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Amarachi Okeh
Maternal health experts have urged the National Health Insurance Authority and Health Maintenance Organisations to adjust the minimum number of sonography that pregnant women are entitled to more than two.
The experts noted that all pregnancies are not the same hence the need to make accommodations for such delicate cases where more than two ultrasound scans could be needed as some pregnant women may not afford to pay for them individually.
The experts also urged women to do any ultrasound scan that is required of them by their doctors, stressing that such scans are crucial to ensuring their health and that of their baby throughout the pregnancy.
According to experts, the two basic scans a pregnant woman is entitled to are one done around the 12th week to estimate the date of delivery and the next at about 20 weeks which is known as the anomaly scan.
Speaking with PUNCH HealthWise, the experts a consultant Obstetrician and Gynaecologist, Dr. Abiodun Adeniran, and Dr. Samuel Ilikannu said women mustn’t skip the scans.
Adeniran stated that there could be various reasons why a woman would be required to do more than just the two basic scans that some HMOs allow a woman.
He explained that HMOs usually make provision for two scans because it is assumed that two scans may just be enough to see a woman through an uncomplicated pregnancy.
He, however, added that if there’s an indication, a woman may have to do more than two scans.
He further explained that doctors would not ask a pregnant woman to do more scans unless there is an indication that her pregnancy is at risk.
“There are so many other reasons why you may ask a woman to do an additional scan. For example, if a woman is bleeding, it is an indication for an ultrasound scan.
“You check the woman and you think that the rate of growth of the womb is smaller or sometimes, not compatible with what you expect for the number of weeks, you request a scan.
“It may get to a point when you suspect that the baby is not lying well, maybe, you request a scan, or she has severe hypertension in pregnancy. If we know it is something that can affect the baby and the mother, you say let’s check the baby and be sure that it is not having any effect on the baby,” he said.
Apart from pregnancies that may require more scans to be done, he said, twin pregnancies often require ultrasound scans more frequently because “there are other complications that may happen with twin pregnancy that you need to be able to monitor.”
On his part, Ilikannu noted that each pregnancy is individualised, hence it is not a one size fits all rule that applies.
He said, not every woman can afford to go for the required scans, especially when they are more than the two often covered by the HMOs due to financial constraints.
“We are a low-income country, not everyone can afford to do scans. The other day I had to assist a pregnant woman I have been asking to do a scan for the past two months financially to do a scan because she didn’t have money and according to her, her family has to eat first before she does any scan.”
“So, let’s say a woman has had a baby who had a congenital abnormality, you’d definitely want to do scans. If you have another patient that is a geriatric pregnancy, you’d want to do a scan for that. Also, when there are multiple gestations, you’d also want to do a scan for that.
“Those are not standard management but we individualise our patients because not everyone is under health insurance. Many pay out of their pockets so the doctors may want to use risk factors to screen the patients,” he said.
He also noted that due to the financial constraint of many families, some facilities sometimes only offer scan services to women with high-risk pregnancies.
Speaking with UK’s Daily Mail, a sonographer, Kate Richardson stated that women need at least seven scans throughout their pregnancy. These scans potentially help avoid unnecessary trauma and the need for emergency C-sections.
She said, “More scans could mean complications are spotted early — including birth defects, abnormalities and the position of the baby before birth.”
According to a study titled Attitude of Expectant Mothers on the Use of Ultrasound in Pregnancy in a Tertiary Institution in South East of Nigeria, the attitude of Nigerian women toward sonography is good. The study, however, says 60 per cent of the women said the test was costly.
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