The worrying reality in South Africa is that some pregnant women are not fully aware of a series of vital prenatal tests that can alert them to any possible birth complications or abnormalities. So says Sister Nikiwe Mabuza from Philips Mother and Child.
They are usually more informed about the normal prenatal tests which include blood tests to determine your blood type, iron level checks, blood glucose level checks and testing your Rh factor, she says.
Another potential reason why many South African pregnant women are not having these tests done is that local municipal clinics do not offer these services. However, public or state hospitals do cater for these tests, but they are only performed if the pregnant woman is “at risk”.
Still, it is imperative that these tests are performed to ensure a proper diagnosis, and to rule out any possible health risks, abnormalities or birth defects which can ultimately put both the mother and unborn child at risk.
Here are the five vital checks that you should be aware of when pregnant
• First trimester prenatal screening test: Many women find out that they are pregnant at home with a home pregnancy test. While the test can confirm pregnancy, it is essential that you book an appointment with your doctor to confirm the pregnancy via a blood test. An ultrasound also needs to be done to find out how far along you are and rule out any possible complications that may arise.
• Second trimester screening test: At this stage of the pregnancy there are several blood tests, called multiple markers, that need to be done.
These markers provide information about a woman's risk of having a baby with certain genetic conditions or birth defects. Screening is usually performed by taking a sample of the mother's blood between the 15th and 20th week of pregnancy (16th to 18th is ideal).
- An amniocentesis procedure: An amniocentesis procedure is done during a women’s 15th and 20th week of pregnancy on women who are at increased risk for chromosome abnormalities. These women include those who are over 35 years of age at delivery, or those who have had an abnormal maternal serum screening test, indicating an increased risk for a chromosomal abnormality or neural tube defect. Here a small sample of the amniotic fluid that surrounds the fetus is obtained to diagnose chromosomal disorders and open neural tube defects (ONTDs), such as spina bifida.
- Chorionic villus sampling (CVS): This is a prenatal test that involves a sample of the placental tissue.
This tissue contains the same genetic material as the fetus and can be tested for chromosomal abnormalities and some other genetic problems. Testing is available for other genetic defects and disorders depending on the family history and availability of laboratory testing at the time of the procedure.
- A glucose tolerance test: Usually conducted in the 24th to 28th weeks of pregnancy, this measures levels of sugar (glucose) in the mother's blood. Abnormal glucose levels may indicate gestational diabetes which could result in several further complications.
What are the typical costs involved?
The different models of antenatal care in South Africa range from government supported (where services are delivered free of cost); to private antenatal health care which is delivered by a medical practitioner (GP, obstetrician) or midwife.
“It is difficult to generalise about costs, but the full suite of tests can cost around R1 500, dependent on the number of tests performed and where the patient goes for the service. The consultation and doctors’ fees come in over and above this. With institutions like The Birthing Team, women can book an all-inclusive first assessment that covers the necessary tests as well as the consultation and an education session with both a midwife and an obstetrician for R1 999,” says Dr Howard Manyonga, obstetrician/gynaecologist and head of The Birthing Team.
“Shared care, where the woman is cared for by both a medical practitioner and a midwife, or a team of independent (private) midwives, is appropriate for a healthy mother with an uncomplicated pregnancy.
“In South Africa, couples who have the benefit of medical insurance, often choose the private health care option where services are rendered by an obstetrician (a medical practitioner who specialises in normal and complicated conditions of pregnancy and women’s health),” Mabuza explains.
Whether or not your medical aid option will cover these costs however is dependent on the type of cover one and what medical aid package you have.
“To clarify this, you should enquire with your medical aid as to what it covers and what it doesn’t during pregnancy. Ideally, this discussion should happen when you take out a plan with your preferred company as each medical scheme provides different pregnancy benefits and cover,” says Mabuza.
“Antenatal care is an essential part of the pregnancy and should start when the pregnancy is diagnosed to monitor it and troubleshoot any potential problems. Sticking to appointments are essential to determine if the baby is healthy and if the pregnancy is progressing well. And of course, the absolute best part of an antenatal visit is hearing the heartbeat and getting a visual ‘sneak peek’ at your growing little one during an ultrasound,” Mabuza says.