“High Risk”

I’ve been meaning to write a post about Canada’s healthcare system, at least from my limited experience, but I don’t quite know where to begin.  And I’m not sure my experience is even reflective of the system as a whole or just here in Québec/Montréal.  Or due to the fact that I arrived here very late in the game.

One of the first things we had to do after arriving in Montréal was apply for Medicare, which is the public health insurance.  Even without being approved (which can take up to 3 months), Hubby and I were each given a letter stating that we had started the application process and that certain things were covered automatically, including my pregnancy.  With this letter, I could get all the prenatal care I needed for free.  Score 1 for Québec.

Getting coverage was the easy part, it turns out.  I’ve already written a bit about my experience with the process of getting in to see an OB.  My first appointment moved relatively quickly, compared to subsequent appointments.  My doctor schedules pregnant women on Tuesdays and Fridays, and each of those days is booked solid.  She told me at my second appointment (which was one of the last of the day) that she’d seen 50 women that day.  It seemed to me that half of them were still there when I showed up for my 1:30 appointment.  This week, I waited over 3 hours to see the doctor.

What I was not told at that initial appointment is that I am responsible for transporting my own urine.  A week later, when asked if I had brought it, I’m sure I looked completely dumbfounded.  At which point, I was instructed that, for all future appointments, I was to pee in a cup (which I was to obtain from a pharmacy) at home and bring it with me.  I would then open the container, the receptionist would stick a test strip into it, and the cup, with my urine still in it, would remain in my possession.  My sister was horrified when I shared this little detail with her.

Then there’s all the testing and re-testing I’ve had to undergo.  Part of it was perhaps due to the fact that my medical records from my previous practitioner seemed to be incomplete, and part of it was my doctor being extra-thorough.  Even though I passed the 1-hour glucose screening with flying colors back at the end of December, my new doctor sent me back to have it done again.  And this time, apparently my numbers came back high.  Not that I would know because they use a totally different scale here.  Stupid metric system.

So I had to go back this morning for the glucose tolerance test.  Since I never had to do it in the US, I’m not sure if it’s really different here, but I was expecting the testing to take three hours.  It only took two.  So that was a plus, I guess, but other than that, it sucked.  When I arrived at the hospital lab at 7:20 this morning, it was already packed.  My number was 69.  There were hardly any seats available in the crowded waiting room, including the overflow row of chairs in the hallway outside.  I did manage to snag one, and even if I hadn’t, I probably would have asked someone else to move, what with being nine months pregnant and starving, since I wasn’t allowed to eat anything before the test.

And I was already thinking, what’s the point, really?  Even if I do have GD, what good does it do me to learn this fact a week before my due date?

But I was already there, and I wasn’t about to get on my doctor’s bad side by disobeying her instructions after she was kind enough to take me on as a patient at the last minute.

So I waited.  I waited for an hour after I first arrived before I was able to have my initial blood draw and down yet another bottle of that nasty drink.  Then I waited some more.  I had remembered to bring books, and there were a couple of places outside the craziness of the lab’s waiting room where I could sit in relative peace, so the time passed fairly quickly.  I had my second blood draw, at which point the numbers being called were nearing 200, then another hour later, the third.  Then I scarfed down two cheese sticks before hoofing it back to the metro station and home.

The other thing my doctor had asked me to do at yesterday’s appointment was schedule a non-stress test (NST).  Because, according to her, my pregnancy is “high risk.”  Because it’s the result of IVF.

Now, maybe she’s just old-fashioned.  Maybe she’s uneducated about IVF (which is odd, considering Québec is the only province that actually covers fertility treatment).  Or maybe I now understand where her receptionist got the nerve to ask if I didn’t have “five or six in there.”  But this statement pissed me off.  My pregnancy has been blessedly uneventful thus far.  I’ve passed every scheduled test (up until two weeks ago) with ease.  I’ve had no complications.  No bleeding.  No indication of any kind that this pregnancy is anything other than “normal.”  And now she’s labeling me “high risk.”  Why?  Just because this baby wasn’t conceived the easy (and cheap!) way?

Not that it matters for the time being.  I tried calling to schedule the NST (twice), left a voicemail, and haven’t received a call back.  Maybe I’ll hear back and maybe I won’t.  Maybe they’ll squeeze me in before I go into labor.

I still have no idea about when that might happen.  Dr. K finally checked my cervix yesterday and proclaimed that it’s “starting to open up.”  But I have no idea what that means.

All I know is I don’t have any appointments scheduled for tomorrow.  No labs.  No tests.  And for that, I am grateful.

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18 thoughts on ““High Risk”

  1. I am so sorry that this has been your experience with the Canadian health system. I am a staunch defender of it because it’s accessible to everyone and I think it’s really awesome. I’m shocked to hear what you’ve been through so far. The wait times for tests, unfortunately, are pretty standard, but having to tote around your pee? That’s ridiculous and nothing I’ve ever heard of before. The attitude your doctor has towards IVF is crazy, too. Again, I really don’t believe that this is typical of our health system. Granted, I’m in Ontario, not Québec, but still…

    I hope your hospital experience is better. Based on what I’ve read, the hospital has an excellent reputation. You should receive great care there.

    Good luck! So exciting to think the wee little babe is going to be here soon!

    • Yeah, I’m looking forward to delivering at this hospital. I think I’ll have a good experience there.

      The wait times don’t bother me too much, and I LOVE that everything is covered, especially getting here so late in my pregnancy! But the whole pee thing…kind of grosses me out!

  2. Wow, that urine thing is pretty weird.

    I’m American and have had experience with the Irish health system. My experience? It’s inferior to the US system – longer waits, etc. But it’s accessible to everyone. I can’t stand thinking about all the sick people in this country who cannot receive care. It just seems so incredibly wrong.

    Hope things go smoothly for you from here on out!

    • I’m super grateful that my pregnancy and delivery are covered here, especially since we got here so far into it. And I do think everyone should have access to health care. The US healthcare system is so screwed up, but I guess every system had its flaws, even the ones that cover everybody.

  3. I had some shitty experience with the UK health system as well – I had to push to get what in the US is an annual exam and a good thing too, because the exam came back with bad results and I nipped something in the bud that could have been really bad.

    That being said, it covers all, so…yeah. Mixed bag.

    This may be somewhat controversial, but my RE, who was/is a very cautious man, told us he considers any pregnancy after IVF “higher risk,” although not “high risk.” There are greater risks of Pre-e and prematurity. They are still low, but higher enough to warrant caution, he thought. So I wonder if your ObGyn is of that cautious school?

    • I think she’s just old school. It makes me wonder how many other IVF patients she’s had and what her experiences with those patients might have been. Actually, she’s not the first doctor to suggest I’m high risk just because of IVF since I got here. It just throws me off because this pregnancy has been so boring (in a good way!) up until now, and I still don’t feel like there’s anything to be concerned about just yet. The results of the GTT may or may not change that.

  4. Yup that would definitely piss me off too. And co aidering that i’ve been especially bitchy lately, it would’ve taken everything in me not tosnap. So i applaud you for keeping it together and i’m sure thumper will too because like you said you’ll need to stay on that doctor’s good side, at least for the next week or so!

    • Yeah, my hormones are having the opposite effect on me. I’m super weepy. Seriously, anything can make me cry! So if I do end up getting news of GD or some other complication, watch out–that’s when I’ll probably lose it.

  5. Part of my job is to attend ‘high risk’ deliveries, and I can tell you that here in the frozen north, they set the bar for high risk pregnancy pretty low. Failing your glucose tolerance test just might be enough, depending on the policies of the hospital you are delivering at. And if it gets you some extra testing to ensure that all is going well in there? That’s not a bad thing. If you do have GD, knowing that, even at this late stage, will help your doc make appropriate decisions while you are in labour- the threshold for c-section may be a bit lower, etc. it really is good information to have.

    I have certainly never heard of anyone having to transport their pee in from home. Very odd. Did they at least give you a sterile container? I always just drank some water on my way to the mid wife’s office, and peed on a stick when I got there.

    It sounds to me like your OB is cautious. That’s a good thing. I think you’ll continue to find that in the Canadian healthcare system, physicians tend to err on the side of over-testing rather than under-testing… It’s costly to the system, but when they find something wrong, trust me-you’re eternally grateful that they are thorough.

    • I can certainly understand being cautious–if I were showing any signs of pre-eclampsia or had a diagnosis of GD. It just seems silly to me to take IVF alone and make that the criteria for labeling me high risk. I guess I shouldn’t complain too much, though. At least I get another check on baby girl.

      And, yes, I did get a sterile container from the pharmacy. It’s still weird, though.

  6. See, the wait time would bother me a great deal, even though it’s free medical care. If you’re brave enough, you could discreetly slip a copy of some information to update their approach to and attitude towards IVF pregnancies.

  7. The pee thing is weird. The cups and sticks were always available to me at the MFM’s office. It’s also weird that they are making you do the GD test again. I had to do one early bc I’m plus-size (don’t get me started) and then repeat at 26 weeks. I squeaked by with a pass and they never sent me again. I would have smacked the IVF-ignorant receptionist for sure. Or said something snarky like “yes, bc it’s not funded where I’m from, I wanted my Brady Bunch in one shot.”

  8. I know how frustrating it can be to be labeled as “high risk,” especially if you feel as if everything has been going swimmingly. I don’t understand the high-risk-just-because-of-IVF thing, but who knows. I now have to have twice weekly NSTs up until delivery because of 100% under-control chronic hypertension (since before pregnancy.) Not ideal, but I am trying to see the positive in it. If the baby is under any distress, the doctor will know immediately and be able to intervene. Hopefully you don’t have too much longer to go though!

    • Yeah, I’m trying to see all this extra testing in a positive light–more opportunities to make sure baby’s okay. But it is weird to me, especially because my midwife in the US was so laid back about everything and kept telling me everything was perfect. Hopefully just a week or two to go!

  9. Pingback: Throwback #MicroblogMondays | Something Out of Nothing

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