April 2016 Moms
ashdawn24
member
Options
Differences in Intervention/Care
ashdawn24
member
Hey all,
I thought it might be interesting to talk about differences in prenatal/postnatal care, labour interventions, etc. in the different areas we are from.
I'm bringing this up because I'm from Canada, and know a lot of you are from the States, and I've been noticing some interesting differences in how things are done in our respective countries.
One thing I'm blown away by is the amount of inductions that seem to be being planned before due dates, seemingly with little reason. It seems like doctors are so much more ready and wiling to plan an induction there in the States "just in case". Obviously there are legit medical reasons for induction, but I feel like American doctors seem much more ready to jump into that medical intervention a lot earlier.
Another thing I'm curious about is how everyone seems to have cervical checks SO early! Granted, I am with a midwife (which is a whole other conversation where things are completely different between the States and Canada), but even my friends with OB/GYNS here don't seem to be offered/know about all that information so early. Maybe it's the difference between public/universal and private healthcare?
Anyhoo, I'm just interested to see what others think? I'm not really biased one way or another, just curious if others notice a difference as well!
I thought it might be interesting to talk about differences in prenatal/postnatal care, labour interventions, etc. in the different areas we are from.
I'm bringing this up because I'm from Canada, and know a lot of you are from the States, and I've been noticing some interesting differences in how things are done in our respective countries.
One thing I'm blown away by is the amount of inductions that seem to be being planned before due dates, seemingly with little reason. It seems like doctors are so much more ready and wiling to plan an induction there in the States "just in case". Obviously there are legit medical reasons for induction, but I feel like American doctors seem much more ready to jump into that medical intervention a lot earlier.
Another thing I'm curious about is how everyone seems to have cervical checks SO early! Granted, I am with a midwife (which is a whole other conversation where things are completely different between the States and Canada), but even my friends with OB/GYNS here don't seem to be offered/know about all that information so early. Maybe it's the difference between public/universal and private healthcare?
Anyhoo, I'm just interested to see what others think? I'm not really biased one way or another, just curious if others notice a difference as well!
Re: Differences in Intervention/Care
I've had friends begging their doctors for elective inductions at 38-40 weeks in otherwise healthy pregnancies to no avail.
There may be more flexibility in getting certain elective tests. Sometimes they are paid by insurance, but sometimes people pay out of pocket.
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12
Cervical checks are done only as needed for specific cases, and I have never heard membrane sweeps, inductions, or c-sections even mentioned during an appointment. They just tend to take a really natural approach, let the body do its thing, and then if needed the doctors are there. I enjoy knowing all my options are there, but I don't need to use them.
I see my OB every appt and then hope he's the one to deliver (two clinics share the hospital's on call, so I wouldn't see some either way), she rotates through 5/6 OBs.
I had one u/s at 20 weeks, she had 4/5.
I requested an early cervical check due to irregular contractions before a short trip at 37w3 (they typically start at 38), they started at 35/36.
My clinic allows elective induction/c/s only after 39 weeks and then only if mom is "favorable" (dilating), hers pretty much anytime after 38.
My clinic will let you go to 42 weeks, hers to 41.
My clinic charges a universal fee plus additional tests/interventions (u/s, labs, etc) and hers charges per appointment/intervention/lab.
Long story short, those are all differences within an hour drive of each other - I think it's more clinic to clinic than a country-wide. Mine also has a lot to do with the hospital being "baby-friendly" which requires jumping through a lot of hoops.
I had a dating US around 10-11w, then another follow up US around 16w to check on a subchoronic hematoma, then the A/S at 20w. Generally they just do A/S at 8-10 and then again at 20.
I had a cervical check at 28w, and starting next week at 36-37 I will start having them weekly. Otherwise, every appointment is basically the same UA, doppler for HB, measure fundal height, chat and go.
We haven't talked about induction. I was electively induced at 39.3 with DS due to near disabling SPD pain. I don't plan on it this time around.
I had two early ultrasounds (I think 6 and 8 weeks) due to having had a miscarriage the cycle before. Those are not standard. I opted for the panorama test that my OB recommended over the NT scan at about 12 weeks. I had a 20 week anatomy scan at an outside practice (which they now offer in house but didn't at the time). I had a growth scan about a month ago and will have another this week; again those are not typical and I'm receiving those due to measuring large and having a gestational diabetes diagnosis.
Cervical checks started at 36 weeks. This OB induces at 41 weeks if you haven't gone into labor by then. Earlier induction would only be for specific risks.
As far as billing, standard care is covered under one umbrella charge which includes delivery. Anything above and beyond (labs, ultrasounds, GD counseling, etc) is billed separately.
I'll give you an anecdote though... My husband dislocated his shoulder as soo as we moved to Minnesota, and then again as soon as we moved to Ottawa, and needed ER trips for both occasions.
In the US: ER consult with Doctor, X rays, nurse anesthetist to administer sedation, amp of propofol, oxygen supplementation while sedated, 4 doctors working together to get shoulder back in place, more X rays, sling , follow up MRI and follow up in sports medicine. Final bill: US$ 12,000.
In Canada: ambulance ride, consult with ER Doctor, X ray, Doctor puts shoulder back in place alone, without sedation and within 5 seconds. Confirmatory X ray. Final bill: CAD$1,500, and that was because we had just arrived in Ontario and husband didn't have his healthcard yet, so we were billed "premium" rates personally (then got it reimbursed).
This was followed by an appointment with ortho surgeon and then shoulder surgery. No cost to us he already had his healthcard by then. But the ER approach and costs can be compared directly.
via highly inflated tax rates.
The U.S. HC system is still grossly overpriced and often inefficient though (in re: to the drawn out process you described above to the shoulder situation @thaisac1).
Tax burden is very similar between the US and Canada, actually. I believe only the very top marginal tax is higher here than there.
https://www.investopedia.com/financial-edge/0411/do-canadians-really-pay-more-taxes-than-americans.aspx#
Inductions are not scheduled ahead of due date unless medically needed OR if you opted into the study being conducted the the hospital about inductions at 39-40 weeks. HOWEVER they do schedule your "overdue" induction date at 38 weeks so that it can be with your primary (there are 5 dr in practice.)