To register for pregnancy: hard work or pleasure?
On the pages of our magazine, we repeatedly raised the issue of the advisability of conducting various diagnostic tests during pregnancy. The movement of the medical community in the direction of refusal of reinsurance and overdiagnosis is already obvious. However, a small experiment conducted by the editorial office showed that there are still problems in organizing care for future mothers.
In many regions of Ukraine, the Maternal and Child Health Project successfully conducted trainings based on WHO recommendations. The combination of evidence-based medicine has become familiar and understandable for everyone. At the final stage of development is a new order of the Ministry of Health of Ukraine, which is to replace the order No. 503. Some shifts in the direction of refusal of reinsurance and overdiagnosis, of course, there are. But a small experiment that allowed to look at the question from another side mdash; themselves expectant mothers, nevertheless revealed certain problems in the organization of care for pregnant women.
Essence of the experiment: our colleagues (doctors, midwives, employees of the magazine) and their relatives, who in this year, 2010, became registered for pregnancy, shared their impressions of the first visit to the JC and forwarded to the editor his recommendations for primary examination. We are talking about various women’s consultations in different regions of Ukraine. The participants of the experiment were registered in both public and private clinics.
The content of these documents, as well as the content of orders of the Ministry of Health of Ukraine, is available on the Internet to any person, including our clients. In order to avoid misunderstandings and complaints, it is worthwhile for every doctor to get acquainted with the legislative base in the field of health care and to show sensitivity both in communicating with future parents and in resolving arising disputes.
And now back to the results of the experiment. I want to emphasize that our experiment mdash; this is not a scientific study. This is just a fishing rod, which we threw to understand if the problem of overdiagnosis is actual in 2010 and what other pitfalls can lie in wait for future parents in the LC. In the experiment, only a few women participated, so it is incorrect to evaluate the results in quantitative and percentage terms. Just describe what moments attracted attention.
- In the state-owned LCD register on pregnancy on a residence permitmuch easier than the place of residence. At the place of residence of women did not deny, but immediately there were a lot of questions, including personal ones, and also received a proposal to provide charitable help to a medical institution. Future moms said that at that moment they were experiencing discomfort and unconscious unrest, even in cases where the financial issue was of no importance to them.
- All future mothers thought that they were given a lot of directions for examinations. Wherein it was difficult to remember where and when to go. Everyone preferred to deal with a heap of papers at home on their own or with the help of friends-acquaintances-the Internet.
- Liked when the doctor wrote a sequence of actions, but take apart over time handwriting of a doctor turned out not easy.
- In the state clinics, they basically wrote by hand, in private issued printouts with circumscribed recommendations. Printouts like, but there were questions: why something was recommended, but something mdash; no, why the analyzes have different costs, have I been assigned the most reliable examinations, etc.
- The minimum number of recommendations for a future mother was in accordance with the requirements of the Ministry of Health Order No. 503.
- The maximum mdash;very surprised. And the editorial staff, and the very future mommy. The examination proposed at the first visit included (in addition to the generally accepted tests) double examination for all maintenanceRNS infections, double bumps from the throat, twice ECG, blood test for the presence of chromosomal abnormalities in the period of 11-13 weeks, examination for the whole spectrum of STIs, etc. I emphasize that this list of studies was proposed to a young, healthy, first-time pregnant woman.
- Generally,in the state housing services offered a much smaller number of surveys and visits than in private clinics.
- In private clinics, prospective mothers were often smiled, the staff was friendly and patient, women escorted to the necessary office, all questions were answered, less hurried.
- Answers on questions expectant mothers often were not clear and distinct. This applies to both state-owned LCDs and private ones.
- Future mothers who did not receive a clear answer to their question, preferred not to argue, to finish the conversation with the doctor and to do as they pleased.
- Cozy atmosphere in the medical institution was pleasant all participants of the experiment, but more significant factor of women yet found the attention of a doctor to yourself, detailed answers to questions, affability and tactfulness of the staff.