‘Doctors Forced To Choose Which Women Have Access To Scans’

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Ellen Coyne, in The Times Ireland edition, reports:

“Babies are dying because of a chronic lack of access to 20-week ultrasound scans, an Irish obstetrics expert has warned.”

Louise Kenny, professor at University College Cork, said that doctors felt “haunted” because they were forced to choose which women would have access to the scans. The procedure identifies major and in some cases life-threatening problems with organ development.”

“Ms Kenny told TDs yesterday that mortality rates increased when medical teams did not know about foetal defects before birth. She said that complicated procedures to save the lives of babies were being performed at the last minute in ambulance journeys between Cork and specialist units in Dublin.”

Only four of the country’s 19 maternity hospitals routinely offer ultrasound scans at 20 to 22 week, also known as foetal anomaly scans.

Members of the Oireachtas health committee were told that the lack of access to the procedure was disproportionately punishing poorer women. A private scan costs about €200.

Babies ‘are dying over ultrasound access’ (The Times Ireland edition)

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51 thoughts on “‘Doctors Forced To Choose Which Women Have Access To Scans’

    1. pluto

      sorry Mahoney but does this not highlight the absolute hypocrisy of the state of affairs in this country and that of our politicians.

      Whilst the Catholic Church, FG and the anti-choice brigade direct seemingly unending resources of energy into opposing the human right to have an abortion, they don’t actually give a crap about trying to rectifying situations such as this where people do actually want to have a baby.

  1. Increasing Displacement

    What’s a scan going to do other than show something?
    It’s not going to change anything.
    There’s not much you can do other than end or continue…

    1. Increasing Displacement

      What fatal conditions are you referring to that can be cured by:-
      A- Surgery
      B – Medication

      Yes I’m serious Nigel.

      1. paul

        steroids can help a foetus’ lung development giving it a greater chance of survival if a pre-term delivery is anticipated or if the foetus is developing too slowly.

      2. Nigel

        If you’re genuinely curious don’t be a prat and go look it up rather than asking a layman. A scan will reveal issues to do with the position of the fetus and the possibility of blockages which could lead to difficulties at childbirth. they can be monitored, via more scans, and a decision made whether to do a delivery or a cesarean birth. There are serious implications for the health of the mother and child associated with these decisions. And that’s only the one I have actual experience of.

          1. Andyourpointiswhatexactly?

            I would imagine that fatal conditions, by definition, aren’t curable. They’d use another word if they weren’t fatal.

          2. Nigel

            ‘Potentially fatal.’ What I described was ‘potentially’ fatal,’ as a worst-case scenario, which was why when they detected it they kept monitoring it in case it worsened and when the time of birth came they knew about it and had a team of surgeons on standby.

          3. mildred st. meadowlark

            To give you an example:

            At the 20 week scan, they can check the position of the placenta. Low lying placenta/placenta praevia is quite common at week 20, but if spotted, the hospital can monitor it and make sure that it moves away from the bottom of the womb. If it doesn’t move, and is blocking the baby’s way out during labour it can be potentially fatal for both mother and baby. The hospital having prior knowledge of this means they can take the best course of action for mother and baby.

          4. Increasing Displacement

            So thats neither surgery nor medication.
            Just clarifying what my question was.
            So lets revisit my statement:

            What’s a scan going to do other than show something? –
            True, no surgery or medication (in all but the 1/30,000 case)

            It’s not going to change anything –
            True, no surgery or medication (in all but the 1/30,000 case)
            May call for further monitoring, but in rare cases.

            There’s not much you can do other than end or continue –
            True, no surgery or medication (in all but the 1/30,000 case)
            May call for further monitorin, but in rare cases.

            Just to be clear.

          5. mildred st. meadowlark

            I feel like you’re missing the point. Say person A gets pregnant,and attends a hospital that doesn’t offer her a 20 week scan. At 30 weeks she presents at a hospital with bleeding, and it emerges that she has placenta praevia, that the placenta is unstable and putting the baby into distress and the lives of mother and baby in danger.

            Person B becomes pregnant and goes to a hospital where she is offered a 20 week scan. It emerges that she too has placenta praevia and it is noted by the hospital, allowing them to monitor the position and health of the placenta as the pregnancy progresses, and allowing them to plan for any complications that may arise.

            I have personally seen the effects of both scenarios.It has it’s value, even if you don’t see the benefit yourself.

          6. Nigel

            ‘Continuing to monitor’ is a change in treatment.
            A c-section is surgery.
            Are you trying to downplay the importance of scans for any particular reason?

          7. Nigel

            Oh good. I was worried you might be. What a relief. Any other aspects of common practice in health care for pregnant women we need to run past you?

      3. Joe Cool

        You know, that thing in your hand? It’s a wonderful piece of technology. Appearantly it has a thing called “the internet”. I hear you can type in a question and amazingly it gives you answers

    2. Andyourpointiswhatexactly?

      “There’s not much you can do other than end or continue’: how is that “not changing anything”? Ending a pregnancy is, I would argue, quite a big change.

    3. JLK

      Anomaly or Anatomy scans at 20-22wks show very detailed examination of your baby. If you have attended one, you wouldn’t question its necessity as each partnis checked through. It’s very thorough and looks at all internal organs to show they exist, are right shape, right location and functioning. Heart chambers and blood flow are checked in detail.
      Depending on the issue that’s identified, it may be treated or helped ahead of delivery, able to monitor and predict if early delivery needed to help save a baby not progressing as normal or worsening of the issue is noted.
      Some treatments can be carried out in utero such as a blood transfusion and more aggressively actual fetal surgery. C sections may be required where otherwise a natural birth would be fatal. Relevant specialist medical/surgical teams can be on standby at birth ready to perform life saving surgery.

      Or you can blindly wait & see what happens. Take your chance all is ok and see how it goes…

      1. Andyourpointiswhatexactly?

        If there’s a big anomaly, they’ll spot it before then. Mine was spotted at a regular crappy machine scan at 12 weeks. Fluid all around the brain and, as weeks went by, the chest. It died at 17 weeks. Even I could see it before they said it, and I’m certainly not trained.
        Though, thinking about it, if it’s that bad the foetus would probably be dead before the 20 week scan anyway, like mine was.

        1. JLK

          Sorry for your loss but I’m sorry that’s not true at all. There’s a significant number of issues that are picked up at 20wk scan as all organs are present, just not matured. 12wk scan may show some but nowhere near the same no of issues. Babies with fatal anomalies can survive to term but not survive much beyond birth. Anecdotally I know babies saved by this scan as they got the treatment and monitoring required, that had they gone without scan from 12wks to birth, would not have survived incl 1 baby would not have identified a serious cardiac issue that needed immediate attention at birth.

  2. Anomanomanom

    The scan should be available if its an absolute necessity, but is €200 for private really that expensive if you think its a necessity and your hospital can’t supply it. I think it cheap.

    1. Malta

      Oh maybe the state should provide a public health service that’s fit for purpose?

      An anomaly scan at 20 weeks is international best practice.

  3. Daisy Chainsaw

    Doctors are so tied up with the legalities of the 8th amendment that they’d rather not scan a woman at 20 weeks for fear they’re giving her information that might lead her to choose not to continue. These are the same legalities that kept a dead woman on life support and killed an otherwise healthy woman because the woman is reduced to a walking foetal container and treated like a mushroom (kept in the dark and fed bullplop).

    Could you imagine a man or child being denied access to all information regarding their condition for fear their choice might go against a religious ethos? I wonder if the 8th amendment included men’s reproductive systems would there be so many in favour of it? Would men be happy to be denied treatment for fear it might lead to them not being able to reproduce and vindicate the right to life??

    1. Andyourpointiswhatexactly?

      Hmm. I don’t know which doctors you are talking about but I have never heard that they are afraid of doing the 20-week scan because of the 8th amendment. Have you any proof of that claim?

      1. Daisy Chainsaw

        There is a litany of stories where the foetus is prioritised over the welfare of the pregnant woman. Why are women killed due to being denied cancer treatment? Why are dead women put on life support machines? Why are miscarrying women forced to continue miscarrying and catch a fatal infection, rather than speed up the process as is best international medical practice? Because the foetal heartbeat trumps all and nothing is allowed to interfere with that foetal heartbeat because of the 8th amendment.

        1. Andyourpointiswhatexactly?

          Okey doke.
          But what about doctors not doing the 20-week scan because of the 8th amendment?

      2. JLK

        Agree with this, that hospitals with religious backgrounds are not offering this as routine service as prefer to keep potential issues unknown in case the woman might travel for abortion. No one doctor is refusing but the ethos of the hospital by not offering it as routine is refusing women that right to know all information about their baby. A doctor in such a hospital cannot put forward all their patients for this scan without a specified reason so this leads to comments like Louise Kenny Obstetrician above, where doctors are haunted by the choice they have to make. How many of their patients could’ve been better informed and babies better treated had they gone for this scan?

  4. 15p

    well isn’t that the way of our country? Fupp the poor. Rich comes first. from top to bottom in every facet of irish life, that is how it is. FG/FF’s ireland.

    1. Andyourpointiswhatexactly?

      That’s the way of most countries, though. It’s not just us. Doesn’t make it right, obv, but it’s a fact of life.

  5. Turgenev

    a) Babies have had surgery within the womb; foetuses have also been removed from the womb, operated on and returned. Rare, but doable. Scans can also show things like a surviving foetus where its twin has died in the womb, giving the doctors the option to decide on whether the dead twin should be carried to term or an early delivery be made, or the dead twin removed and the surviving foetus left to continue its development… there are many, many reasons for a 20-week scan.

    b) http://www.rte.ie/archives/exhibitions/eamon-de-valera/719124-address-by-mr-de-valera/

  6. Anne

    It’s the same with any sort of scan on the public system. If you need an MRI, you’ll be waiting months on end. And I’m taking 6 to 8 months.

    If you don’t have insurance, the health insurers won’t take you on once you become sick.
    If you’re out of a job because of being sick, it can be difficult to pay for a scan privately.

    The only difference here, is that the scans are needed within the timeframe of the pregnancy, at the 20 to 22 week mark, but it’s the same for all scans and procedures in the country.

    The healthcare system is a shambles.

  7. Peter Dempsey

    “Anyone who has private health insurance is a selfish I’m-Alright-Jack type” (someone on Rabble, 2015)

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