Obstetricians and Gynaecologists have long been regarded as the first line of defence for pregnant women, but a recent report by The New York Times suggests that they may be in a position to make a bigger impact on the outcome of your pregnancy than you realise.
The article, which comes as a major public health campaign is ramping up for the Olympics, found that of all the primary care providers surveyed, obstetricians performed the most effective prenatal care for the most pregnant women.
It’s a stark contrast to what’s happening in the United States, where women are being treated for a wider range of ailments including preterm birth, low birth weight, and the common cold.
In America, obstetrical care is mostly focused on helping pregnant women with preterm births, as a form of preventive medicine, but the study found that obstetrician-gynecologists performed the least effective prenatal visits.
As a result, they were found to have a higher rate of false positive pregnancy tests, which is the most common reason women go to the hospital to have an ultrasound.
A common mistake women make is to take a false positive test, which in the US means the pregnancy is still very much alive, but not yet viable, even if it’s in the clear.
“We are the first care providers in the world to do this,” said Dr. Joanne M. Doudna, president and CEO of the Society of Obstetrician and Gynecologists of North America.
The Times article suggests that obstetricians may be able to change the way they look at prenatal care, and that a growing number of women may have their pregnancies tested without an appointment, as well as by telephone or email, rather than being forced to wait in line at a clinic.
The study’s findings are likely to fuel debate about the ethics of the practice, which has become increasingly common since the advent of internet prenatal testing.
While most of the world is focusing on women’s healthcare, obstetrist-gynaecologists, like other healthcare professionals, are increasingly seen as a secondary, tertiary care provider.
The New Zealand study also showed that women are willing to pay for a prenatal visit.
A majority of the women in the study, though, were not able to pay to see an obstetric professional, with the study finding that 80% of women were willing to put up with a visit even if they didn’t want one.
The authors of the study also found that the average woman was willing to wait an extra hour in line for an obstetrical appointment, and were willing, for example, to take less than a minute to call in an appointment if the woman had trouble paying.
They also found women were less likely to take the time to find out if an appointment would be necessary and that they were less willing to go into labour if they weren’t comfortable with a specific doctor.
“Our findings are concerning because it suggests that women who have had a low birthweight pregnancy, for which the obstetric service may be unable to provide treatment, may not be able or willing to accept a prenatal appointment, because they are not willing to face a false negative pregnancy test,” Dr. Dijana Zilberman, director of the Department of Obstetrics and Gynaecology at Columbia University, told The New Yorker.
“There is a risk that they might refuse to have their pregnancy examined and might go into labor later on, or they might give birth to a baby who is severely malformed.”
This is not the first time that women have spoken out against obstetric care in the public health arena.
In 2017, the National Institutes of Health released a report on the impact of prenatal care on women.
The report found that women with low birth weights who were referred to obstetric services for treatment were far more likely to have preterm delivery, which was a greater risk for severe fetal abnormalities.
And in 2013, a report from the Cochrane Collaboration found that low birth rates were the biggest predictor of maternal mortality, and women with a low BMI had the highest risk.
The findings of the new study, however, do not suggest that obstetrical services should be removed from women’s health plans.
Rather, the study suggests that in order to have the greatest impact on women who are most vulnerable to prenatal care issues, healthcare providers need to do a better job of communicating with patients about the importance of prenatal screening, and offering prenatal testing when needed.
“Patients are often concerned about the quality of their prenatal care and their decision to have one,” Dr Doudnas told The Times.
“The message is that, in order for a provider to deliver the most value to the patient, it’s important that they are able to communicate the importance to her of getting tested and that it is not just routine screening.”
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