Antenatal Clinic......

Good nite...fellow bloggers...Lol

I do apologise for not updating on Friday evening, I returned to a parish called Point hill in St Catherine's (which is in the country) were there is no Internet, But I am back in Kingston now and can make contact xx

So just to update you about Friday....I spent the day in Antenatal Clinic with a Mentor called Sis Mills who's job description is of course "nurse/midwife and public health practitioner".

So where do I start....Antenatal clinic has the same function as we know it.....to facilitate care to women antenataly and to detect any deviations from the norm and refer where appropriate.

Fact!!!!Did I mention that this particular hospital had a screening process that women went through to assess whether they were able to receive care from conception to birth of baby???Let me start with a little background on how the system works....

In Jamaica it has recently been confirmed that residents will no longer have to pay for health care.......I will go into more depth about this topic at a later date. UHWI is the one hospital that facilitates a private health care and a public health care at a cost.......In order for a pregnant woman to receive care from this hospital it will cost her $24,500 (That is providing she has a normal delivery with no complications....) She would have to pay an extra $60,000 if she had to have a caeserean section....
The breakdown of costs are as follows: Clinic visits $10,000, Normal Delivery $10,000, Lab Fees $3000, HIV, VDRL screening $1000.....furthermore if a woman is Reh - then she would require an Anti D injection (Rhogan) which would cost $24,000....and for the women with financial constraints.....MMMmmmm. I posed the question "what if a woman arrives in Labour and has no means of payment???" I was advised that woman do arrive in labour and they are delivered at this hospital with no antenatal care throughout pregnancy.......there are ways and means of getting round the system and some women know this.

The clinic is divided in to 4 "firms" as it would be termed in J.A. Firm A is on a Tuesday where normal pregnant woman are provided with health care. Firm B, which is held on a Thursday will provide health care to women who have had multiple miscarriages, diabetic women, teenagers, women who are over 35years old, woman who have a parity of 4+ and woman who have High BP. Firm C is on a Wednesday for the women who are in between firm A and B, so they are not completely normal in pregnancy with no complications but they are not as serious as the problems in firm B.Firm D is held on a Tuesday and the antenatal women have high risk pregnancy's because of their conditions i.e sickle cell and cardiac problems, or multiple pregnancy ect.
Women are seen at 12, 20, 28, 32, 36, 38 and 40 weeks....(more if needed)
Fact!!!!All teenage pregnancies under 16yrs old are reported to the social services were a thorough investigation is carried out, and where necessary the authorities will be involved. It is the Midwifes/Nurses duty to report each case, and if they fail to do so they will be charged $250,000.......so I have feeling that no one forgets!!!

Getting back to the subject of the screening process of being accepted under the care of UHWI, .....all the pregnant women who request health care to be given to them by UHWI go through an Interview process for acceptance. At 7 am in the morning the women  (about 40-50 of them )wait patiently out side the antenatal clinic building....some accompanied with a friend, partner or by themselves. At approx 7.15 the women are let in to a room filled with chairs. A spokes person addresses the women as a whole.....explaining the procedure and process of the day and what it will entail, also covering what is required of each individual who is accepted for care for example the dress code.....No shorts, No mini skirts, No hair in rollers, No cleavage, and to dress modestly...and  no revealing of the bump with half tops......Now I would like us to adopt the dress code....He...He...imagines telling our woman that they had to dress a certain way before attending clinic????Do you think we would have any women left????NOPE!!!No one questioned this and they were happy to go along with what was said. Woman were also advised if accepted to bring hand towels to each appointment and soap would be provided.....I am loving the money saving techniques.....I feel we should try some of them!!
The women are then given sheets to fill out requesting data about previous pregnancy....Gynae and obstetric history...where they last delivered, where they live ect. All the papers are collected and the information is given to the senior Sister in charge, and it is her job to read through each persons individual status and decide whether to accept or decline the individual. Women get declined for a numerous amount of reasons...one being if they are not between 8-16 weeks (i.e their gestation is greater than 16 weeks), or they live outside the attachment area, or they delivered at a different hospital previously.

Fact!!!!Did you know that abortions are illegal in J.A?????(They are only meant to be carried out for medical reasons....although women have been known to pay doctors illegally to carry out abortions by themselves!!!)
Once the documentation is collected and the screening process has been carried out, the women are then addressed again as one....It is explained to them what they must expect, and why certain screening needs to be carried out....i.e...screening for sexually transmitted diseases...a discussion is held where women can ask questions and questions are asked to the women....it reminded me of our antenatal classes...very informative to the women...Then the women are asked to Que and pay their fees (whilst each woman pays their fee they are taken into a side bay and booking commences........(the same way we book our ladies with a full extensive history taken.) Only difference is the women are palpated and a pap smear is carried out.....(Our version of a swab...)
Fact!!!!Metal Speculum's are still used, the Midwife is expected at the end of each clinic to wash them and autoclave them...accompanied with the instruments that are used......Can you imagine midwifes.....having to wash our instrument's after use and then having to put them through the autoclave????Nope...neither can I......I keep telling you ...these Midwifes are multi-talented!!!!

Good night Bloggers

Miss P