Carrie and Anthony Petruso’s Guatemala Adventure

Clinics near and far

written by Anthony

Friday July 10thWe traveled back to the same Alelsi clinic of the previous day, but this time dealt predominately with prenatal care.   The purpose of prenatal care is pretty obvious, to try to identify the “saboteurs” of pregnancy to get the best outcome for the mother and baby.  In the US, this involves a somewhat dizzying slew of screening tests (RPR, Rubella titer, HIV, GC, Pap, UA, H/H,  triple screen to name a few) with about 16 different visits to a physician before birth for a normal, healthy woman.  While prenatal care in general is one of the most cost-effective area of medicine, the particular cost-effectiveness and utility of the type of approach used in the US is questionable.  Obviously things are done a lot differently in the clinics we work at, and while the care we can provide is nowhere near as comprehensive as in the US the idea is to maintain effectiveness while being efficient and working within our restraints.  Only basic screens are available to identify anemia and urinary infections, other things would only be treated or checked for if there was a specific reason to.  However, ultrasound is readily available and this is really quite useful. A quick peak at the baby’s head, heart, and spine allow us to estimate delivery dates, ensure adequate growth and heart function, check for twins and make sure that the baby will be coming out head first. If these things aren’t lining up right, then we may recommend that the women head to Hospital Santa Elena where she can deliver with obstetricians present.  Pretty much everyone we see, however, will deliver at home with traditional midwifes and this usually won’t be any sort of a problem.

Ok, it’s sleepy time.