2015年3月1日日曜日

Going to Prenatal Checkup

After having a hard time making the appointment with the obstetrician, 
I was told to go to the doctor’s office, not the hospital, for the first visit.

The waiting room was bright, clean and cozy. It reminded me of a 
dentist’s office.
When my daughter found the big basket with snacks and drinking water, 
she was so happy.
The receptionists and nurses were pleasant, and I was led to 
the consultation room without waiting.

Good! So far, better than I expected.

The doctor was a beautiful woman, thirty-something with long brown hair.
We shook hands lightly and started to talk. 

As I had feared, 
I couldn’t understand her English at all…

New Yorkers’ English is very fast, and it’s famous for being difficult 
to understand, especially for foreigners. 
To make matters worse, I’m having a hard time in my everyday conversation. 
I couldn’t catch even the vocabulary  full of technical terms, in her English.

Though I was confused and didn’t even have an idea what I needed to ask, 
the conversation was finished.

After that I was told go to another room and lie down on the bed. 
As the doctor started to examine my uterus, I saw something on the small 
screen beside on the bed.

“ Wow, I’m surely having a baby! ” I said excitedly. 
“ Yes, you are,” she said calmly with gentle smile.

After the consultation, she asked me, 

“Any questions?”
“No, fine. Thank you.” 

I answered with a fuzzy smile on my face; it’s a bad habit common 
among Japanese. 

We are brought up not to show our true emotions, 
and I wanted the doctor to think I understood everything. 
So we smile.

Oh, No…I’m so bad. What am I doing?!

For myself and my baby and our relationship with the doctor, 
I have to prepare well next time. 

I thought everything was done for the day, but it was not. 
A big nurse with pink nails led me to another room to take my blood samples.
She took them very speedily and lined up the test tubes in a row, 
one after another. 
When she stuck the fifth needle into my arm, I asked timidly,

“Excuse me, how many do you need?” 
“You will finish soon,” she said.

But I really didn’t know how many she took in all and left the office dizzy.

At the subway station, I bought orange juice and drank it up all at once.
Then I came to my senses and thought.

Now come to think of it, when is my due date?
Did the doctor say, “Congratulations”?  
Well, it’s OK. It’s not a big deal.

I came back home absentmindedly, but I called my parents in Japan
immediately to confirm my pregnancy, and the first consultation day was finished.

Two weeks later.
For the second checkup, I prepared questions to ask the doctor.

My friends had told me, 

“ If you’re 35 or older, 
you may know it’s a boy or girl at a very early stage.” 

I wanted to ask if that was true.

In Japan, this test ,called “Non-Invasive Prenatal Testing” ( NIPT), 
started in 2013 and has gotten into the news.

I learned about the test on the web and knew its main purpose is not 
to clarify gender, but to check for chromosomal abnormality like 
Down’s syndrome.


As NIPT examines blood samples, it is so much safer and easier 
than the existing test, which is amniotic fluid, withdrawn from 
the amniotic sac with a long needle.

On the other hand, many pregnant women who test positive want abortions. 
This result is still making waves in all over the world. 

Therefore, the Japanese government is very careful about introducing NIPT.
In Japan, not all pregnant women can take the test, 
but those who meet specific conditions can take it at only a few hospitals 
in a big city. 

To take NIPT in Japan, it cost about $2,000, which is not covered 
by national health insurance, but still, many Japanese women wish 
to take the test.

Even in America, NIPT is relatively new, having started in 2012, 
but I don’t feel this test is as special as in Japan, at least in New York City.

In New York State, even pregnant women under 35 can take the test 
if they want since 2014.
My general impression is that NIPT seems widespread in America, 
but there may be opinions on the pros and cons of this issue.

Being pregnant myself, I understand that women hesitate to take the test, 
worried about testing positive.

NIPT is such a sensitive test, but the doctor explained to me lightly 
and said, 
“ I strongly recommend that you take the test,” 
and the consultation was finished.

When I was preparing, I felt I could understand the doctor’s English.
I still couldn’t get half of what she said, though…

That day, I was led to another room to take blood samples again..

Then I found that when I couldn’t understand fully what the doctor said, 
I should doublecheck with a nurse.
I asked a slim Indian nurse with red nails. 

“ Well, I heard some people take a test to check for Down’s syndrome risk, 
but when will it be taken? 
“ Now!” she said and shot the needle in a flash.
“ What? Is this the one?!” 

I was expecting that before the test, I would be told to read an explanation 
on paper and 
“ please think and talk to your husband and sign on your name at the bottom.” 

Or did the doctor say that at the first meeting? 
And did I agree without knowing? 

Everything is my own responsibility here, 
but can I really survive being so passive? 

Am I really OK letting myself go with the flow?  

Again I was disappointed with my English, 
and the second checkup was finished.

By the way, when I checked online, I found there are several kinds of NIPT test, 
but I had taken the test named MaterniT21
This test costs about $2,800, according to the medical receipt, but luckily, 
insurance covered most of it and I paid less than $100.

In America, if a patient is over 35 and a doctor recommends the test, 
it’s covered by insurance. 
That may be one reason NIPT spread nationwide.

And as my friend said, I could get the result in a week, my 12th week.

The probability of chromosomal abnormality was quite low.
I felt relieved.

When I had my daughter three yeas ago, the doctor saw the ultrasound 
and at first told me the baby might be a boy.
But this time, the doctor told me from a more reliable test 
that our second baby was a girl.

Incidentally, I talk about money as usual.
As I received the receipt on the insurance company’s website, 
the first visit was claimed for $4,200 in total. Ultrasound cost $1,000 each time.
Fortunately, most has been covered by insurance, and I have paid 
only a few hundred dollars.
I’d be really scared if I didn’t have insurance.

Even though I had a hard time looking for a doctor in our insurance network 
and have been having a difficulty in English conversation, 
I really feel secure without anxiety about money.

I remembered that when I was pregnant in Japan, the local government 
mailed me a series of free vouchers for all checkups.
And when the baby was born we could get “celebration money” 
from the government.

Before having a prenatal checkup in America, I thought it was not so easy 
to give birth in Japan. 

But! I was wrong.

If I say “childbirth,” as opposed to “raising a child,” 
now I think Japan is not a bad country.