Oh, Snap! (kutsuwamushi) wrote in little_details,
Oh, Snap!

[ANON POST] British doctor/patient confidentiality and medical complications of pregnancy

Setting: contemporary England

scenario: Character A is pregnant and has a history of schizophrenia, currently controlled through medication. She stops seeing her psychiatrist and disappears around her 7th or 8th month of pregnancy. Her family reports her as a missing person. She gives birth alone in a house in another city. The fetus is stillborn, she panics, and does not seek medical assistance.

Q1: Preferably, I want A to show up in a hospital several days (at least 2) after the birth due to complications. Are there any possible complications of childbirth that could go a few days without emergency care without proving fatal, but would be serious enough to force her to go to the hospital (either of her own volition or because she's unconscious or obviously ill/injured enough that someone sees her and calls an ambulance)? The issue can be a contributing or causal factor in the miscarriage or unrelated. I've come up with several dangerous and potentially fatal conditions related to pregnancy, but haven't come up with any info on which conditions, if any, would work for this scenario and time line.

Q2: If I need to get her into a hospital for other reasons, what signs would a doctor use to determine A had given birth very recently? Since she has not been treated with Parlodel lactation would be evident, but that alone doesn't indicate how recent the birth was. Would there be something more concrete (or something more medical-termy) than the visual evidence of recent tearing around the vagina and postpartum bleeding? Would she be given a blood test for pregnancy hormones? (Searching terms gives me a lot of anecdotes and info about animal births but not medical/forensic indications of recent birth.)

Q2: Google research suggests that "child protection" can be a legitimate reason to breach doctor/patient confidentiality in the UK, but in this situation when A arrives at the hospital there would be no child but obvious signs of recent child birth. A would be disoriented and evasive when asked about the pregnancy. Would a doctor or nurse be acting ethically if she reported to the police her suspicions that the infant had been abandoned (she would have knowledge that the body of a baby had been found recently, if that's relevant)? Would it make a difference if her primary psychiatrist, who would have knowledge of her pregnancy and mental health history, reported her suspicions after being contacted by emergent care doctors? All of this would happen before autopsy results reveal that no homicide has occurred.
Tags: uk: health care and hospitals, ~medicine: reproduction

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