Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
And now we have spoken through the week to women
who say that they've been unable to book scans while pregnant,
some traveling to Catherine for scans as they're going through
the public system and have been unable to get in
here in Darwin and Palmerston. Now we spoke to a
Catherine's sonographer yesterday who said the average of around ten
patients a week is going to Catherine for scans at
(00:21):
the moment. Now joining me on the show is doctor
Jeremy Chin, the co director of Obstetrics and Gynecology from
nt Health. Good morning to you, doctor Chin.
Speaker 2 (00:32):
Hi, how are you going?
Speaker 1 (00:33):
Yeah, really good, Thank you so much for your time
this morning. Now, can you tell us at what stages
are scans needed for pregnancy?
Speaker 2 (00:41):
Yeah, that's a great question, and I think the reality
for many women who are on their pregnancy journey at
the moment is that they'll have a number of scans
throughout the pregnancy, even if it's low risk, even if
it's uncomplicated. And these are all recommended scans, and the
first one will usually be, you know, after they've seen
GP with a positive pregnancy test, either a blood or
(01:03):
urine test, and that'll be really to confirm that we've
got one baby inside the womb, that it's growing and
developing well, and we can measure the baby there to
see that it's got the right size for the gestation,
so we can accurately assess when the baby was conceived
and therefore when it's likely that the baby might be born.
But the next one after that will be that sort
(01:25):
of around the twelve week scan to check the thickness
of the back of the neck, and that will be
offered to women who are pregnant by their GP and
it will be not all women will choose to have it,
but many many women will choose to have it because
it can contribute and can be part of a risk
assessment with blood tests for things like Down syndrome and
(01:46):
other chromosomal changes and variations. So that would be the
next one. Most women after that would probably have one
or two more ultrasounds, and the most common one would
be what we call the anomaly or the anatomy scan
at about twenty weeks gest station the middle of pregnancy.
You get to see the hands, the feet, You get
to get a nice profile of the baby. Often that's
(02:08):
where the baby photos come from. You get an idea
whether you're having a baby of the male or the
female sex with some level of accuracy. But it's really
to look at you two arms, two legs, heart, lungs, liver,
bow in all those kinds of very detailed things that
we can see now on ultrasound.
Speaker 1 (02:27):
Now, doctor Chin, if you go through the public system,
are those scans, when are those scans conducted? And where
do they happen?
Speaker 2 (02:37):
Yeah? Yeah, And that's a really good question that there's
a clear transition from primary health care into the public system,
which people would be used to thinking of as coming
to the hospital or coming to the anti natal clinic
with their scans. And so when we see people who
are pregnant, it's often at about fourteen to sixteen weeks pregnant,
(02:59):
So they've already had their routine blood tests done by
their GP, they've already had their scans done by their GP,
if that's what they've chosen to do. And for us,
it's about making sure that everything's going well for their pregnancy,
making sure we can dot all the eyes and cross
all the t's, planning for the rest of their pregnancy,
and booking in their twenty week scan. And for those
people who come through our public clinics at Royal Darwin Hospital,
(03:20):
for example, will offer them that service publicly through either
our ultrasound departments located in Royal Darwin Hospital and Palmerston Hospital.
The slip can also be used. The referral slips can
also be used at a private radiology center because some
women may find that it's more convenient for them, it's
open at better times, or they might have a have
(03:41):
already met an ultrasound specialist too they really connect with
And that's perfectly fine too with.
Speaker 1 (03:47):
Obviously, I mean, we've had quite a few pregnant moms
get in contact with us over the last couple of
weeks about their concerns with not actually being able to
get in for those scans. People that are going through
the public system that are saying, you know, they're due
for their twelve week scan, but it's being delayed a
number of weeks.
Speaker 2 (04:06):
Yeah, And I think that that that handover from the
public primary care system with their GPS, where people would
normally be referred to a private provider to get that
new coal translucency, that twelve week specialist scan done, which
is only accredited in the private systems at the moment
is really that transition. So we would expect when women
(04:26):
are coming to us that that they've had that opportunity,
they've been offered that appointment, they've had time to find
a provider, a private provider of their choice.
Speaker 1 (04:36):
What happens if they can't, Because that's been the biggest
concern is that for some of these expectant mums that
they're really quite worried that if they can't actually do that,
you know, that they're not going through all the all
the processes that they feel they should be.
Speaker 2 (04:52):
Yeah, yeah, and that that can be a considerable source
of anxiety. I think we should acknowledge that often bat
you know, for women who are undertaking their first pregnant,
but even second, third, fourth pregnancies, it is a time
when there's a lot more change and you know, there's
always another test to be offered. I think there's a
couple of things to say there. This is an issue
that's faced nationally. So the concept that women are seeing
(05:14):
their GPS and being offered a twelve week nucle scan
in the private system is across jurisdictions. Queensland, South Australia,
the Northern Territory included in Western Australia, and so the
access to public hospital nucle translucency scans where they're available
is only for very high women with specific high risk categories,
(05:37):
and there are a very very small number of people.
Most of the women who are coming through our service
for a young, fit, healthy for example, so they wouldn't
qualify whether they would be in the NT in Queensland
or in Victoria for example. The twelve week scan itself
has become a much more complex area and gps are
getting increasingly skilled and knowledgeable in this area, and so
(05:59):
a lot of the twelve week scan will be able
to show us the thickness at the back of the
neck and we'll be able to see the baby's anatomy.
But a lot of people are actually also having that
scan to help them make decisions about the risk of
chromosomal changes. And there are other chromosomal changes tests that
we can do non invasive prenatal testing from a blood
test which is available in the private system at the
(06:20):
moment as well, that I think some of your listeners
and women in the NT are accessing.
Speaker 1 (06:25):
Yeah, well, and I guess the big concern here from
a lot of women is that if they're not actually
able to get in for those scans. Is there going
to be a risk to their unborn child?
Speaker 2 (06:36):
Yeah, And I think that the answer is that the
scan itself doesn't pose any risk, and not having the
scan also doesn't pose any risk. But it does change
things because it's less information that people will have to
make decisions about how their pregnancy will be going forward.
And the state of the art for obstetric care is
really antiinatal care has been turned on its head. We're
(06:58):
learning more and more and this is translating research into
practice of not quite here landed on you know, in
mainstream care yet. But I think in the future we
are going to be seeing a push towards earlier scans,
earlier tests, so that women can make choices about how
their pregnancy is going to go. And also we can
start therapeutics to radically change the way pregnancies are going,
(07:20):
for example, reducing their risk of pregnancy related complications from
high blood pressure, et cetera, et cetera. So I think
we should watch this space absolutely, and there's definitely something
to do for all of us, you know, as obstetricians,
as maternity services, care providers, and as a nation to
try and help risks, sertify care for women so that
(07:42):
their journey throughout pregnancy can be as positive as possible.
Speaker 1 (07:45):
So, Doctor Chin, from what I can gather from what
you are saying at this point in time, the women
that are struggling to get a scan, it's not through
the health department where there are delays, but it's through
them trying to book in for those scan through private practices.
So maybe we don't have enough sonographers.
Speaker 2 (08:04):
Yeah, I think, you know, we have a fantastically skilled
group of sonographers at the hospital. We're very lucky to
have them and they're a very value part of the workforce.
They do fantastic work and I'm hoping that many of
your listeners when they go through their pregnancy scans are
lucky enough not to meet them, because they're obviously reserved
for very high risk cases. But generally we're seeing, you know,
(08:27):
in the workforce, and you'll see this around Australia. There's
been a change in the workforce dynamics and it seems
clear from the access that your listeners and other women
are having in the NT but also in other jurisdictions
that it's affecting the private sphere.
Speaker 1 (08:42):
Now I have just received a message from one of
our listeners from Rachel and it says, good morning, Katie.
Regarding ultrasounds, I'm experiencing the same issue. We've got a
referral from our GP for urgent US for early pregnancy
dating scan viability called territory X ray and DPHI. I
met and was advised for urgent appointment. The waitless time
(09:04):
would see us getting seen at the end of November.
Had to turn up and literally wait at DPH for cancelation.
Have had a complex history with our first pregnancy resulting
in the still birth of our son in the late
third trimester, have undergone eighteen cycles of IVF following our
son's death, and spontaneously became pregnant after seven years of trying.
(09:25):
Despite pregnancy history and PTSD and anxiety. We still have
to sit and wait to see if this pregnancy is viable.
And I mean, that's a really difficult, difficult situation for h.
Speaker 2 (09:40):
That's message to here, arrible posision to be in. And
I think it's really important that we really make a
distinction here about services available for complicated or high risk
pregnancies for which our public service is always available and
low risk and otherwise uncomplicated pregnancies. So for those people
experience a complication of pregnancy in the first trimester, we
have an early pregnancy service at Royal Darwin Hospital. Next
(10:02):
day bookings are usually available from Mondays to Fridays. We
have a session running right now actually, and for women
who have had previous complications. This is a journey. This
war from what you're reading, and Rachel, I'm really really
sorry that this is something you've experienced. You know, this
is this is not you know, a low risk pregnancy.
I think anybody would would would agree with that, and
(10:24):
so the public service would absolutely be available and for
all GPS I think who might also be listening. Our
anti natal clinic referrals are absolutely open for these high
risk pregnancies, for counseling, for discussions and for services in
first trimester for complications high risk absolutely.
Speaker 1 (10:42):
Doctor Chin. Before I let you go, I mean, what
is your advice for territory mums this morning, For the
number of mums that have been in contact with us
who are really quite worried about not being able to
get in for you know, for various scans and feeling
a bit uneasy about this whole process. Some going to
the extreme of traveling all the way to Catherine.
Speaker 2 (11:02):
Yeah. So the first thing I'd say is if you
if you're experiencing a complication of pregnancy, our doors are
always open. So for example, if you're expecting that you're pregnant,
you haven't had a scan yet, and you've got pain
or bleeding from the vagina, I'd absolutely encourage you to
connect with our services, either through your primary health provider
(11:24):
or in the case of emergency, through our emergency department.
That's the first thing. The second thing is for those
people with high risk pregnancies, I definitely encourage you to
go and see your GP and ensure that your GP
has put through the appropriate referral flagging the high risk
nature of your pregnancy to our anti natal clinic where
we not undergo our normal triaging processes. I think the
(11:44):
other thing is to think about avoiding delays in diagnosis.
So for example, for those people who think they might
be pregnant, Am I maybe pregnant? Could I maybe not
have I missed my period? My period might be coming
a little bit later. Definitely get those beat eight CG
tests done if you're thinking about getting a scan, so
(12:05):
that there isn't a delay to get that referral so
you can get your foot in the door early. And
for most people it's it's ideal that we're getting scanned
around the six weeks seven week mark. But for otherwise normal, young, fit,
healthy young women with uncomplicated pregnancies, it's okay to get
that scan done a few weeks later, seven eight weeks,
for example, nine weeks to get the size of the baby,
(12:27):
to get the dates right, to know exactly what's going on.
There's negligible harm or risk associated with that. I really
wouldn't call it a clinical delay in using those words,
And certainly for those people who who have some stress
and anxiety, I'd like to reassure them that this this
scan by one or two or three weeks is really
(12:48):
something that's part and parcel of how things are going
at the moment, and really we're here to reassure people
that that that's not going to be harmful for them
or their pregnancies.
Speaker 1 (12:58):
Well. MT Health medic called co director of Obstetrics and
Gynecology doctor Jeremy Chin, I really appreciate your time this morning.
I know you're an incredibly busy man, so we appreciate
your time and appreciate you really reassuring the women of
the territory today, no.
Speaker 2 (13:16):
Worries, it's being a pleasure.
Speaker 1 (13:17):
Thank you.
And now we have spoken through the week to women
who say that they've been unable to book scans while pregnant,
some traveling to Catherine for scans as they're going through
the public system and have been unable to get in
here in Darwin and Palmerston. Now we spoke to a
Catherine's sonographer yesterday who said the average of around ten
patients a week is going to Catherine for scans at
(00:21):
the moment. Now joining me on the show is doctor
Jeremy Chin, the co director of Obstetrics and Gynecology from
nt Health. Good morning to you, doctor Chin.
Speaker 2 (00:32):
Hi, how are you going?
Speaker 1 (00:33):
Yeah, really good, Thank you so much for your time
this morning. Now, can you tell us at what stages
are scans needed for pregnancy?
Speaker 2 (00:41):
Yeah, that's a great question, and I think the reality
for many women who are on their pregnancy journey at
the moment is that they'll have a number of scans
throughout the pregnancy, even if it's low risk, even if
it's uncomplicated. And these are all recommended scans, and the
first one will usually be, you know, after they've seen
GP with a positive pregnancy test, either a blood or
(01:03):
urine test, and that'll be really to confirm that we've
got one baby inside the womb, that it's growing and
developing well, and we can measure the baby there to
see that it's got the right size for the gestation,
so we can accurately assess when the baby was conceived
and therefore when it's likely that the baby might be born.
But the next one after that will be that sort
(01:25):
of around the twelve week scan to check the thickness
of the back of the neck, and that will be
offered to women who are pregnant by their GP and
it will be not all women will choose to have it,
but many many women will choose to have it because
it can contribute and can be part of a risk
assessment with blood tests for things like Down syndrome and
(01:46):
other chromosomal changes and variations. So that would be the
next one. Most women after that would probably have one
or two more ultrasounds, and the most common one would
be what we call the anomaly or the anatomy scan
at about twenty weeks gest station the middle of pregnancy.
You get to see the hands, the feet, You get
to get a nice profile of the baby. Often that's
(02:08):
where the baby photos come from. You get an idea
whether you're having a baby of the male or the
female sex with some level of accuracy. But it's really
to look at you two arms, two legs, heart, lungs, liver,
bow in all those kinds of very detailed things that
we can see now on ultrasound.
Speaker 1 (02:27):
Now, doctor Chin, if you go through the public system,
are those scans, when are those scans conducted? And where
do they happen?
Speaker 2 (02:37):
Yeah? Yeah, And that's a really good question that there's
a clear transition from primary health care into the public system,
which people would be used to thinking of as coming
to the hospital or coming to the anti natal clinic
with their scans. And so when we see people who
are pregnant, it's often at about fourteen to sixteen weeks pregnant,
(02:59):
So they've already had their routine blood tests done by
their GP, they've already had their scans done by their GP,
if that's what they've chosen to do. And for us,
it's about making sure that everything's going well for their pregnancy,
making sure we can dot all the eyes and cross
all the t's, planning for the rest of their pregnancy,
and booking in their twenty week scan. And for those
people who come through our public clinics at Royal Darwin Hospital,
(03:20):
for example, will offer them that service publicly through either
our ultrasound departments located in Royal Darwin Hospital and Palmerston Hospital.
The slip can also be used. The referral slips can
also be used at a private radiology center because some
women may find that it's more convenient for them, it's
open at better times, or they might have a have
(03:41):
already met an ultrasound specialist too they really connect with
And that's perfectly fine too with.
Speaker 1 (03:47):
Obviously, I mean, we've had quite a few pregnant moms
get in contact with us over the last couple of
weeks about their concerns with not actually being able to
get in for those scans. People that are going through
the public system that are saying, you know, they're due
for their twelve week scan, but it's being delayed a
number of weeks.
Speaker 2 (04:06):
Yeah, And I think that that that handover from the
public primary care system with their GPS, where people would
normally be referred to a private provider to get that
new coal translucency, that twelve week specialist scan done, which
is only accredited in the private systems at the moment
is really that transition. So we would expect when women
(04:26):
are coming to us that that they've had that opportunity,
they've been offered that appointment, they've had time to find
a provider, a private provider of their choice.
Speaker 1 (04:36):
What happens if they can't, Because that's been the biggest
concern is that for some of these expectant mums that
they're really quite worried that if they can't actually do that,
you know, that they're not going through all the all
the processes that they feel they should be.
Speaker 2 (04:52):
Yeah, yeah, and that that can be a considerable source
of anxiety. I think we should acknowledge that often bat
you know, for women who are undertaking their first pregnant,
but even second, third, fourth pregnancies, it is a time
when there's a lot more change and you know, there's
always another test to be offered. I think there's a
couple of things to say there. This is an issue
that's faced nationally. So the concept that women are seeing
(05:14):
their GPS and being offered a twelve week nucle scan
in the private system is across jurisdictions. Queensland, South Australia,
the Northern Territory included in Western Australia, and so the
access to public hospital nucle translucency scans where they're available
is only for very high women with specific high risk categories,
(05:37):
and there are a very very small number of people.
Most of the women who are coming through our service
for a young, fit, healthy for example, so they wouldn't
qualify whether they would be in the NT in Queensland
or in Victoria for example. The twelve week scan itself
has become a much more complex area and gps are
getting increasingly skilled and knowledgeable in this area, and so
(05:59):
a lot of the twelve week scan will be able
to show us the thickness at the back of the
neck and we'll be able to see the baby's anatomy.
But a lot of people are actually also having that
scan to help them make decisions about the risk of
chromosomal changes. And there are other chromosomal changes tests that
we can do non invasive prenatal testing from a blood
test which is available in the private system at the
(06:20):
moment as well, that I think some of your listeners
and women in the NT are accessing.
Speaker 1 (06:25):
Yeah, well, and I guess the big concern here from
a lot of women is that if they're not actually
able to get in for those scans. Is there going
to be a risk to their unborn child?
Speaker 2 (06:36):
Yeah, And I think that the answer is that the
scan itself doesn't pose any risk, and not having the
scan also doesn't pose any risk. But it does change
things because it's less information that people will have to
make decisions about how their pregnancy will be going forward.
And the state of the art for obstetric care is
really antiinatal care has been turned on its head. We're
(06:58):
learning more and more and this is translating research into
practice of not quite here landed on you know, in
mainstream care yet. But I think in the future we
are going to be seeing a push towards earlier scans,
earlier tests, so that women can make choices about how
their pregnancy is going to go. And also we can
start therapeutics to radically change the way pregnancies are going,
(07:20):
for example, reducing their risk of pregnancy related complications from
high blood pressure, et cetera, et cetera. So I think
we should watch this space absolutely, and there's definitely something
to do for all of us, you know, as obstetricians,
as maternity services, care providers, and as a nation to
try and help risks, sertify care for women so that
(07:42):
their journey throughout pregnancy can be as positive as possible.
Speaker 1 (07:45):
So, Doctor Chin, from what I can gather from what
you are saying at this point in time, the women
that are struggling to get a scan, it's not through
the health department where there are delays, but it's through
them trying to book in for those scan through private practices.
So maybe we don't have enough sonographers.
Speaker 2 (08:04):
Yeah, I think, you know, we have a fantastically skilled
group of sonographers at the hospital. We're very lucky to
have them and they're a very value part of the workforce.
They do fantastic work and I'm hoping that many of
your listeners when they go through their pregnancy scans are
lucky enough not to meet them, because they're obviously reserved
for very high risk cases. But generally we're seeing, you know,
(08:27):
in the workforce, and you'll see this around Australia. There's
been a change in the workforce dynamics and it seems
clear from the access that your listeners and other women
are having in the NT but also in other jurisdictions
that it's affecting the private sphere.
Speaker 1 (08:42):
Now I have just received a message from one of
our listeners from Rachel and it says, good morning, Katie.
Regarding ultrasounds, I'm experiencing the same issue. We've got a
referral from our GP for urgent US for early pregnancy
dating scan viability called territory X ray and DPHI. I
met and was advised for urgent appointment. The waitless time
(09:04):
would see us getting seen at the end of November.
Had to turn up and literally wait at DPH for cancelation.
Have had a complex history with our first pregnancy resulting
in the still birth of our son in the late
third trimester, have undergone eighteen cycles of IVF following our
son's death, and spontaneously became pregnant after seven years of trying.
(09:25):
Despite pregnancy history and PTSD and anxiety. We still have
to sit and wait to see if this pregnancy is viable.
And I mean, that's a really difficult, difficult situation for h.
Speaker 2 (09:40):
That's message to here, arrible posision to be in. And
I think it's really important that we really make a
distinction here about services available for complicated or high risk
pregnancies for which our public service is always available and
low risk and otherwise uncomplicated pregnancies. So for those people
experience a complication of pregnancy in the first trimester, we
have an early pregnancy service at Royal Darwin Hospital. Next
(10:02):
day bookings are usually available from Mondays to Fridays. We
have a session running right now actually, and for women
who have had previous complications. This is a journey. This
war from what you're reading, and Rachel, I'm really really
sorry that this is something you've experienced. You know, this
is this is not you know, a low risk pregnancy.
I think anybody would would would agree with that, and
(10:24):
so the public service would absolutely be available and for
all GPS I think who might also be listening. Our
anti natal clinic referrals are absolutely open for these high
risk pregnancies, for counseling, for discussions and for services in
first trimester for complications high risk absolutely.
Speaker 1 (10:42):
Doctor Chin. Before I let you go, I mean, what
is your advice for territory mums this morning, For the
number of mums that have been in contact with us
who are really quite worried about not being able to
get in for you know, for various scans and feeling
a bit uneasy about this whole process. Some going to
the extreme of traveling all the way to Catherine.
Speaker 2 (11:02):
Yeah. So the first thing I'd say is if you
if you're experiencing a complication of pregnancy, our doors are
always open. So for example, if you're expecting that you're pregnant,
you haven't had a scan yet, and you've got pain
or bleeding from the vagina, I'd absolutely encourage you to
connect with our services, either through your primary health provider
(11:24):
or in the case of emergency, through our emergency department.
That's the first thing. The second thing is for those
people with high risk pregnancies, I definitely encourage you to
go and see your GP and ensure that your GP
has put through the appropriate referral flagging the high risk
nature of your pregnancy to our anti natal clinic where
we not undergo our normal triaging processes. I think the
(11:44):
other thing is to think about avoiding delays in diagnosis.
So for example, for those people who think they might
be pregnant, Am I maybe pregnant? Could I maybe not
have I missed my period? My period might be coming
a little bit later. Definitely get those beat eight CG
tests done if you're thinking about getting a scan, so
(12:05):
that there isn't a delay to get that referral so
you can get your foot in the door early. And
for most people it's it's ideal that we're getting scanned
around the six weeks seven week mark. But for otherwise normal, young, fit,
healthy young women with uncomplicated pregnancies, it's okay to get
that scan done a few weeks later, seven eight weeks,
for example, nine weeks to get the size of the baby,
(12:27):
to get the dates right, to know exactly what's going on.
There's negligible harm or risk associated with that. I really
wouldn't call it a clinical delay in using those words,
And certainly for those people who who have some stress
and anxiety, I'd like to reassure them that this this
scan by one or two or three weeks is really
(12:48):
something that's part and parcel of how things are going
at the moment, and really we're here to reassure people
that that that's not going to be harmful for them
or their pregnancies.
Speaker 1 (12:58):
Well. MT Health medic called co director of Obstetrics and
Gynecology doctor Jeremy Chin, I really appreciate your time this morning.
I know you're an incredibly busy man, so we appreciate
your time and appreciate you really reassuring the women of
the territory today, no.
Speaker 2 (13:16):
Worries, it's being a pleasure.
Speaker 1 (13:17):
Thank you.
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