Concern for women without private health insurance who suffer miscarriage

Women without private health insurance who suffer an early miscarriage in this country are more likely to be hospitalised and in need of a blood transfusion than private patients, a study has found.

Research on more than 50,000 cases where women were admitted to an acute maternity hospital due to an early miscarriage found public patients had almost double the risk of being hospitalised and more than double the risk of needing a blood transfusion compared to private patients.

The study by researchers from University College Cork and Cork University Hospital examined a total of 50,534 cases where women required hospitalisation for early miscarriage between 2005 and 2016.

It found that there were 69.1 hospital admissions for early miscarriage among public patients for every 1,000 births compared to 44.8 per 1,000 for patients with private health insurance. It also showed that 1.2% of public patients who suffered an early miscarriage then required a blood transfusion compared to 0.6% for those with private health insurance cover.

One of the report’s main authors, Indra San Lazaro Campillo of the Pregnancy Loss Research Group at UCC’s Irish Centre for Fetal and Neonatal Translational Research, claimed the research team had found no other study which assessed the possible impact of health insurance coverage on the risk of complications among hospital admission for early miscarriage.

“In order to promote an equal provision of care to pregnant women who miscarry in hospital settings, this possible association should be investigated,” said Ms Campillo, a PhD candidate at UCC.

The study also showed women who suffer an early miscarriage in Ireland are less likely to require hospitalisation now than 15 years ago. However, they face an increased risk of requiring a blood transfusion and a longer stay in hospital.

Overall, the study showed that there were 63 hospital admissions for early miscarriage for every 1,000 births over the 11-year period but the rate decreased from 70.6 per 1,000 deliveries in 2005 to 51.5 by 2016. On average one in four women, will experience an early miscarriage when the pregnancy is lost within the first 13 weeks of gestation.

The research, which is published in the medical journal, Reproductive Health, noted various international studies show early miscarriage occurs in between 10% and 30% of all pregnancies. Ms Campillo said that the objective of the study was to explore the national trends in incidence rates of hospital admissions for early miscarriage in hospitals across the country.

“Early miscarriage hospitalisation became 19% less common during 2005-2016 but the risk of blood transfusion doubled,” said Ms Campillo.

The vast majority of women only needed to stay in hospital for one day but 10% stayed for two days and 3.6% required a stay of three or more days. Women aged 40 years or older were three times more likely to require hospitalisation for early miscarriage than women under 25.

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