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.
Pregnancy diagnosis by rectal palpation is one of the most frequent procedures performed by dairy veterinarians, but very little is known about the economically optimal schedule for palpation. In a practitioner survey, 34 days was the median response for how soon after breeding veterinarians reported routinely palpating cows (see companion abstract). Previous research showed that cows checked later in gestation were more likely to stay in the herd and calve again, but those studies did not address the optimal herd-level schedule. The purpose of this study was to estimate the effect of palpation schedule on days open and culling for four pregnancy diagnosis schedules in herds using only artificial insemination for breeding.
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