Crickey. Just found this, web-site below. No wonder Americans are always confused by our antenatal care system. Seems more laid back than this. Health Tip: Prenatal Checkups
(HealthDay News) -- If you've just learned you're pregnant, don't hesitate to schedule a doctor's appointment.
Regular doctor visits during pregnancy are important to ensure that you and your baby stay healthy, according to the University of Arkansas for Medical Sciences.
At some point, you can expect to undergo:
A physical exam, including a pelvic and breast exam, checking your heart, lungs, eyes, ears, nose and throat, and measuring your height and weight.
Blood, urine and blood pressure tests, and a Pap smear to check for disease that could affect your health during pregnancy.
Checks for several harmful conditions, including anemia, bladder infections, syphilis, gonorrhea, HIV, cervical cancer, hepatitis B, vaginal infections and other problems.
Questioning about the state of your health and that of the baby's father.
-- Felicity Stone
http://www.medicinenet.com/script/main/art.asp?articlekey=81210
We never do the first bullet point. I suppose it's a general health check really, and in the US I believe they have obs/gyn for their pregnancy care whereas over here the first point of contact is generally the G.P who knows, or should know, your general health status and history. Pelvic exam?????
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Antigonos (23.5.07 10:55) Unfortunately, so many Americans have insurance which does not cover routine physical exams and lab work, that for a great many women the first time they go to a doctor is when they discover, or suspect, they are pregnant. They haven't got a GP. But even here in Israel, where we have a universal HMO system, many women have never seen a gynecologist prior to becoming pregnant. My sister-in-law, for example, had her first pelvic exam AFTER she began to have vaginal bleeding in her first trimester--at which time it was discovered she had a bicornuate uterus with two complete chambers. Eventually she delivered a severely premature baby at 29 wks. |
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midwifemuse / Website (23.5.07 12:39) Antigonos - I did wonder why the full medical check-up and thought the absence of a G.P may be the reason. In England we no longer carry out pelvic exams during pregnancy until, like your SIL, there is a problem and even then the first action is generally a scan. I hope your SIL's baby is OK. Prematurity outcomes are really still so variable that I never assume that all is well, or otherwise. |
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mumof4 / Website (23.5.07 13:57) Yes - I often visted the OBGYN in places we lived where I had no Primary Care Dr (GP). The checks included an internal exam on my first visit when I was about 6 or 7 weeks. Also had internal scans at this early stage. Perhaps also the rigorous checks throughout are to be able to charge the insurance companies more? When you are in the appointment Dr/midwife is already circling theform of codes as to what they will be submitting charge wise to Insurance Companies. Oh, and we get weighed at every bloody check up over here too. |
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geepeemum / Website (23.5.07 18:28) Aaah. I can't imagine ever doing a pelvic exam. it's even discouraged if early bleeding is it not? I can't see the point of it at all. Mind you routine beta-HCG seems to be common in the US - everything seems so interventional there. Also I've never done a breast exam in pregnancy. I repeat - what's the point? I once went on a course where a old retired GP - who was an expert witness no less! - told us that breast exams should be mandatory on starting the combined pill and that he would support anyone suing us for not doing one. (he was totally slated of course!) And smears are contra-indicated during pregnancy as pregnancy can affect the results. And I never weigh anyone at all unless they request it. i'd have killed anyone who tried to weigh me. |
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midwifemuse / Website (23.5.07 19:01) mumof4 - Seems pretty thorough (invasive), over here we would think too thorough (invasive). Interesting to see if outcomes are any different. As for constant weighing, those days are long gone. geepeemum - I'm so glad you said that about early bleeding and PV's. One of the G.P's I work with does an internal...and then sends the woman in! I have no idea what he hopes to discover, other than bulging membranes or that his finger has gone through a placenta lying over the os. Breast exams, what is the point? They are often so lumpy in pregnancy that everyone would be sweating over nothing. I ask women their weight at booking (BMI) and then I weigh them at 28 and 36 weeks if I'm concerned or trying to encourage them to watch their diet. |