however is not the preferred high level of care we aim to provide in maternity. The birth of a child should be a momentous occasion and I was concerned to read that your trauma is impacting your decision to have another child and to deliver at Bunbury Hospital. We aim to provide patient-centred care for patients, their families and loved ones and no one should feel that they can’t attend our service and receive high-quality medical care.

I would welcome the opportunity to understand and investigate your experience further to know how we can support you and improve our quality of care. I would also like to offer you the opportunity for a personal debrief if you feel that would be of benefit. You can contact me via the patient engagement coordinator by email at swfeedback@health.wa.gov.au or by telephone on 08 9722 1521.

Thank you again for taking the time to provide feedback to our organisation and I hope to hear from you.

Dr Lauren Megaw

Head of Department – Obstetrics

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Response from Dr Lauren Megaw, Head of Department, Obstetrics, WA Country Health Services about a year and a half ago
Dr Lauren Megaw
Head of Department, Obstetrics,
WA Country Health Services
Submitted on 14/11/2022 at 6:53 PM
Published on Care Opinion on 15/11/2022 at 9:47 AM


Dear zebracb78,

Thank you for taking the time to contact us about your care. I haven't heard back from you since my response and I hope I was able to address your concerns. If you do want a further response, please don't hesitate to contact me.

Kind regards

Dr Lauren Megaw

Head of Department - Obstetrics

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