Click here to read It’s no fun having an Ultrasound at the IWK at Halifax.OpenFile.ca
Carly Butler, 21 weeks pregnant with her first child, felt “like a slab of meat” sitting on the ultrasound table on the first floor of the IWK’s Diagnostic Imaging Ultrasound Department waiting room.
The experience was negative from the start; Butler says when she entered the first-floor waiting room, “There were notices everywhere telling you what you can’t do.” The signs say patients won’t be provided with photos, won’t be told the sex of their baby and ask patients not to ask any questions because the sonographer must focus carefully while performing the exam. “It’s a little cold and intimidating,” says Butler.
During her third ultrasound, Butler thought she’d be more prepared for what to expect, but, she says, “it was even worse than the first time.” The technician gave Butler and her partner a big lecture about the technicality and difficulty of what she was doing, and told them not to talk to her or ask questions.
Butler says when the technician was measuring the baby’s head and she asked how big it was, the response was “I told you I wouldn’t answer any questions.”
“It was at that point the whole experience really started to upset me because I felt like the whole atmosphere is one where you’ve done something wrong…like this pregnancy is a bad thing and therefore you don’t have any rights over the child,” she says. “You’re not allowed to know anything about it and I just felt like a kind of slab of meat lying there.”
“The lack of any conversation or human interaction at all makes you feel they would rather you were drugged and knocked out and put through on a conveyer belt and then they wouldn’t have to deal with this problematic mother who is harbouring this fetus.”
Jocelyn Vine, VP of patient care at the IWK (short, of course, for Izaak Walton Killam), says ultrasounds in the first-floor DIU department are not detailed, but look for issues related to the overall health of the fetus. Obstetrical ultrasounds—the ultrasounds they do in the DIU—are performed by registered ultrasonographers, who send them off for interpretation.
And the reason mothers are told they can’t know the sex of their baby, ask questions during the exam, or have a picture from the DIU is because the sonographers need focus to do the exam properly and because it goes against Health Canada’s suggestions—implying that asking those questions could jeopardize their baby or the exam. The IWK’s guidebook says no cameras, recorders, or family members are allowed, other than one mature (over 12) family member.
That doesn’t explain why all the sour faces, though.
Butler was told different reasons why she couldn’t get a picture of her baby. The woman at the front desk told her in the past people could get a CD for $50 but the machine was broken. The technician told her they just didn’t provide pictures and didn’t give an explanation. When Butler asked if she could learn the sex of the baby at her next appointment, “I was made to feel like I was being really high maintenance and they said if you really have to know you can go privately, but you’ll pay through the nose—as if this was a really weird request.”
Butler’s second ultrasound was on the seventh floor—the Fetal Assessment Treatment Centre, a unit for patients with higher risk of complications that provides more in-depth, detailed exams. There are no signs warning a patient not to ask questions or telling them what information they won’t get, and there is no mention of Health Canada guidelines. There is a sign saying that patients may purchase a picture of their unborn child. Butler asked questions, had them answered, and was generally content. Ultrasound photos were offered free of charge, without even having to ask, Butler says.
On the seventh floor, Vine says, the baby’s sex is determined and noted during an exam that takes extra time. A fully trained maternal fetal specialist physician does part of the exam. On the first floor, she says, “we have to use every minute of time that we have on the machine and with the ultrasonographers to focus on the real health aspect.” Patients need to have their ultrasounds on specific dates, as recommended by their obstetrician and to spend time discovering the baby’s gender could throw their schedule off—backlogging other appointments, she says. “It really does come down to using resources to the best advantage from a health perspective,” says Vine. “Cost is always a concern for us.”
Before 2002, all women at the IWK had the option to know the sex of their baby and buy a picture. However, Vine says that because of the increase in women who go for routine ultrasounds, time constraints are a big issue. “That really is what is driving the situation,” she says.
Vine didn’t mention Health Canada Guidelines and the need not to talk or ask questions in the exam room, and, in terms of the information mothers receive, told OpenFile “I’m not familiar with the materials lately, so we can look at that to see if there’s anything in the handouts that can be changed to reflect that better.”
Butler says she understands why she can’t be told any specific medical information but, “not why that has to translate into complete robotic silence [in the exam room].”
“Surely there’s some kind of middle ground. And so I just started to cry,” she says of her third ultrasound, “the whole thing was just so horrible, I was just lying there sobbing and [the technician] still didn’t say a word. Nothing.”
Have you had a similar experience at the IWK? Or does this sound like a worst-case scenario? Do you work at the IWK and want to better explain your side of the story? Comment below, and we’ll get back to you