Improved obstetric follow-up | Quebec Produces Computerized “Provincial Pregnancy Notice”

One in four pregnant Quebec women is not monitored from the first trimester of pregnancy. To address this problem, the Quebec government has just created a computerized “Provincial Pregnancy Notification Form” that anyone expecting a child has to fill out, including women who do not have a health insurance card.

Posted on March 10th

Luise Leduc

Luise Leduc
The press

The goals: to enable all women to find out about health services and professionals in their area, to provide them with food stamps if necessary and to generally ensure that all pregnancies have a good start.

The service called My Pregnancy, which will be the subject of an official announcement in a few days, is already open and confirmed The press the office of Lionel Carmant, Minister Delegate for Health and Social Services.

Such an initiative has long been called for by experts. It was also one of the first recommendations of the Laurent Commission, created after the tragic death of the little girl from Granby.

Quebec hopes to reach particularly vulnerable women, too many of whom are isolated during their pregnancy.

“Do you feel lonely sometimes or often? “What is your highest school diploma?” “Do you sometimes have trouble paying for your groceries or your rent? “Have you any difficulties you would like to discuss with a professional?” »

These are some of the questions asked of the women who fill out the notice. If a woman finds herself in one of these situations, a staff member will contact her.

The main objective is prevention among the poorest. By identifying women at risk, we can educate them about the services CLSCs provide, including prenatal meetings and postpartum support.

A list of doctors

But the idea is that all women sign up. Because even those who are lucky in life and well taken care of, often experience the unpleasant surprise at the beginning of the process that their family doctor does not follow up on their pregnancy (a practice that is increasingly perceived as more complicated). to extensive screenings and late pregnancies).

The program therefore provides for the parallel creation of a list of health professionals who agree.

Those who have already followed are also asked to fill out the Pregnancy Notice to enable better planning of prenatal care. By making the effort, the government says, “you will enable health and human services organizations to better understand the services needed for all pregnant women, newborns and young families in Quebec.”

But the big question, notes Laurence Sauvageau, a Montreal pharmacist, remains whether doctors will sign up.

“It’s beautiful, this project. This front door [dans le système] brings hope”, but on condition that the doctors cooperate, observes Laurence Sauvageau.

Since pharmacists are the most available professionals, expectant mothers, for whom it is the cross and the banner, turn to them very regularly to see a doctor. “We can help them with nausea, vomiting and vitamins,” but that doesn’t amount to true pregnancy monitoring, she notes.

A long-awaited program

Such a system has been required for more than four years. In recent years, certain regions like Estrie and Quebec have set up local programs like this, but in some cases they have been rudimentary (the famous fax machine, you know).

Before the Laurent Commission in 2019, Nathalie Garon, director of the state youth-family program in Mauricie, pleaded for the implementation of such a pregnancy notification throughout Quebec. Even before a child is born, it is necessary “to recognize the difficulties of the mother and the couple,” she said. According to her and other experts, this is a “must have” in order to be active in the protection of minors.

If follow-up care is essential in the first trimester, the mother is screened for Down syndrome and HIV during this period. With triple therapy from the beginning of pregnancy, there is a very good chance that the child will be born unimpaired.

It is also important that pregnant women can get advice on nutrition and smoking cessation from the start of pregnancy or get help with drug use.

As early as 2014, the Health and Social Services Agency advocated that all women be monitored from the first trimester of pregnancy. “Access to medical surveillance of pregnancy is often below recommended practice,” the agency wrote in a statement.

Learn more

  • 31%
    Percentage of Montreal women who do not have prenatal care in the first trimester

    SOURCE: STUDY BY ROXANE BORGÈS DA SILVA AND MIKE BENIGERI, ANALYSIS OF THE DELAY IN FIRST PREGNANCY SURVEILLANCE AS PART OF THE MONTREAL PREGNANCY NOTIFICATION SYSTEM IMPLEMENTATION PROJECT (2020)

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