A woman who has spent a decade navigating the emotional ups and downs of IVF is urging hospitals to separate fertility and gynaecology services from maternity units, describing her recent appointment experience as “heartbreaking.”
Niamh Smyth and her husband Justyn have been trying to start a family for over ten years. Their journey has included four rounds of IVF, with three unsuccessful attempts and one pregnancy that ended in miscarriage. After waiting nearly five years for a gynaecology appointment, Smyth finally attended her scheduled visit in May at the Ulster Hospital in Northern Ireland. But what should have been a straightforward appointment turned into an emotionally charged ordeal when she discovered where the gynaecology department was located.
“I phoned them and asked where the gynaecology department was,” she recalled. “They told me it was inside the maternity unit. Whenever I heard that, my heart just dropped.”
Walking into the maternity unit, Smyth found herself surrounded by expectant parents and families, a stark and painful contrast to the difficult news she was about to receive about her own fertility. “It was heartbreaking,” she said. “I went in for my appointment, which was a hard appointment, and then had to walk back out past those families.”
The South Eastern Trust, which runs the Ulster Hospital, has acknowledged the issue and said it hopes to relocate outpatient gynaecology services away from the maternity unit in the coming months. But for Smyth, the experience has sparked a broader conversation about how healthcare environments can inadvertently add to the emotional burden of those struggling with fertility.
A Shared Experience
It wasn’t until after her appointment that Smyth began to reflect on what had happened. She realised she couldn’t be the only one who felt upset about the location of her appointment, so she decided to share her story online. The response was overwhelming. Women from across Northern Ireland reached out with similar experiences, revealing a pattern that has persisted for years.
“It isn’t just me; it’s been going on for years and nothing has changed,” she said.
Her story resonates deeply with many, including Sinn Féin MLA Órlaithí Flynn, who has also undergone fertility treatment. Flynn said she has “very vivid memories” of attending appointments at the Regional Fertility Clinic after her own miscarriage. She described how the environment can heighten emotional pain.
“Your senses are totally heightened in terms of noticing babies coming and going from maternity hospitals and noticing pregnant mothers going in to have their babies,” Flynn explained. “All of those things seem a lot more sharp and a lot more real, and it can hurt.”
Flynn believes health trusts need to consider the emotional impact of where they place fertility and gynaecology services. She has called for the location of these services to be a key consideration within the Department of Health’s Women’s Health Strategy.
The Case for Separate Services
Independent MLA Claire Sugden agrees with Smyth’s call for separate services, arguing that the current setup adds to the trauma experienced by women at risk of miscarriage. Sugden said women’s healthcare has been too focused on clinical needs and not enough on the emotional and psychological support that patients require.
“I think we need to do better in Northern Ireland around designing women’s healthcare and recognising that it’s just more than a body and body parts,” she told the BBC’s Good Morning Ulster programme. “There’s actually a human being at the heart of it, with emotions and family.”
Sugden acknowledged that reconfiguring services would require additional resources, but she insisted the move is necessary for women’s welfare. “It can’t be just the usual excuse of: ‘There’s no money and we can’t move forward.'”
What the Health Trusts Say
BBC News NI contacted all five health trusts in Northern Ireland to ask about the locations of their fertility and gynaecology services relative to maternity units. The responses varied.
The Belfast Trust said its Regional Fertility Centre operates from a “dedicated facility” with “its own separate entrance,” while the Southern Trust said fertility treatment is provided from a “standalone clinic.” However, the Western, Northern, and South Eastern trusts acknowledged that attending appointments close to maternity services in some of their hospitals can be difficult for some women.
Both the Northern and Western trusts said they are actively exploring ways to improve the experience for women dealing with fertility struggles. The South Eastern Trust, where Smyth was treated, has already indicated plans to move outpatient gynaecology services out of the maternity unit.
Encouraging Change
For Smyth, sharing her painful experience has been difficult, but she hopes it will drive meaningful change for other women facing similar journeys. She believes that fertility services should be housed separately from maternity units, to spare women the added stress of navigating a space filled with reminders of what they are hoping for but have not yet achieved.
“You’re going through probably one of the hardest things you can go through. It just adds more stress and more pressure at a time when you really don’t need it,” she said.
Her story has struck a chord, and it highlights a broader issue within women’s healthcare: the need to design services that acknowledge the emotional realities of patients, not just their medical conditions. As the conversation continues, there is hope that her courage will lead to changes that make a difficult journey a little less painful for others.
If you have been affected by the issues raised in this story, you can visit the BBC Action Line for support.
